scholarly journals Profile of the most common complaints for five health professions in Australia

2020 ◽  
Vol 44 (1) ◽  
pp. 15
Author(s):  
Merrilyn Walton ◽  
Patrick J. Kelly ◽  
E. Mary Chiarella ◽  
Terry Carney ◽  
Belinda Bennett ◽  
...  
Keyword(s):  
Clinical Care ◽  
Health Professions ◽  
Work Environments ◽  
Health Practitioner ◽  
Medical Practitioners ◽  
Australian Health ◽  
Health Impairment ◽  
South Wales ◽  
Work Tasks ◽  
National Cohort

Objective The aims of this study were to profile the most common complaints and to examine whether any demographic factors are associated with receiving a complaint for five health professions in Australia. Methods A national cohort study was conducted for all complaints received for medicine, nursing/midwifery, dentistry, pharmacy and psychology from 1 July 2012 to 31 December 2013 (18 months). Data were collected from the Australian Health Practitioner Regulation Agency (AHPRA), the New South Wales (NSW) Health Professional Councils’ Authority and the NSW Health Care Complaints Commission. The frequency and risk of complaints were summarised for the five professions and by demographic information. Results There were 545283 practitioners registered with AHPRA between 1 July 2012 and 31 December 2013, consisting of 20935 dentists, 101066 medical practitioners, 363040 nurses/midwives, 28370 pharmacists and 31872 psychologists. During the study period there were 12616 complaints, corresponding to an annual rate of 1.5 per 100 practitioners. Complaints were most common for doctors and dentists (5% per annum per practitioner) and least common for nurses/midwives (0.5% per annum per practitioner). Sex (P<0.01), age (P<0.01) and country of birth (P<0.01) were all associated with risk of complaint. The most common complaints were clinical care (44% of all complaints), medication (10%) and health impairment of the practitioner (8%). Types of complaints varied by profession, sex and age. Conclusions The risk of a complaint is low, but varies by profession and demographics. The types of complaints also vary by profession and demographics. Differences between professions is most likely driven by their different work tasks and work environments. What is already known on this subject? Although complaints are summarised annually from state and national health regulators, no overall national summary of complaints across professions exists. Thus, it is difficult to examine which complaints are most common, how professions differ from each other or what factors may be associated with risk and type of complaint. Previous studies have primarily focused on a single profession, such as medicine, where, for example, the number of prior complaints, sex, doctor speciality and age have been found to be associated with recurrent complaints. What does this paper add? This paper is the first of this kind to provide a national summary of all complaints from five of the most common health professions in Australia. We found that regardless of profession, men were at least twice as likely to have a complaint made against them than women. We also found that the types of complaint differed between men and women. There were similarities across professions for the most common types of complaints, but clear differences between professions were also noted. Not surprising, clinical care was typically the most common type of complaint for the five professions, but somewhat surprising was the inclusion of health impairment as one of the most common types of complaints. What are the implications for practitioners? Identifying the most common complaints, and the factors associated with these, may assist practitioners to understand their risk(s) of complaint and could potentially assist educators and regulators develop education programs that help reduce complaints.

scholarly journals Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010–17

2020 ◽  
Vol 44 (2) ◽  
pp. 190 ◽  
Author(s):  
Jenni Millbank
Keyword(s):  
New York ◽  
Health Professionals ◽  
Clinical Care ◽  
Sexual Misconduct ◽  
Health Professions ◽  
Health Practitioner ◽  
Legal Representation ◽  
Chi Squared ◽  
Uniform Manner ◽  
Board Level

