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Wang Y, Ram SS, Scahill S. Characteristics and risk factors of pharmacist misconduct in New Zealand: a retrospective nationwide analysis. BMC Health Serv Res 2024; 24:223. [PMID: 38378632 PMCID: PMC10880377 DOI: 10.1186/s12913-024-10591-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Professional misconduct has evolved into a worldwide concern, involving various forms and types of behaviours that contribute to unsafe practices. This study aimed to provide insights into the patterns characterising pharmacist misconduct and uncover underlying factors contributing to such instances in New Zealand. METHODS This research examined all cases of pharmacist misconduct sourced from the Health Practitioners Disciplinary Tribunal (HPDT) database in New Zealand since 2004. Characteristics of the sampled pharmacists and cases were extracted, followed by a systematic coding of the observed misconduct issues. Identification of risk factors was accomplished through content analysis techniques, enabling an assessment of their prevalence across various forms of misconduct. RESULTS The dataset of pharmacist misconduct cases comprised 58 disciplinary records involving 55 pharmacists. Seven types of misconduct were identified, with the most commonly observed being quality and safety issues related to drug, medication and care, as well as criminal conviction. A total of 13 risk factors were identified and systematically classified into three categories: (1) social, regulatory, and external environmental factors, (2) systematic, organisational, and practical considerations in the pharmacy, and (3) pharmacist individual factors. The most frequently mentioned and far-reaching factors include busyness, heavy workload or distraction; health impairment issues; and life stress or challenges. CONCLUSIONS The patterns of pharmacist misconduct are complicated, multifaceted, and involve complex interactions among risk factors. Collaborative efforts involving individual pharmacists, professional bodies, responsible authorities, policy-makers, health funders and planners in key areas such as pharmacist workload and well-being are expected to mitigate the occurrence of misconduct. Future research should seek to uncover the origins, manifestations, and underlying relationships of various contributing factors through empirical research with appropriate individuals.
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Affiliation(s)
- Yufeng Wang
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
| | - Sanyogita Sanya Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Shane Scahill
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland, 1023, New Zealand
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Wang Y, Ram S(S, Scahill S. Risk identification and prediction of complaints and misconduct against health practitioners: a scoping review. Int J Qual Health Care 2024; 36:mzad114. [PMID: 38155372 PMCID: PMC10791111 DOI: 10.1093/intqhc/mzad114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/17/2023] [Accepted: 12/26/2023] [Indexed: 12/30/2023] Open
Abstract
Identifying the risk and predicting complaints and misconduct against health practitioners are essential for healthcare regulators to implement early interventions and develop long-term prevention strategies to improve professional practice and enhance patient safety. This scoping review aims to map out existing literature on the risk identification and prediction of complaints and misconduct against health practitioners. This scoping review followed Arksey and O'Malley's five-stage methodological framework. A comprehensive literature search was conducted on MEDLINE, EMBASE, and CINAHL databases and finished on the same day (6 September 2021). Articles meeting the eligibility criteria were charted and descriptively analysed through a narrative analysis method. The initial search generated 5473 articles. After the identification, screening, and inclusion process, 81 eligible studies were included for data charting. Three key themes were reported: methods used for identifying risk factors and predictors of the complaints and misconduct, synthesis of identified risk factors and predictors in eligible studies, and predictive tools developed for complaints and misconduct against health practitioners. The findings reveal that risk identification and prediction of complaints and misconduct are complex issues influenced by multiple factors, exhibiting non-linear patterns and being context specific. Further efforts are needed to understand the characteristics and interactions of risk factors, develop systematic risk prediction tools, and facilitate the application in the regulatory environment.
