Search PubMed⌕ Search

Biomedical subjects

J H Hubben

Publications and source records attributed to J H Hubben.

14 recordsLinked to original sources
PubMed2006

[Outcomes of disciplinary proceedings against gynaecologists: comparison between the periods 1980-1991 and 1992-2003].

In a study of the archives of the Chief Inspector for Healthcare in The Netherlands during the period 1992-2003, the number of complaints against gynaecologists submitted to disciplinary boards (n = 371) was found to be higher than during the period of 1980-1991 (n = 240). On the other hand, the number of complaints per gynaecologist had decreased from 6.3 complaints per 100 gynaecologists in 1992 to 2.6/100 in 2003. The number ofcomplaints declared legitimate relative to the number of submitted complaints remained the same in both periods (55/240 (23%) in 1980-1991 and 84/371 (23%) in 1992-2003), although the percentage ofcomplaints ruled as legitimate did increase during the course of the second period from 14 between 1992-1997 to 28 during the 1998-2003 period. Interesting points included the number of rulings regarding the death of an infant (40%), the interpretation of the cardiotocography recording, the need to keep medical records up to date (in particular the informed consent) and the fact that almost 50% of complaints ruled to be legitimate related to how the locum position was arranged, the role of the duty gynaecologist and that of the house officer.

Clinical Competence↗
PubMed2006

[The psychiatrist working in a multidisciplinary team and the "Revised Profile of the Psychiatrist." Legal and organizational statements outside reality?].

The document entitled 'Herziene Profielsschets Psychiater (Revised Profile of a Psychiatrist)' contains the following statement: 'Belonging to and working in a multidisciplinary team does not invalidate one of thefundamental rules of psychiatric practice according to which the psychiatrist can only refer a patientfor investigation and treatment if he himself has actually seen the patient'. This statement overlooks thefact that many psychiatrists are employees i.e. they work in hospitals or group practices, and are not in private practice. As employees they fall under a larger body of legal and organisational rules and regulations than do psychiatrists in private practice. The revised profile fails to take this aspect into account.

Employment↗
PubMed2005

[Publication practice and policy for disciplinary proceedings regarding health care in the Netherlands].

OBJECTIVE: To provide insight into practice and policy regarding the publication of disciplinary verdicts in Dutch health care. DESIGN: Descriptive. METHOD: The study covered all of the verdicts issued by disciplinary boards and courts of justice that were published in the Dutch the Staats-courant (Government Gazette) during the period 1995-2002. The following attributes were recorded for each verdict: year of publication and verdict, the disciplinary board concerned, the accused professional, the type of complainant, the nature of the complaint and verdict, and the journals that were offered the decision. The published verdicts were related to the total number of verdicts and cases during the study period. Questionnaires were used to investigate the publication policy of the disciplinary boards. RESULTS: A total of 4% of all verdicts were published in the Dutch Government Gazette (323/8902). The central disciplinary board decided to publish more often than the regional disciplinary boards (8% and 2%, respectively). There were considerable differences between the various regional disciplinary boards (range: 1-5%). Per professional group the percentage of verdicts in cases that were published ranged from 2% to 23%. The decisions were offered to over 20 journals, but mainly to the Tijdschrift voor Gezondheidsrecht [Dutch Journal of Health Law] (TvGR; 92%) and Medisch Contact [Medical Contact] (MC; 88%). The TvGR published almost two-thirds of the verdicts offered (63%), and the MC published almost three-quarters (74%). In the decision to publish, the disciplinary boards differed in their interpretation of the concept of 'general importance'. CONCLUSION: If disciplinary proceedings are to achieve the desired quality-promoting effect on professional practice, then more attention will need to be paid to the publication policy, and the disciplinary boards will have to develop a joint code of practice. More verdicts could be published, also in professional journals.

Humans↗
PubMed2005

The disciplinary code for nurses and its contribution to the quality of nursing care in the Netherlands.

AIM: To obtain insight into the contribution of the disciplinary code for nurses to monitoring the quality of nursing care in the Netherlands. METHODS: Complaints dealt with in the period 1998-2001 were studied. Questionnaires were sent to 3200 nurses (71%), all 388 members of the disciplinary boards (89%) and 43 lawyers (65%). RESULTS: There was an increase in the number of nurses who were accused (20 in 1998, 12 in 1999, 54 in 2000, and 56 in 2001) and also in the annual percentages of sanctions imposed (0% in 1998, 8% in 1999, 13% in 2000 and 16% in 2001). The disciplinary code appears to be an important corrective instrument for serious professional misconduct.

Attitude of Health Personnel↗
PubMed2004

[No spectacular rise in claims for medical damages in The Netherlands: 1993-'01 compared to 1980-'90].