Objective There is a gap in knowledge regarding serious disciplinary matters concerning health professionals under the Health Practitioner Regulation National Law Act 2009 (hereafter ‘National Law’). The present study applies a typology of misconduct to the first 7 years of available tribunal cases under the National Law brought against the five most populous regulated health professions with the overarching goal of mapping the relationship between type of misconduct and outcome. As subquestions, the study examined whether the ostensibly uniform law is producing consistency of outcomes, both between the professions and between jurisdictions. Methods All publicly available Australian tribunal-level decisions concerning complaints of serious misconduct and/or impairment brought against the five most populous regulated health professions (nurses and midwives, doctors, psychologists, pharmacists, and dentists) were gathered from 1 July 2010 to 30 June 2017. Decisions were coded for case and respondent attributes, the type/s of misconduct alleged, whether proved, and the relevant disciplinary outcome. Respondent attributes were: profession, sex, legal representation, and certain identified ‘risk’ factors from previous studies. The type of allegation was coded based on five main categories or heads of misconduct, with subtypes within each. Outcomes for proved conduct were coded and categorised for severity. Analyses of cases was conducted using SPSS, version 21 (IBM, New York, NY, USA). Data was subject to statistical analysis using Pearson’s Chi-squared test with an α value of 0.05. Results Major variations were identified in outcomes across the professions, with doctors being subject to less severe outcomes than other professions, in particular compared with nurses, even when the same main head of misconduct was in issue. Differences in legal representation did not completely account for such variation. Marked disparities were also identified between outcomes in different states and territories, suggesting that the National Law is not being applied in a uniform manner. Conclusion Tribunal cases reflected complaint data in that: (1) male practitioners were greatly over-represented as respondents; (2) outcomes were most severe for sexual misconduct and least severe for clinical care; and (3) doctors faced less severe outcomes than other professions. There were also significant variations in severity of outcome by jurisdiction. Variations were more pronounced when deregistration was the focus of analysis. What is known about this topic? Existing research on complaints data under the National Law in place since 2010 has suggested that doctors may be receiving less severe outcomes than other professions at board level. There is a gap in knowledge concerning serious disciplinary matters heard by tribunals. Unlike data on complaints against regulated health professionals collated by AHPRA, legal tribunals, which hear only the most serious matters, do not record data on cases in a consistent or centralised form. What does this paper add? This study is the first to compare tribunal outcomes for the five most populous professions by reference to the type of misconduct proved. The finding that different professions are receiving different outcomes for the same malfeasance is novel. Other novel findings include significant variations in severity of outcome by jurisdiction, more pronounced variations in outcomes by both profession and jurisdiction when deregistration was the focus of analysis and variations in outcome according to legal representation. What are the implications for practitioners? There are major implications for policy makers and decision makers in terms of whether the National Law is operating consistently, with important outcomes for practitioners in terms of equitable and fair treatment when facing disciplinary charges.

Reinterpreting the Hospital Corridor: “Wasted Space” or Essential for Quality Multidisciplinary Clinical Care?

2008 ◽  
Vol 2 (1) ◽  
pp. 17-29 ◽  
Author(s):  
Jane Carthey
Keyword(s):  
Care Delivery ◽  
New South ◽  
Clinical Care ◽  
Health Facilities ◽  
Health Capital ◽  
Australian Health ◽  
South Wales ◽  
Necessary Evil ◽  
Asset Managers

The planning of New South Wales (NSW) and other Australian health facilities is guided by the Australasian Health Facility Guidelines (AHFG), which prescribe allowances for circulation (corridors and similar areas for movement between spaces) of between 10% and 40% of functional floor areas. A further allowance of up to 28% for Travel and Engineering is then assumed (University of NSW & Health Capital Asset Managers' Consortium, 2005). Therefore the “circulation” and “travel” space manifested as the corridors and similar movement spaces within health facilities is both extensive and expensive. Consequently, such space often becomes regarded as a necessary evil and, in the name of efficiency, is often minimized wherever possible. This paper revisits the view that corridor space allocations (circulation) must always be minimized to achieve design or functional efficiencies. Minimizing circulation or travel inevitably assumes that the realized space savings will then be reallocated to “more important” areas of the facility. Yet the corridors and other movement spaces also are very important to the functioning of multidisciplinary clinical teams and the quality of care delivery. Ultimately, inflexibly reducing the space allocated to such spaces may be regarded as a false economy.

Management and outcomes of health practitioner complaints in Australia: a comparison of the national and New South Wales systems

2020 ◽  
Vol 44 (2) ◽  
pp. 180
Author(s):  
Merrilyn Walton ◽  
Patrick J. Kelly ◽  
E. Mary Chiarella ◽  
Terry Carney
Keyword(s):  
New South ◽  
New South Wales ◽  
Boundary Crossing ◽  
Health Practitioner ◽  
National System ◽  
Health Impairment ◽  
Regulatory Authorities ◽  
South Wales ◽  
Two Systems