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Affiliation(s)
- Yufeng Wang
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Sanyogita (Sanya) Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Shane Scahill
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
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Begeny CT, Arshad H, Cuming T, Dhariwal DK, Fisher RA, Franklin MD, Jackson PC, McLachlan GM, Searle RH, Newlands C. Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights. Br J Surg 2023; 110:1518-1526. [PMID: 37697690 PMCID: PMC10564399 DOI: 10.1093/bjs/znad242] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/01/2023] [Accepted: 07/01/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND This observational study, paired with National Health Service (NHS) workforce population data, examined gender differences in surgical workforce members' experiences with sexual misconduct (sexual harassment, sexual assault, rape) among colleagues in the past 5 years, and their views of the adequacy of accountable organizations in dealing with this issue. METHODS This was a survey of UK surgical workforce members, recruited via surgical organizations. RESULTS Some 1704 individuals participated, with 1434 (51.5 per cent women) eligible for primary unweighted analyses. Weighted analyses, grounded in NHS England surgical workforce population data, used 756 NHS England participants. Weighted and unweighted analyses showed that, compared with men, women were significantly more likely to report witnessing, and be a target of, sexual misconduct. Among women, 63.3 per cent reported being the target of sexual harassment versus 23.7 per cent of men (89.5 per cent witnessing versus 81.0 per cent of men). Additionally, 29.9 per cent of women had been sexually assaulted versus 6.9 per cent of men (35.9 per cent witnessing versus 17.1 per cent of men), with 10.9 per cent of women experiencing forced physical contact for career opportunities (a form of sexual assault) versus 0.7 per cent of men. Being raped by a colleague was reported by 0.8 per cent of women versus 0.1 per cent of men (1.9 per cent witnessing versus 0.6 per cent of men). Evaluations of organizations' adequacy in handling sexual misconduct were significantly lower among women than men, ranging from a low of 15.1 per cent for the General Medical Council to a high of 31.1 per cent for the Royal Colleges (men's evaluations: 48.6 and 60.2 per cent respectively). CONCLUSION Sexual misconduct in the past 5 years has been experienced widely, with women affected disproportionately. Accountable organizations are not regarded as dealing adequately with this issue.
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Affiliation(s)
- Christopher T Begeny
- Faculty of Health and Life Sciences, Department of Psychology, University of Exeter, Exeter, UK
| | - Homa Arshad
- Barts Bone and Joint Health, Barts NHS Trust, Royal London Hospital, London, UK
| | - Tamzin Cuming
- Department of Surgery, Homerton University Hospital, London, UK
| | - Daljit K Dhariwal
- Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Rebecca A Fisher
- School of Medical Sciences, Division of Medical Education, University of Manchester, Manchester, UK
| | - Marieta D Franklin
- Department of Trauma and Orthopedics, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | | | | | - Carrie Newlands
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
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Chen ZF, Hsu YHE, Lee JJ, Chou CH. Are They Thinking Differently? The Perceptions and Differences in Medical Disputes between Veterinarians and Clients. Vet Sci 2023; 10:vetsci10050367. [PMID: 37235450 DOI: 10.3390/vetsci10050367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
Medical disputes in veterinary practices are widespread; yet, a limited amount of research has been conducted to investigate the factors contributing to medical disputes. This study examined veterinarians' and clients' perceptions regarding risk factors and possible solutions to medical disputes. A total of 245 respondents from Taiwan, including 125 veterinarians and 120 clients, completed an electronic self-administered, semi-structured questionnaire in 2022. The questionnaire covered six dimensions: medical skills, complaint management, the attitudes of stakeholders during interactions, medical expenses, clients' perspectives, and communication modes. The results highlighted significant differences in the perceptions of risk factors for inducing medical disputes and possible solutions between clients and veterinarians in veterinary practice. First, young veterinarians and clients perceived medical skills as the highest risk factor for inducing medical disputes, while experienced veterinarians disagreed (p < 0.001). In addition, veterinarians with medical dispute experience identified stakeholders' attitudes during interactions as the top contributing factor. Second, regarding possible solutions, all veterinarians preferred offering clients cost estimates and cultivating empathy and compassion towards them. On the other hand, clients underscored the importance of obtaining informed consent for treatments and expenses and suggested that veterinarians should supply comprehensive written information to facilitate this process. This study underlies the importance of understanding stakeholders' perceptions to mitigate medical disputes and advocates for improved communication education and training for young veterinarians. These findings provide valuable insights for veterinarians and clients, contributing to preventing and managing medical disputes in veterinary practices.
