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Objective. To support policy makers and healthcare workers to reduce high rates of bullying, discrimination, and harassment (BDH) that affect doctors in Australian specialty training sites. Methods. This audit assessed the quality of policies regarding BDH and associated complaints of the Australian Medical Council-accredited Australasian specialty training Colleges (Colleges). Policies were systematically identified and scored against a national standard BDH policy checklist. Results. Fourteen of the 16 Colleges have each written and curated their own BDH policies for their members, with wide variation between Colleges regarding content and processes. This impairs the efficacy of BDH handling in specialty training sites. Conclusions. Key areas for improvement were identified. A checklist is proposed that is specific to College BDH policies and processes involving specialty training sites. [ABSTRACT FROM AUTHOR]

Patients from racial/ethnic minority backgrounds can experience racism and race-based discrimination in the health system, enduring unfair and inferior treatment that negatively affects physical and mental health and well-being and may, in some cases, lead to premature and avoidable death. Racism within the health system also acts as a deterrent to health care access because individuals may choose to avoid healthcare settings for fear of repeated exposure to racism. Racism and its impacts in health are well documented and health care-related regulatory organisations and antidiscrimination commissions in Australia are the recipients of racism complaints that occur within the health system. However, the extent and nature of complaints of racism in healthcare settings (i.e. self-reported incidents of racism) and how they are managed by regulatory organisations and antidiscrimination commissions are not well understood. This paper provides a summary of existing approaches to complaints in the Australian health system related to healthcare regulatory organisations and antidiscrimination commissions. We offer recommendations for improvements to data collection and dissemination of racism complaints to better understand the nature and extent of racism and race-based discrimination in the health system, and thus inform changes to process and practices that will reduce the incidence of racism and improve health outcomes. [ABSTRACT FROM AUTHOR]

Sexual harassment is persistent, prevalent and under-reported in Australian workplaces despite its legal regulation over many decades. The most recent survey data in Australia indicate that the majority of individuals who are subject to sexual harassment at work do not make a formal report or lodge a complaint. The opportunity for voice that organisational processes provide to those who experience sexual harassment at work is a particular focus, given the under-reporting problem. The paper also considers the impact of organisational processes on those who observe the inappropriate behaviour and/or the organisational response. Ultimately, this paper argues that organisations should reduce their reliance on individual complaints by expanding the pathways by which concerns can be raised or observed behaviours addressed that offer alternative voice mechanisms, with an emphasis on problem-solving and early intervention where this is appropriate. The paper also considers different communications strategies, such as approaches to training, the sharing of information about workplace incidents, and leadership on the issue within organisations. [ABSTRACT FROM AUTHOR]

Background: Complaints against pharmacists provide an opportunity for learning and improvement within the profession. The aim of the present study was to describe the nature and prevalence of complaints about pharmacists in Australia and to identify factors associated with an increased risk of complaints. Method: De‐identified data on all pharmacists registered to practise in Australia between 1 January 2011 and 31 December 2016 was linked with complaints about pharmacists lodged with health regulators during the same period. Descriptive statistics describe the source, nature, outcome, and clustering of complaints. Regression analyses identify factors associated with complaints. Results: Around 6% of pharmacists who were registered over the six‐year study period were subject to at least one complaint to a regulator. Over half of these complaints resulted in regulatory action. Four‐fifths of complaints related to five issues: accuracy and appropriateness of dispensing, lawfulness of supply, communication and interpersonal behaviour, records and information, and the health of the pharmacist. Fewer than 1% of pharmacists were the subject of two or more complaints: this group accounted for nearly a third of all complaints. Male pharmacists and those aged 36 to 44 years were at increased risk of complaints compared with their peers. Conclusion: A small group of pharmacists in Australia receive a disproportionate share of complaints. Complaints against pharmacists provide an opportunity for learning and improvement within the profession. Improved understanding of complaint patterns may assist in the development of programs to reduce risk to patients and support safe practice by pharmacists. [ABSTRACT FROM AUTHOR]