Objective. The aim of this study was to summarise the process and outcomes of complaints from five regulated health professions in Australia, and to compare these between the national and New South Wales (NSW) systems. Methods. This is a retrospective cohort study of all complaints lodged from 1 July 2012 to 31 December 2013 for medicine, nursing and midwifery, dentistry, psychology and pharmacy registered practitioners. Data were extracted from the Australian Health Practitioner Regulation Agency, the NSW Health Professional Councils’ Authority and the NSW Health Care Complaints Commission databases. The main outcome measures were frequencies and percentages of process decisions and outcomes. Results. Systems differed in classification of complaints as conduct (national 47%; NSW 22%) and performance (national 45%; NSW 71%). Thirty-eight per cent of complaints were investigated or managed through a health or performance stream (national 40%; NSW 34%), but the national system investigated more matters (national 35%; NSW 6%). Over 50% of complaints resulted in ‘no further action’ (national 60%; NSW 70%). The most common action was caution or counsel (national 12%; NSW 15%), followed by conditions, (national 10%; NSW 5%). Practitioner registration surrender was more common with the NSW than national system (national 0.1%; NSW 1.3%), but registration suspensions or cancellations were similar (national 0.6%; NSW 1.0%). Conclusion. The main difference between the two systems is the administrative decision as to how complaints are assessed. In NSW, a classification of a complaint as ‘performance’ usually means the complaint is not investigated; rather, the practitioner is assessed by peers and may be required to undergo further education and training. Reaching agreement and understanding of complaints that should be investigated and those appropriate for performance review would strengthen a national approach to health complaint regulation. What is known about the topic? The national system of managing healthcare complaints is relatively new (since 2010) compared with the NSW system (since 1993). Annual reports of the regulatory authorities provide summaries of types and outcomes of complaints separately for each profession, and separately for NSW and the national system, but we do not know how the two systems directly compare in terms of complaint management or their outcomes. What does this paper add? This study examined how different types of complaints are managed between the two systems and whether there are any differences in outcomes. The types of complaints are almost identical between the two systems, but classification of complaints as ‘performance’ or ‘conduct’ differed. Immediate action is more common in the national than NSW system, especially for health impairment and boundary crossing. Health impairment complaints are much less likely to be discontinued at the assessment stage in NSW compared with the national system. The NSW and national systems are similar in terms of complaints proceeding to either an investigation or performance or health assessment, but the national system investigates more than the NSW system. For many types of complaints the outcomes were similar between systems, but there were clear differences for some types of complaints, such as health impairment and boundary crossing. What are the implications for practitioners? An efficient and fair regulatory system is crucial for maintaining practitioner trust, as well as trust of the public. This study shows that there are many similarities between the national and NSW systems in terms of process and outcomes, but there are differences in the way some types of complaints are assessed between the two systems. This knowledge may assist regulatory authorities in their efforts to achieve a nationally consistent approach to complaints.

scholarly journals Characteristics and predictors of regulatory immediate action imposed on registered health practitioners in Australia: a retrospective cohort study

2020 ◽  
Vol 44 (5) ◽  
pp. 784
Author(s):  
Owen M. Bradfield ◽  
Marie M. Bismark ◽  
David M. Studdert ◽  
Matthew J. Spittal
Keyword(s):  
Substance Abuse ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Care ◽  
Sexual Misconduct ◽  
Health Practitioner ◽  
The Public ◽  
Australian Health ◽  
Health Practitioners

ObjectiveImmediate action is an emergency power available to Australian health practitioner regulatory boards to protect the public. The aim of this study was to better understand the frequency, determinants and characteristics of immediate action use in Australia. MethodsThis was a retrospective cohort study of 11200 health practitioners named in notifications to the Australian Health Practitioner Regulation Agency (AHPRA) between January 2011 and December 2013. All cases were followed until December 2016 to determine their final outcome. ResultsOf 13939 finalised notifications, 3.7% involved immediate action and 9.7% resulted in restrictive final action. Among notifications where restrictive final action was taken, 79% did not involve prior immediate action. Among notifications where immediate action was taken, 48% did not result in restrictive final action. Compared with notifications from the public, the odds of immediate action were higher for notifications lodged by employers (mandatory notifications OR=21.3, 95% CI 13.7–33.2; non-mandatory notifications OR=10.9, 95% CI 6.7–17.8) and by other health practitioners (mandatory notifications OR=11.6, 95% CI 7.6–17.8). Odds of immediate action were also higher if the notification was regulator-initiated (OR=11.6, 95% CI 7.6–17.8), lodged by an external agency such as the police (OR=11.8, 95% CI 7.7–18.1) or was a self-notification by the health practitioner themselves (OR=9.4, 95% CI 5.5–16.0). The odds of immediate action were higher for notifications about substance abuse (OR=9.9, 95% CI 6.9–14.2) and sexual misconduct (OR=5.3, 95% CI 3.5–8.3) than for notifications about communication and clinical care. ConclusionsHealth practitioner regulatory boards in Australia rarely used immediate action as a regulatory tool, but were more likely to do so in response to mandatory notifications or notifications pertaining to substance abuse or sexual misconduct. What is known about this topicHealth practitioner regulatory boards protect the public from harm and maintain quality and standards of health care. Where the perceived risk to public safety is high, boards may suspend or restrict the practice of health practitioners before an investigation has concluded. What does this paper add?This paper is the first study in Australia, and the largest internationally, to examine the frequency, characteristics and predictors of the use of immediate action by health regulatory boards. Although immediate action is rarely used, it is most commonly employed in response to mandatory notifications or notifications pertaining to substance abuse or sexual misconduct. What are the implications for practitioners?Immediate action is a vital regulatory tool. Failing to immediately sanction a health practitioner may expose the public to preventable harm, whereas imposing immediate action where allegations are unfounded can irreparably damage a health practitioner’s career. We hope that this study will assist boards to balance the interests of the public with those of health practitioners.