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Affiliation(s)
- Zih-Fang Chen
- Zoonoses Research Center, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Yi-Hsin Elsa Hsu
- Executive Master Program of Business Administration in Biotechnology, Taipei Medical University, Taipei 11031, Taiwan
- School of Healthcare Administration, Taipei Medical University, Taipei 11031, Taiwan
| | - Jih-Jong Lee
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Chung-Hsi Chou
- Zoonoses Research Center, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
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Searle R. How many more people will be abused before we act on sexual violence in healthcare? BMJ 2023; 381:1094. [PMID: 37220919 DOI: 10.1136/bmj.p1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Morris K, Spittal MJ. Grading pharmacists' risk of complaints to a regulator: A retrospective cohort study. JOURNAL OF PHARMACY & PHARMACEUTICAL SCIENCES : A PUBLICATION OF THE CANADIAN SOCIETY FOR PHARMACEUTICAL SCIENCES, SOCIETE CANADIENNE DES SCIENCES PHARMACEUTIQUES 2023; 26:11228. [PMID: 37026084 PMCID: PMC10071827 DOI: 10.3389/jpps.2023.11228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/06/2023] [Indexed: 04/08/2023]
Abstract
Background: Tools to grade risk of complaint to a regulatory board have been developed for physicians but not for other health practitioner groups, including pharmacists. We aimed to develop a score that classified pharmacists into low, medium and high risk categories. Methods: Registration and complaint data were sourced from Ontario College of Pharmacists for January 2009 to December 2019. We undertook recurrent event survival analysis to predict lodgement of a complaint. We identified those variables that were associated with a complaint and included these in a risk score which we called PRONE-Pharm (Predicted Risk of New Event for Pharmacists). We assessed diagnostic accuracy and used this to identify thresholds that defined low, medium and high risk. Results: We identified 3,675 complaints against 17,308 pharmacists. Being male (HR = 1.72), older age (HR range 1.43-1.54), trained internationally (HR = 1.62), ≥1 prior complaint (HR range 2.83-9.60), and complaints about mental health or substance use (HR = 1.91), compliance with conditions (HR = 1.86), fees and servicing (HR = 1.74), interpersonal behaviour or honesty (HR = 1.40), procedures (HR = 1.75) and treatment or communication or other clinical issues (HR = 1.22) were all associated with lodgement of a complaint. When converted into the PRONE-Pharm risk score, pharmacists were assigned between 0 and 98 points with higher scores closely associated with higher probability of a complaint. A score of ≥25 had sufficient accuracy for classifying medium-risk pharmacists (specificity = 87.0%) and ≥45 for high-risk pharmacists (specificity = 98.4%). Conclusion: Distinguishing isolated incidents from persistent problems poses a significant challenge for entities responsible for the regulation of pharmacists and other health practitioners. The diagnostic properties of PRONE-Pharm (minimizing the false positives) means that the risk score is useful for "ruling-out" low risk pharmacists using routinely collected regulatory data. PRONE-Pharm may be useful when used alongside interventions appropriately matched to a pharmacist's level of risk.
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Affiliation(s)
- Katherine Morris
- Information & Data Management, Ontario College of Pharmacists, Toronto, ON, Canada
- *Correspondence: Katherine Morris,
| | - Matthew J. Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
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Bradfield OM, Bismark M, Scott A, Spittal M. Vocational and psychosocial predictors of medical negligence claims among Australian doctors: a prospective cohort analysis of the MABEL survey. BMJ Open 2022; 12:e055432. [PMID: 35649606 PMCID: PMC9171255 DOI: 10.1136/bmjopen-2021-055432] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To understand the association between medical negligence claims and doctors' sex, age, specialty, working hours, work location, personality, social supports, family circumstances, self-rated health, self-rated life satisfaction and presence of recent injury or illness. DESIGN AND SETTING Prospective cohort study of Australian doctors. PARTICIPANTS 12 134 doctors who completed the Medicine in Australia: Balancing Employment and Life survey between 2013 and 2019. PRIMARY OUTCOME MEASURE Doctors named as a defendant in a medical negligence claim in the preceding 12 months. RESULTS 649 (5.35%) doctors reported being named in a medical negligence claim during the study period. In addition to previously identified demographic factors (sex, age and specialty), we identified the following vocational and psychosocial risk factors for claims: working full time (OR=1.48, 95% CI 1.13 to 1.94) or overtime hours (OR 1.70, 95% CI 1.29 to 2.23), working in a regional centre (OR 1.69, 95% CI 1.37 to 2.08), increasing job demands (OR 1.16, 95% CI 1.04 to 1.30), low self-rated life satisfaction (OR 1.43, 95% CI 1.08 to 1.91) and recent serious personal injury or illness (OR 1.40, 95% CI 1.13 to 1.72). Having an agreeable personality was mildly protective (OR 0.91, 95% CI 0.83 to 1.00). When stratified according to sex, we found that working in a regional area, low self-rated life satisfaction and not achieving work-life balance predicted medical negligence claims in male, but not female, doctors. However, working more than part-time hours and having a recent personal injury or illness predicted medical negligence claims in female, but not male, doctors. Increasing age predicted claims more strongly in male doctors. Personality type predicted claims in both male and female doctors. CONCLUSIONS Modifiable risk factors contribute to an increased risk of medical negligence claims among doctors in Australia. Creating more supportive work environments and targeting interventions that improve doctors' health and well-being could reduce the risk of medical negligence claims and contribute to improved patient safety.