Background Traditionally, managing patient complaints and medicolegal claims has been largely a reactive process. However, attention has recently turned to systematically learning from complaints and litigation to prevent recurrence. Within a high-volume maternity service, we explored whether developing predictive tools for patient complaints and litigation to support proactive management was feasible. Objectives To develop and assess two screening tools to predict the likelihood of (i) patient complaints and/or (ii) medicolegal claims arising from maternity care and to assess practitioner awareness of patient risk factors. Methods Births between 1 April 2011 and 30 April 2016 at a university hospital maternity service in Melbourne, Australia were considered. Univariate binary logistic regression was performed to identify the variables contributing to complaints and claims. Backwards-stepwise logistic regression was applied to develop each screening tool. Clinicians completed a survey to assess awareness of identified risk factors. Results In the study period, there were 41,443 births, 173 complaints and 19 claims. The complaints tool had only fair predictive capacity (receiver operating characteristic 0.72, p < 0.001) and the claims tool failed. Neither approach afforded sufficient discrimination to be useful in routine predictive modelling. One hundred and one practitioners completed the survey (response rate 15.7%). Practitioners were better at recognising risk factors for legal claims than for patient complaints. Conclusion Whilst new risk factors for patient complaints and medicolegal claims were identified, we were unable to develop a screening tool that was sufficiently discriminatory to be useful in routine predictive triaging. However, increasing practitioner awareness of key risk factors may afford opportunities to improve care quality. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe characteristics of ED admissions that resulted in unsolicited complaints and compare with overall ED admissions. The site utilised is an inner city tertiary hospital, with 630 beds, with approximately 82 600 annual presentations, where 32.5% were children. Methods: Complaints between the dates of 27 November 2012 and 10 March 2016 were reviewed. Performance indicators and the distribution of presentations by diagnostic code were reviewed. Results: A total of 572 different complaint reasons were found and grouped into 12 categories. The most common reasons for complaints were treatment (33.2%) and communication (28.3%), and most complaints concerned medical staff. Other variables including wait times have no effect on patient complaints. Utilising aggregate numbers, the overall paediatric complaint ratio was 0.98:1000 presentations, and the total adult department complaints were 1.78:1000 presentations. Conclusion: As seen in this study the vast majority of patient complaints were associated with treatment and communication issues and skewed towards doctors. It may be feasible for medical staff to undertake communication training as clinician‐patient communication in the ED is an important aspect in the improvement of patient satisfaction and in decreasing patient complaints as waiting times and triage categories had no major influence on patient complaints. [ABSTRACT FROM AUTHOR]

Endodontic treatment can be challenging for a number of reasons, including the microscopic nature of the clinical environment, reliance on tactile sensation and lack of direct visualization of the work being performed. Commonly, endodontic patients present with pain and distress, which can exacerbate an already difficult clinical situation. Complications may might arise prior to, or during treatment, despite practising with the utmost care and skill. Preventing and managing these complications can take considerable time and energy, and oftentimes assistance from or referral to more experienced colleagues is required. The aim of this review is to discuss medico-legal considerations in endodontics, with clinical correlations and a focus on the Australian legal landscape. [Correction added on 18 October 2023, after first online publication: The abstract was amended from a structured to an unstructured abstract.]., (© 2023 The Authors. Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

Summary: Background: Plastic surgeons and other doctors who perform cosmetic procedures face relatively high risks of malpractice claims and complaints. In particular, alleged problems with the consent process abound in this area, but little is known about the clinical circumstances of these cases. Method: We reviewed 481 malpractice claims and serious health care complaints resolved in Australia between 2002 and 2008 that alleged failures in the informed consent process for cosmetic and other procedures. We identified all “cases” involving cosmetic procedures and reviewed them in-depth. We calculated their frequency, and described the treatments, allegations, and outcomes involved. Results: A total of 16% (77/481) of the legal disputes over informed consent involved cosmetic procedures. In 70% (54/77) of these cases, patients alleged that the doctor failed to disclose risks of a particular complication, in 39% patients claimed that potential lack of benefit was not explained, and in 26% patients allegations centred on the process by which consent was sought. Five treatment types—liposuction, breast augmentation, face/neck lifts, eye/brow lifts, and rhinoplasty/septoplasty—featured in 70% (54/77) of the cases. Scarring (30/77) and the need for reoperation (18/77) were among the most prevalent adverse health outcomes at issue. Conclusion: A mix of factors “supercharges” the informed consent process for cosmetic procedures. Doctors who deliver these procedures should take special care to canvas the risks and possible outcomes that matter most to patients. [ABSTRACT FROM AUTHOR]

Background: There are little data available on the number and type of complaints made against dental care providers in Australia, despite anecdotal reports of an increasing trend in health-related complaints and litigation.Methods: Data were obtained from the Dental Practice Board of Victoria on complaints received between July 2000 and December 2004.Results: There were 651 complaints against all dental care providers in the study period, which equates to a rate of 4.1 complaints per 100 dental care providers per year. Dentists were responsible for 490 of the complaints, with 66 complaints against dental prosthetists and 43 complaints against dental specialists. There were very few complaints against dental therapists and students, and no complaints against dental hygienists, with 47 complaints against unregistered people or institutions.Conclusions: This study found that there was a relatively low rate of complaints made against dental care providers in Victoria, with most occurring against dentists in private practice in Melbourne. Less that 10 per cent of complaints resulted in an adverse finding against the dental care provider. [ABSTRACT FROM AUTHOR]