scholarly journals A snapshot of potential: Using situational assessments to capture the moment

2021 ◽  
pp. 1-4
Author(s):  
Jessica Short
Keyword(s):  
Work Environments ◽  
Job Seekers ◽  
Work Settings ◽  
Hands On ◽  
Work Tasks ◽  
Support Employment ◽  
Employment Support ◽  
Situational Assessment ◽  
The Moment ◽  
Employment Choices

BACKGROUND: A contributing factor to the higher unemployment rates of adults with disabilities is the limited opportunities to gain insight into employment options. Assessments are often used to learn a job seekers skills, preferences, and support needs. Situational assessments in real work settings create hands-on experiences with a variety of work tasks and work environments which better inform the employment choices of job seekers. METHODS: This article explores situational assessments and introduces a tool designed for the employment support professional conducting the assessment to capture information necessary to make more informed employment choices. RESULTS: This article defines situational assessments while introducing a person-centered tool to support employment support professionals to effectively document and analyze the observations of each situational assessment.

Professional Misconduct in Psychiatry: Sexual Behaviour with Patients. A Report of Recent New South Wales Findings

1994 ◽  
Vol 28 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Eleanor M. Dawson
Keyword(s):  
Sexual Behaviour ◽  
Psychiatric Treatment ◽  
New South ◽  
New South Wales ◽  
Professional Misconduct ◽  
Medical Practitioners ◽  
Legal Documents ◽  
South Wales ◽  
Legal Context ◽  
The Supreme Court

In the period 1989–1991 the Medical Tribunal in the state of New South Wales conducted enquiries into seven complaints about professional misconduct of a sexual nature incidental to psychiatric treatment. This study is submitted in the interests of patients, profession and public in accordance with the ethos of the Medical Practitioners Act (NSW). It is based on personal observations and published legal documents and refers to the legal context and procedures. It addresses the substance and style of complaints and complainants and of defences and respondents. The names of six psychiatrists and one trainee psychiatrist were removed from the Medical Register. In three instances decisions or orders were unsuccessfully appealed in the Supreme Court. In two instances associated complaints (of illicitly prescribing drugs of addiction and of divulging confidential information) were also found to be professional misconduct. Courtroom pitfalls are illustrated and practical principles explicit in judgements are reiterated.

Prevalence of chronic disease risk factors in 35- to 44-year-old humanitarian arrivals to New South Wales (NSW), Australia

2019 ◽  
Vol 25 (1) ◽  
pp. 19 ◽  
Author(s):  
Meena Chandra ◽  
Anthea Duri ◽  
Mitchell Smith
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Disease Risk ◽  
New South ◽  
New South Wales ◽  
Indigenous Populations ◽  
Indigenous Australian ◽  
Australian Health ◽  
Chronic Disease Risk ◽  
South Wales

The aim of this study is to compare the prevalence of chronic disease risk factors in humanitarian arrivals to Sydney, New South Wales (NSW) with the Australian Indigenous and non-Indigenous populations aged 35–44 years. Data on risk factors collected from 237 refugees presenting to the NSW Refugee Health Service (RHS) from January 2015 to August 2016 were retrospectively analysed and compared with data from the Australian Health Surveys, 2011–13 for the Indigenous and non-Indigenous Australian populations. This study found significantly higher levels of triglycerides (z=3; 95% CI, 0.16–0.26); hypertension (z=3.2; 95% CI, 0.17–0.29); and smoking (z=3.5; 95% CI, 0.27–0.33) in refugees compared with the general Australian population. The Indigenous population had significantly higher levels of triglycerides (z=4; 95% CI, 0.16–0.26); body mass indexes (BMIs) (z=3.3; 95% CI 0.58–0.72); and smoking (z=5.4; 95 CI 0.27–0.33) compared with refugees. Based on the study findings, screening for chronic disease risk factors from age 35 years may be warranted in all humanitarian arrivals to Australia, along with dietary and lifestyle advice.

scholarly journals The Relevance of Telemedicine in Continuing Medical Education

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 97S-102S
Author(s):  
Samir Kumar Praharaj ◽  
Shahul Ameen
Keyword(s):  
Medical Education ◽  
Continuing Medical Education ◽  
Clinical Care ◽  
Traditional Methods ◽  
Medical Practitioners ◽  
Knowledge And Skills ◽  
Online Format ◽  
Technological Limitations

Continuing medical education (CME) is essential for medical practitioners to update their knowledge and skills periodically to provide clinical care in keeping with the evidence available. Traditional methods of CME such as workshops, conferences, and seminars are helpful to bridge the gaps in practice. With advancing technologies, online format is used to deliver CME with appropriate modifications. Although there are distinct advantages of online CME in regards to wider reach and flexibility, there are certain drawbacks beyond just technological limitations. Interactivity using ingenious ideas may be required to motivate and engage learners during online CME.

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