Transforming forensic care in level-one emergency departments in Gauteng through emancipatory practice development

Abstract

Healthcare providers in emergency departments encounter victims of violence and crime daily. Such victims of violence and crime enter emergency departments in need of medical attention, and they carry forensic evidence on their bodies. Healthcare providers offer medical attention, but, in the process, they may inadvertently destroy forensic evidence this may later deny a forensic patient the right to justice. The guidance available to healthcare providers in their training is often unclear, and the legislation and policies on forensic care are somewhat ambiguous, and are left open to the interpretation of the healthcare providers. In this context, this research provides insight into how emancipatory practice development transformed forensic care in three level-one emergency departments in Gauteng, South Africa. The research approach used was action research, in a critical realist paradigm. An emancipatory practice development conceptual framework was applied. The study was conducted with the participants, using collaborative, inclusive and participatory processes. The research commenced with an exploration and explanation of the existing forensic care practised in emergency departments. Then the actual and expected forensic roles and responsibilities were explored with healthcare providers. Next, action plans were developed and implemented. Finally, the outcomes of the research were collaboratively evaluated. The findings indicated that limited forensic care was already being provided at the time of the study. The research increased awareness of forensic care in the participating departments, as healthcare providers took the initiative to preserve evidence better, making use of the knowledge and resources acquired while participating in the research. The participants pointed out that the emancipatory practice development process followed required outsider initiation, combined with sustained support and fostering of relationships. Finally, they indicated that the research process had connected the research to the practice for them. This study demonstrated that emancipatory practice development may increase awareness of forensic care, and may encourage the healthcare providers involved to take ownership. It may simultaneously contribute to changes in existing practice. Based on the findings, healthcare providers' forensic roles and responsibilities were structured into a framework to guide their practice. Furthermore, the steps taken to follow a systematic approach, as required by the emancipatory practice development conceptual framework, have been clarified this may provide some guidance to other researchers who wish to use the same process.