OBJECTIVE: To acquire insight into the number and nature of claims for damages that were filed in the period 1993/'01 in hospitals insured by MediRisk and to compare this with the period 1980/'90. DESIGN: Descriptive. METHOD: Data were collected from the registration system for insurance claims maintained by MediRisk, an insurer of medical liability risks. The data were processed up to and including 31 October 2002. There were 4058 claims in 3316 closed and 742 open dossiers. The results were compared with those from a comparable investigation into the period 1980/'90 (3970 claims; 1550 dossiers investigated). The number of invasive medical interventions in the period 1990-2001 was obtained from Prismant in Utrecht. Study of the dossiers yielded information about the use of legal procedures. RESULTS: Compared to 1980/'90 there was a 34% increase in the number of claims for damages following medical interventions during the period 1993/'01. This increase was smaller than the growth in the number of high-risk interventions (47%). The percentage of rejected claims for damages was 6o in the period 1980/'90 and 68 in 1993/'01. In both periods, most of the claims pertained to surgical specialisms, in particular general surgery. In 370 of the 3316 closed dossiers (11%) a legal procedure was mentioned: complaints committee (5%; in 1980/'90 hospitals were not required to have a complaints committee), civil court (3%; this was 4% in 1980/'90) and the Medical Disciplinary Board (3%; this was 6% in 1980/'90). CONCLUSION: The increase in the number of claims for damages filed against hospitals insured with MediRisk was limited compared to the number of medical interventions carried out. The number of legal procedures arising from these claims did rise in the absolute sense, but fell in relation to the number of claims for damages.

Humans↗
PubMed2004

[No improvement of disciplinary jurisprudence since the implementation of the Individual Health Care Professions Act (IHCP Act)].

OBJECTIVE: To compare the number and nature of the complaints, the complainants, the accused health professionals and the sanctions imposed by the disciplinary boards before and after the Individual Health Care Professions Act (IHCP Act) came into effect at the end of 1997. DESIGN: Descriptive, retrospective. METHOD: The authors examined all 4980 verdicts pronounced by the disciplinary boards in the first instance during the period 1995-1997 (before the IHCP Act) and then during the period 1999-2001 (after the IHCP Act), together with the resulting appeal procedures involving physicians, dentists, pharmacists and midwives. The following were noted: the year of the verdict, the number and nature of the complaints, the types of complainants, the categories of professionals accused, the nature of the verdicts, and the number of appeal procedures. RESULTS: During the first period, 2453 complaints were brought before the disciplinary board, compared to 2527 during the second period. Most of the complaints were made against physicians (92% in both periods). The number of complaints that were declared to be justified fell from 19% to 15% (p < 0.001). In both periods, approximately half of the complaints concerned 'lack of care or inadequate care' or 'incorrect treatment', the most frequent verdict was a warning (67% and 72%, respectively), and appeals were lodged against almost one-third of the verdicts. The number of complaints submitted by the Inspectorate for Health Care decreased from 47 to 19. CONCLUSION: In any important aspects, the IHCP Act did not lead to improvement in the disciplinary jurisprudence. The decrease in the number of complaints that were declared to be justified could be explained by the change in composition of the disciplinary boards prescribed by the IHCP Act (more lawyers and less fellow professionals). Informing citizens about disciplinary jurisprudence and other procedures for lodging complaints may increase the number of justified complaints and hence the number of 'justified' verdicts. There is a need for further clarification of the tasks and responsibility of the Inspectorate for Health Care in case of complaints to the disciplinary boards.

Humans↗
PubMed2003

[Admission and discharge criteria for intensive care departments].

Admission and discharge criteria for intensive care departments have been drawn up in order to optimise the use of scarce and costly intensive care facilities. Every patient who could benefit from admission must be assessed by the intensive care specialist beforehand. Admission is indicated for patients with disrupted vital functions in whom recovery of dysfunctioning or failing organ systems is expected, patients who will act as organ donors and patients who undergo diagnostic investigations associated with a high risk of vital complications. Frequent assessment (several times per day) of the 'indication to stay' is indicated in the case of many patients in order to maximise the admission capacity. Discharge from the intensive care department is indicated if the vital functions are stable without life support and no longer require monitoring or treatment, if nursing the patient in the ward is possible, if continuation of the medical treatment is no longer worthwhile, if the patient no longer consents to the treatment and if the benefit of a treatment no longer outweights its negative effects.

Cost-Benefit Analysis↗
PubMed1999

Incompetence in practice in health care in the Netherlands: report of a study.

Recent health legislation in the Netherlands makes specific provisions for patients who are not (fully) capable of acting reasonably in their own interests. If this legislation is actually to improve the legal position of incompetent people, it must be clear to whom these provisions apply. The description in modern legislation is that the person 'is regarded as not being able to make a reasonable assessment of his interests in the issue in question'. The law does not provide criteria according to which competence can be assessed in practice. In the present study, data on the competence assessment of 133 clients were collected by means of a poll held among those people who decide on competence in practice and a total of 485 assessors were polled. Client files were also examined with the intention of gaining insight into the carers' motivation to involve or exclude clients from the decision-making process. Finally, interviews were conducted with clients who have a mild or moderate intellectual disability. Large differences appeared to exist between the various assessors in the assessment of the general competence of clients. A general assessment of a client's competence is not sufficient in daily practice; therefore, partial competence was also assessed. Opinions about the partial competence of clients varied considerably among assessors. A ranking was compiled of discriminating characteristics in the qualification of competence or incompetence.

Adult↗
PubMed1998

[A lack of understanding of the rulings by disciplinary committees].

The fact that certain rulings of disciplinary committees evoked much criticism among colleagues is distressing in itself, but such criticism should be interpreted with due caution, as different explanations are conceivable. For instance, the published abstract of the committee ruling may have gaps with regard to facts and motivation. It is also possible that the committee has good grounds to accentuate the professional standards, which understandably may meet some resistance among the medical profession. Finally, it is theoretically possible that the disciplinary tribunal is not fully informed about relevant professional standards and current practice. It is precisely to minimize such possible communication breakdowns that disciplinary powers have largely been entrusted to persons from the medical profession.

Guidelines as Topic↗