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Background: It is uncertain if patient's characteristics are associated with complaints and claims against doctors. Additionally, evidence for the effectiveness of remedial interventions on rates of complaints and claims against doctors has not been synthesised. Methods: We conducted a rapid review of recent literature to answer: Question 1 "What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?" and Question 2 "What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received from a doctor?". We used a systematic search (most recently in July 2023) of PubMed, Scopus, Web of Science and grey literature. Studies were screened against inclusion criteria and critically appraised in duplicate using standard tools. Results were summarised using narrative synthesis. Results: From 8079 search results, we reviewed the full text of 250 studies. We included 25 studies: seven for Question 1 (6 comparative studies with controls and one systematic review) and 18 studies for Question 2 (14 uncontrolled pre-post studies, 2 comparative studies with controls and 2 systematic reviews). Most studies were set in hospitals across a mix of medical specialties. Other than for patients with mental health conditions (two studies), no other patient characteristics demonstrated either a strong or consistent effect on the rate of complaints or claims against their treating doctors. Risk management programs (6 studies), and communication and resolution programs (5 studies) were the most studied of 6 intervention types. Evidence for reducing complaints and medico-legal claims, costs or premiums and more timely management was apparent for both types of programs. Only 1 to 3 studies were included for peer programs, medical remediation, shared decision-making, simulation training and continuing professional development, with few generalisable results. Conclusion: Few patient characteristics can be reliably related to the likelihood of medico-legal complaints or claims. There is some evidence that interventions can reduce the number and costs of claims, the number of complaints, and the timeliness of claims. However, across both questions, the strength of the evidence is very weak and is based on only a few studies or study designs that are highly prone to bias. [ABSTRACT FROM AUTHOR]

The question of how Aboriginal Elders influence the leadership of non-Aboriginal led service organisations when working biddiya to biddiya (boss to boss) emerged while conducting a qualitative analysis as part of the evaluation of the Looking Forward Moving Forward project. This project brought together non-Aboriginal service leaders, Aboriginal Elders and Aboriginal and non-Aboriginal researchers to implement and evaluate a framework for engagement to promote organisational change and transform the way in which services respond to Aboriginal people in need of mental health and drug and alcohol support in Perth, Western Australia. This paper uses a case study to demonstrate how Elders on Nyoongar Country have influenced one non-Aboriginal service leader. At the heart of this case study is a close examination of a recorded, semi-structured, in-depth focus group exchange between a non-Aboriginal leader, Elders and co-researchers. This exchange foregrounds the Elders' and co-researchers' voices, capturing the dialogic nuances and interplay of the interaction to provide a more detailed picture of how building long-term relationships with Elders influences leaders. A key theme to emerge from the data was the developmental change in leadership approaches resulting from the biddiya to biddiya working relationship between Elders and this non-Aboriginal leader. The data show that, along with their deepening relationship, the leader demonstrated an openness and humility to be teachable. This leader demonstrated how he applied his new learning, integrating new ways of working into his leadership practice to change the way his organisation responded to Aboriginal people seeking support and to enhance the organisation's cultural safety. [ABSTRACT FROM AUTHOR]