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Affiliation(s)
- Owen M Bradfield
- Law and Public Health Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marie Bismark
- Law and Public Health Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Morena N, Zelt N, Nguyen D, Dionne E, Rentschler CA, Greyson D, Meguerditchian AN. Use of Online Patient Reviews to Assess Medical Oncologist Competency: Mixed-Method Sequential Explanatory Study (Preprint). JMIR Form Res 2022; 7:e39857. [PMID: 37140959 DOI: 10.2196/39857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/24/2023] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Patients increasingly use web-based evaluation tools to assess their physicians, health care teams, and overall medical experience. OBJECTIVE This study aimed to evaluate the extent to which the standardized physician competencies of the CanMEDS Framework are present in web-based patient reviews (WPRs) and to identify patients' perception of important physician qualities in the context of quality cancer care. METHODS The WPRs of all university-affiliated medical oncologists in midsized cities with medical schools in the province of Ontario (Canada) were collected. Two reviewers (1 communication studies researcher and 1 health care professional) independently assessed the WPRs according to the CanMEDS Framework and identified common themes. Comment scores were then evaluated to identify κ agreement rates between the reviewers, and a descriptive quantitative analysis of the cohort was completed. Following the quantitative analysis, an inductive thematic analysis was performed. RESULTS This study identified 49 actively practicing university-affiliated medical oncologists in midsized urban areas in Ontario. A total of 473 WPRs reviewing these 49 physicians were identified. Among the CanMEDS competencies, those defining the roles of medical experts, communicators, and professionals were the most prevalent (303/473, 64%; 182/473, 38%; and 129/473, 27%, respectively). Common themes in WPRs include medical skill and knowledge, interpersonal skills, and answering questions (from the patient to the physician). Detailed WPRs tend to include the following elements: experience and connection; discussion and evaluation of the physician's knowledge, professionalism, interpersonal skills, and punctuality; in positive reviews, the expression of feelings of gratitude and a recommendation; and in negative reviews, discouragement from seeking the physician's care. Patients' perception of medical skills is less specific than their perception of interpersonal qualities, although medical skills are the most commented-on element of care in WPRs. Patients' perception of interpersonal skills (listening, compassion, and overall caring demeanor) and other experiential phenomena, such as feeling rushed during appointments, is often specific and detailed. Details about a physician's interpersonal skills or "bedside manner" are highly perceived, valued, and shareable in an WPR context. A small number of WPRs reflected a distinction between the value of medical skills and that of interpersonal skills. The authors of these WPRs claimed that for them, a physician's medical skills and competence are more important than their interpersonal skills. CONCLUSIONS CanMEDS roles and competencies that are explicitly patient facing (ie, those directly experienced by patients in their interactions with physicians and through the care that physicians provide) are the most likely to be present and reported on in WPRs. The findings demonstrate the opportunity to learn from WPRs, not simply to discern physicians' popularity but to grasp what patients may expect from their physicians. In this context, WPRs can represent a method for the measurement and assessment of patient-facing physician competency.
