Health

Find out about restorative approaches to address health issues.

Several pairs of hands with surgical gloves operate on an unseen patient

Restorative practice and surgical mesh

In 2019, we co-designed, delivered and evaluated New Zealand’s restorative response to surgical mesh harm.

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Our work | Tā mātou mahi

We co-design, deliver and evaluate restorative initiatives that can promote safety and wellbeing and mitigate, and respond to healthcare harm. Our partners include government agencies, community groups, consumers, clinicians and Kaumātua in Aotearoa NZ and international health settings.

Healthcare harm is any physical, psychological, or spiritual injury or experience that occurs as a result of providing or receiving healthcare. We include spiritual harm because, in a Māori worldview, harms are understood as a diminishment of mana, of the spiritual power and authority of individuals, whānau and communities.

Our people | Ō mātou tāngata

Senior Research Fellow

School of Government

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Senior Research Fellow

School of Government

Healing and learning from harm

We made a short film in partnership with the Health Quality Safety Commission and Accident Compensation Corporation (ACC).

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The Collaboratives for Restorative Initiatives in Health

The National Collaborative, Aotearoa NZ

We facilitate the National Collaborative which aims to support the development of a restorative initiatives in Aotearoa, NZ within a Te Tiriti o Waitangi framework. Restorative practice and hohou te rongopai (peace-making) are held together as complementary but distinct approaches. Members include government agencies, Kaumātua, Kuia, consumers, and clinicians.

The Collaborative was formed in February 2020, by Te Ngāpara Centre for Restorative practice at Te Herenga Waka Victoria University. Membership includes stakeholders from across the health and disability system, such as senior representatives from national agencies (Health, Quality and Safety Commission (the Commission), Ministry of Health, Accident Compensation Corporation (ACC), Health and Disability Commissioner), as well as kaumātua and kuia, and those providing perspectives from the sharp end of care provision (such as consumers and clinicians).

Restorative initiatives are increasingly being applied to respond to healthcare harm. The Ministry of Health is at the forefront of global innovation having delivered a major and internationally unprecedented project that employed a restorative approach to address the harm from surgical mesh use in 2019. Following this leadership, clinicians, consumers, and organisations are increasingly applying relational and tikanga Māori approaches to complaints, adverse events, and human resource issues as ‘restorative practice’ and ‘Hohou te Rongopai’ (peace-making). Being Tiriti led, the Collaborative holds both together as complementary but distinct approaches, referred to here as restorative initiatives.

The purpose of the Collaborative is to “build a restorative community in the health and disability system that is grounded in whanaungatanga and manaakitanga.”  We aim to achieve our purpose by (a) working collaboratively within and across agencies, iwi, hapu, and advocacy groups; (b) pursuing an authentic Tiriti partnership over the next  2–5-years, that is co-designed and co-governed by the multiple parties involved, with clear individual agency and iwi roles and responsibilities; (c) being opportunistic, adaptive and sharing resources; (d) building capability and educating the health and disability sector (undergraduate, post graduate and within professional groups); (e) understanding and evaluating what works, for whom and in what circumstances; (f) being inclusive so that all those that might be affected by restorative initiatives have a voice.

The International Collaborative

The international collaborative is a group of academics, clinicians and patient advocates who are working to co-design, build capability, and research restorative initiatives in international health systems. Members include representatives from Canada, the UK, US, and Australia.  If you are interested in our work, please contact jo.wailling@vuw.ac.nz

A restorative response to surgical mesh harm

In 2019, we co-designed, delivered and evaluated New Zealand’s restorative response to surgical mesh harm. We believe this to be the first use of restorative inquiry on this scale within a health system.  You can read the reports that detail the approach used and the subsequent evaluation.

Building capability in the health sector

We are currently working with the New Zealand Health Quality and Safety Commission to develop health sector capability in restorative practice and hohou te rongopai.

If your work involves responding to conflict, complaints or adverse events and you are interested in attending a micro credential course in restorative foundations or restorative responses in health and disability systems, you can access our courses.

The Health Quality & Safety Commission

Health Quality & Safety Commission New Zealand logo

The Health Quality & Safety Commission aims to improve the quality, safety and experience of care for people using health and disability services. We work with consumers and whānau, the health and disability workforce, providers and other agencies. We believe how we work is as important as the work that we do.

Restorative practice encourages open, respectful communication with everyone affected by a harmful event. When harm occurs everyone must feel safe to take part in the review. They must have an equal voice as we together seek to understand what happened, address the needs of those harmed, and learn for future improvement. Restorative practices have strong alignment with te ao Māori worldviews such as reconciliation, reciprocity and whānau involvement.

Our Memorandum of Understanding is intended to capture the spirit of partnership and collaboration between the Health Quality & Safety Commission and Te Ngāpara Centre for Restorative Practice. It recognises the shared aspirations and intentions of both to socialise and implement restorative practice within the health and disability sector.

You can read more about the Commissions work on restorative practice.

Our research | Tā mātou rangahau

We evaluate restorative interventions within the complex health environment, aiming to understand how and for whom the emergent structural, cultural, relational, and agentic relations produce and maintain outcomes.  We use participatory design and methods.

Knowledge is developed within a negotiated space that intends to unlock the innovation potential of Māori and Pākehā understanding, people, and resources.

Publications

Wailling, J., Kooijman, A., Hughes, J., & O'Hara, J. (2022). Humanising harm: Using a restorative approach to heal and learn from adverse events. Heath Expectations. doi:10.1111/hex.13478

Wailling, J., Long, J., & Stolarek, I. (2020). The context and influences of safety: An exploration of social networks, actions, and behaviour. International Journal for Quality in Health Care, 33(1). doi:10.1093/intqhc/mzaa157

Wailling, J., Wilkinson, J., & Marshall, C. (2020). Healing after harm: An evaluation of a restorative approach for addressing harm from surgical mesh. Kia ora te tangata: He arotakenga i te whakahaumanu.

Wailling, J., & Keelan, W. (2020). Working restoratively to co-create safe health care.  Retrieved from https://www.hqsc.govt.nz/blog/working-restoratively-to-co-create-safe-health-care-part-one/

Wailling, J., & Keelan, W. (2020). Working restoratively to co-create safe health care – part one.  Retrieved from https://www.hqsc.govt.nz/blog/working-restoratively-to-co-create-safe-health-care-part-one/

Wailling, J., Marshall, C., & Wilkinson, J. (2019). Hearing and responding to the stories of survivors of surgical mesh - Ngā kōrero a ngā mōrehu –he urupare [Report for the Ministry of Health].

Wailling, J., Marshall, C., Robinson, B., & Everest, J. (2019). Responding to harm from surgical mesh [A report for the Ministry of Health]. Wellington, New Zealand: Diana Unwin Chair in Restorative Justice. Victoria University of Wellington

Wailling, J., Robinson, B., & Coombs, M. (2019). Surveillance, anticipation, and firefighting: Perspectives of patient safety from a New Zealand case study. Journal of Nursing Management, 27(5), 939-945. doi:10.1111/jonm.12732