| Budget Amount *help |
¥3,060,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥360,000)
Fiscal Year 2011: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2010: ¥1,500,000 (Direct Cost: ¥1,500,000)
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| Research Abstract |
This research project consists of four sub-projects.(1) I conducted an interview research with one private hospital which has about 400 units. I interviewed head of each department(section) of the hospital regarding organizational factors which affect truth-telling and apology in medical mal-practice cases. One important factor commonly mentioned by the interviewees was the organizational culture and leadership of hospital."In this hospital, leaders trust their staff's decision making, and the staff trust that their leader will protect them and take responsibility for their challenge and decision making if a problem occurs". This trust-cycle among the organizational staff led by a strong leadership by the hospital head is positively affect truth-telling and apology if needed in case of medical mal-practice.(2) I did focus group interviews with Japanese leaders in health care organizations in order to test the applicability of Foster and Hick's positive psychology leadership model for h
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ealth care field developed in the United States. This model is used to produce a positive psychological cycle including a trust cycle among health care staff and between health care professions and patients/families. From the interviews, I found that elements of ideal leaders in health care organizations in Japan are fairly different from the American ones. In Japan, the ability of "listening and nurturing staff like as a parent" was pointed as an important ability, while in the US, the ability of "stating, directing and leading" was pointed. When we apply the leadership training model which is developed in the United States(the Western World) to Japanese context, we should not just copy but also modify it, it seems to be useful to use the US model as a catalyst for discussion to deepen the Japanese participants' thoughts about leadership.(3) It is generally difficult for a third-party researcher to conduct an organizational research regarding medical practice issues since it is a very sensitive issue for an organization. In this context, community based participatory research(CBPR) seems to be useful to overcome this problem since this methodology tries to involve the organizational people in the research and tries to do research based on their needs. Also, existing organizational study flame work seems to be helpful for us to make a question list of for further organizational research regarding factors which affect truth-telling and apology in medical mal-practice cases.(4) Strategic peacebuilding flamework will be useful to make a strategic plan for organizational change/intervention to respond well to medical mal-practice and conflict-which makes an organization possible not only to rely on only personal leadership and skills of a top-leader or a mediator but also to utilize the resources of entire organization. In application of the idea of restorative justice philosophy to medical mal-practice and conflict cases, I made a new(temporary) model : all stakeholders of the accident should be involved. medical staff, admin staff, patients, and family, to the extent possible, and collaboratively discuss 1) what painful things were occurred, 2) what were root causes of it, 3) What are needs and responsibility of all stakeholders regarding the root causes, 4) What should be done for the better future, 5) what is role of each stakeholders in the plan for future. Less
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