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Affiliation(s)
- Nina Morena
- Art History and Communication Studies, McGill University, Montreal, QC, Canada
| | - Nicholas Zelt
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Diana Nguyen
- McGill University Health Centre Research Institute, Montreal, QC, Canada
- St Mary's Research Centre, Montreal, QC, Canada
| | | | - Carrie A Rentschler
- Art History and Communication Studies, McGill University, Montreal, QC, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Ari N Meguerditchian
- McGill University Health Centre Research Institute, Montreal, QC, Canada
- St Mary's Research Centre, Montreal, QC, Canada
- Department of Surgery, McGill University, Montreal, QC, Canada
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10
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Leslie K, Dunk M, Staempfli S, Cook K. Mandatory Reporting of Colleagues to Regulators: An Overview of Requirements for Registered Nurses in 12 Canadian Jurisdictions. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(21)00118-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Austin EE, Do V, Nullwala R, Fajardo Pulido D, Hibbert PD, Braithwaite J, Arnolda G, Wiles LK, Theodorou T, Tran Y, Lystad RP, Hatem S, Long JC, Rapport F, Pantle A, Clay-Williams R. Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance. BMJ Open 2021; 11:e050377. [PMID: 34429317 PMCID: PMC8386219 DOI: 10.1136/bmjopen-2021-050377] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/05/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners. DESIGN Systematic review. DATA SOURCES Ovid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched. RESULTS Sixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out. CONCLUSIONS It is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor's risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm. PROSPERO REGISTRATION NUMBER PROSPERO registration number: CRD42020182045.
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Affiliation(s)
- Elizabeth E Austin
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Vu Do
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Ruqaiya Nullwala
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Diana Fajardo Pulido
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Peter D Hibbert
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Gaston Arnolda
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Louise K Wiles
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Tahlia Theodorou
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Sarah Hatem
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Annette Pantle
- Medical Council of New South Wales, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Harbitz MB, Stensland PS, Abelsen B. Medical malpractice in Norway: frequency and distribution of disciplinary actions for medical doctors 2011-2018. BMC Health Serv Res 2021; 21:324. [PMID: 33836746 PMCID: PMC8034155 DOI: 10.1186/s12913-021-06334-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physicians who perform unsafe practices and harm patients may be disciplined. In Norway, there are five types of disciplinary action, ranging from a warning for the least serious examples of malpractice to loss of licence for the most serious ones. Disciplinary actions always involve medical malpractice. The aims of this study were to investigate the frequency and distribution of disciplinary actions by the Norwegian Board of Health Supervision for doctors in Norway and to uncover nation-wide patient safety issues. METHODS We retrospectively investigated all 953 disciplinary actions for doctors given by the Board between 2011 and 2018. We categorized these according to type of action, recipient's profession, organizational factors and geographical location of the recipient. Frequencies, cross tables, rates and linear regression were used for statistical analysis. RESULTS Rural general practitioners received the most disciplinary actions of all doctors and had their licence revoked or restricted 2.1 times more frequently than urban general practitioners. General practitioners and private specialists received respectively 98.7 and 91.0 disciplinary actions per 1000 doctors. Senior consultants and junior doctors working in hospitals received respectively 17.0 and 6.4 disciplinary actions per 1000 doctors. Eight times more actions were received by primary care doctors than secondary care doctors. Doctors working in primary care were given a warning 10.6 times more often and had their licence revoked or restricted 4.6 times more often than those in secondary care. CONCLUSION The distribution and frequency of disciplinary actions by the Norwegian Board of Health Supervision clearly varied according to type of health care facility. Private specialists and general practitioners, especially those working in rural clinics, received the most disciplinary actions. These results deserve attention from health policy-makers and warrant further studies to determine the factors that influence medical malpractice. Moreover, the supervisory authorities should assess whether their procedures for reacting to malpractice are efficient and adequate for all types of physicians working in Norway.
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Affiliation(s)
- Martin B Harbitz
- Department of Community Medicine, UiT The Arctic University of Norway, Norwegian Centre for Rural Medicine, 9037, Tromsø, Norway.