Purpose - Customer retention has been a significant topic since the mid-1990s, but little research has been conducted into management processes that are associated with excellent customer retention performance. This research investigates the associations between customer retention outcomes and a number of management processes including customer retention planning, budgeting and accountability and the presence of a documented complaints-handling process.
Design/methodology/approach - This is carried out using a quantitative survey of 170 companies in Australia. Participants represented all major standard industrial classification (SIC) codes.
Findings - It was found that excellence at customer retention is positively and significantly associated with the presence of documented complaints-handling processes. None of the other variables is significantly associated with the dependent variable.
Research limitations/implications - This research has limited generalisability to other regions and the self-report nature of the data is not independently corroborated.
Practical implications - The research emphasises the importance of developing and implementing documented complaints-handling processes. Future research should examine whether standardised processes such as those embodied in ISO 10002 are more effective than ad hoc processes.
Originality/value - The major contribution of this paper is the clear link that it establishes between customer retention performance and the presence of a documented complaints-handling process. [ABSTRACT FROM AUTHOR]

Advertising expenditure has risen globally and in Australia there has been a 2.7- fold increase in the last ten years. It is suggested that some advertisements may be "unacceptable", that is, unfair, misleading, deceptive, offensive, false or socially irresponsible. This research is concerned with consumer behaviour and consumer complaint behaviour specifically in the area of advertising in Australia. The findings indicate that complainants are significantly different from the population at large. This research will afford the regulatory bodies a better understanding of the complaining public as well as educating marketing communications strategists in effectively reaching their target markets. [ABSTRACT FROM AUTHOR]

Objectives: To understand complaint risk among mental health practitioners compared with physical health practitioners., Design: Retrospective cohort study, using incidence rate ratios (IRRs) to analyse complaint risk and a multivariate regression model to identify predictors of complaints., Setting: National study using complaints data from health regulators in Australia., Participants: All psychiatrists and psychologists ('mental health practitioners') and all physicians, optometrists, physiotherapists, osteopaths and chiropractors ('physical health practitioners') registered to practice in Australia between 2011 and 2016., Outcome Measures: Incidence rates, source and nature of complaints to regulators., Results: In total, 7903 complaints were lodged with regulators over the 6-year period. Most complaints were lodged by patients and their families. Mental health practitioners had a complaint rate that was more than twice that of physical health practitioners (complaints per 1000 practice years: psychiatrists 119.1 vs physicians 48.0, p<0.001; psychologists 21.9 vs other allied health 7.5, p<0.001). Their risk of complaints was especially high in relation to reports, records, confidentiality, interpersonal behaviour, sexual boundary breaches and the mental health of the practitioner. Among mental health practitioners, male practitioners (psychiatrists IRR: 1.61, 95% CI 1.39 to 1.85; psychologists IRR: 1.85, 95% CI 1.65 to 2.07) and older practitioners (≥65 years compared with 36-45 years: psychiatrists IRR 2.37, 95% CI 1.95 to 2.89; psychologists IRR 1.78, 95% CI 1.47 to 2.14) were at increased risk of complaints., Conclusions: Mental health practitioners were more likely to be the subject of complaints than physical health practitioners. Areas of increased risk are related to professional ethics, communication skills and the health of mental health practitioners themselves. Further research could usefully explore whether addressing these risk factors through training, professional development and practitioner health initiatives may reduce the risk of complaints about mental health practitioners., Competing Interests: Competing interests: BV and MB are trainees with the Royal Australian and New Zealand College of Psychiatrists, LN is a consultant psychiatrist, and BG formerly chaired the Psychology Board of Australia., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Recent media reports have highlighted the risks to patients that may occur when practitioners in the chiropractic, osteopathy and physiotherapy professions provide services in an unethical or unsafe manner. Yet research on complaints about chiropractors, osteopaths, and physiotherapists is limited. Our aim was to understand differences in the frequency and nature of formal complaints about practitioners in these professions in order to inform improvements in professional regulation and education. Methods: This retrospective cohort study analysed all formal complaints about all registered chiropractors, osteopaths, and physiotherapists in Australia lodged with health regulators between 2011 and 2016. Based on initial assessments by regulators, complaints were classified into 11 complaint issues across three domains: performance, professional conduct, and health. Differences in complaint rate were assessed using incidence rate ratios. A multivariate negative binomial regression model was used to identify predictors of complaints among practitioners in these professions. Results: Patients and their relatives were the most common source of complaints about chiropractors, osteopaths and physiotherapists. Concerns about professional conduct accounted for more than half of the complaints about practitioners in these three professions. Regulatory outcome of complaints differed by profession. Male practitioners, those who were older than 65 years, and those who practised in metropolitan areas were at higher risk of complaint. The overall rate of complaints was higher for chiropractors than osteopaths and physiotherapists (29 vs. 10 vs. 5 complaints per 1000 practice years respectively, p < 0.001). Among chiropractors, 1% of practitioners received more than one complaint – they accounted for 36% of the complaints within their profession. Conclusions: Our study demonstrates differences in the frequency of complaints by source, issue and outcome across the chiropractic, osteopathic and physiotherapy professions. Independent of profession, male sex and older age were significant risk factors for complaint in these professions. Chiropractors were at higher risk of being the subject of a complaint to their practitioner board compared with osteopaths and physiotherapists. These findings may assist regulatory boards, professional associations and universities in developing programs that avert patient dissatisfaction and harm and reduce the burden of complaints on practitioners. [ABSTRACT FROM AUTHOR]