How Can We Make Health Regulation More Humane? A Quality Improvement Approach to Understanding Complainant and Practitioner Experiences

Abstract

Health-professional regulation plays a central role in patient safety by responding to concerns about the conduct of health practitioners that may breach professional standards. This study aims to understand the experience of both complainants and registered health practitioners during the management of a notification (complaint or concern) with a health-practitioner board in Australia. Experience-survey responses from complainants (n=1,217) and practitioners (n=1,604) with a recently closed notification were analyzed using descriptive and thematic analysis. Respondents in both groups felt the process was not fair or impartial, and lacked transparency and adequate updates. The time taken to reach an outcome was a frustration for many (complainants 46%, practitioners 49%). A notable difference between the groups was their view of the outcome: 70% of practitioners were satisfied and 71% of complainants dissatisfied. Finally, many practitioners (89%) reported high levels of stress. Designing regulatory processes that are robust and humane is complex and multifaceted. However, the symmetry of priorities for both parties identified — fairness, transparency, communication, timeliness and empathic contact — highlights the value of understanding both complainant and practitioner experiences. This knowledge can lead to improvements in the trustworthiness and effectiveness of health-practitioner regulation, and its contribution to patient safety.