| | - Per Steinar Stensland
- Department of Global Public Health and Primary Care, University of Bergen, 5007, Bergen, Norway
| | - Birgit Abelsen
- Department of Community Medicine, UiT The Arctic University of Norway, Norwegian Centre for Rural Medicine, 9037, Tromsø, Norway
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Searle R, Rice C. Making an impact in healthcare contexts: insights from a mixed-methods study of professional misconduct. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2020. [DOI: 10.1080/1359432x.2020.1850520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- R.H. Searle
- Adam Smith Business School, University of Glasgow, Glasgow, UK
| | - C. Rice
- Centre for Trust, Peace and Social Relations, Coventry University, Coventry, UK
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Taouk Y, Bismark M, Hattingh HL. Pharmacists subject to complaints: a national study of pharmacists reported to health regulators in Australia. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2020. [DOI: 10.1002/jppr.1633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Yamna Taouk
- Centre for Health Policy Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia
| | - Marie Bismark
- Centre for Health Policy Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia
| | - Hendrika Laetitia Hattingh
- Gold Caost Health Queensland Health Gold Coast Australia
- School of Pharmacy and Pharmacology Quality Use of Medicines Network Clinical Sciences 2 Griffith University Australia
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Nowotny BM, Davies-Tuck M, Scott B, Stewart M, Cox E, Cusack K, Fletcher M, Saar E, Farrell T, Anil S, McKinlay L, Wallace EM. Preventing critical failure. Can routinely collected data be repurposed to predict avoidable patient harm? A quantitative descriptive study. BMJ Qual Saf 2020; 30:186-194. [PMID: 31915180 DOI: 10.1136/bmjqs-2019-010141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 12/22/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine whether sharing of routinely collected health service performance data could have predicted a critical safety failure at an Australian maternity service. DESIGN Observational quantitative descriptive study. SETTING A public hospital maternity service in Victoria, Australia. DATA SOURCES A public health service; the Victorian state health quality and safety office-Safer Care Victoria; the Health Complaints Commission; Victorian Managed Insurance Authority; Consultative Council on Obstetric and Paediatric Mortality and Morbidity; Paediatric Infant Perinatal Emergency Retrieval; Australian Health Practitioner Regulation Agency. MAIN OUTCOME MEASURES Numbers and rates for events (activity, deaths, complaints, litigation, practitioner notifications). Correlation coefficients. RESULTS Between 2000 and 2014 annual birth numbers at the index hospital more than doubled with no change in bed capacity, to be significantly busier than similar services as determined using an independent samples t-test (p<0.001). There were 36 newborn deaths, 11 of which were considered avoidable. Pearson correlations revealed a weak but significant relationship between number of births per birth suite room birth and perinatal mortality (r2 =0.18, p=0.003). Independent samples t-tests demonstrated that the rates of emergency neonatal and perinatal transfer were both significantly lower than similar services (both p<0.001). Direct-to-service patient complaints increased ahead of recognised excess perinatal mortality. CONCLUSION While clinical activity data and direct-to-service patient complaints appear to offer promise as potential predictors of health service stress, complaints to regulators and medicolegal activity are less promising as predictors of system failure. Significant changes to how all data are handled would be required to progress such an approach to predicting health service failure.
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Affiliation(s)
- Benjamin Michael Nowotny
- Obstetrics and Gynaecology, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia.,The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.,Safer Care Victoria, Department of Health and Human Services, Melbourne, Australia, Victoria, Australia
| | - Miranda Davies-Tuck
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.,Safer Care Victoria, Department of Health and Human Services, Melbourne, Australia, Victoria, Australia
| | - Belinda Scott
- Executive Office, Djerriwarrh Health Services, Bacchus Marsh, Victoria, Australia
| | - Michael Stewart
- PIPER, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Elizabeth Cox
- Obstetrics and Gynaecology, Monash Health, Clayton, Victoria, Australia
| | - Karen Cusack
- Executive Office, Victorian Health Complaints Commission, Melbourne, Victoria, Australia
| | - Martin Fletcher
- Executive Office, Australian Health Practitioner Regulation Agency, Melbourne, Victoria, Australia
| | - Eva Saar
- Executive Office, Australian Health Practitioner Regulation Agency, Melbourne, Victoria, Australia
| | - Tanya Farrell
- Safer Care Victoria, Department of Health and Human Services, Melbourne, Australia, Victoria, Australia.,Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Shirin Anil
- Safer Care Victoria, Department of Health and Human Services, Melbourne, Australia, Victoria, Australia
| | - Louise McKinlay
- Safer Care Victoria, Department of Health and Human Services, Melbourne, Australia, Victoria, Australia
| | - Euan M Wallace
- Obstetrics and Gynaecology, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia .,Safer Care Victoria, Department of Health and Human Services, Melbourne, Australia, Victoria, Australia
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