Developing a coding taxonomy to analyze dental regulatory complaints

Monika Roerig,Julie Farmer,Krystal Evans,Abdulrahman Ghoneim,Noha Gomaa,Wanda La,Laura Dempster,Carlos Quiñonez

doi:10.1186/s12913-020-05943-7

Abstract

BackgroundAs part of their mandate to protect the public, dental regulatory authorities (DRA) in Canada are responsible for investigating complaints made by members of the public. To gain an understanding of the nature of and trends in complaints made to the Royal College of Dental Surgeons of Ontario (RCDSO), Canada’s largest DRA, a coding taxonomy was developed for systematic analysis of complaints.MethodsThe taxonomy was developed through a two-pronged approach. First, the research team searched for existing complaints frameworks and integrated data from a variety of sources to ensure applicability to the dental context in terms of the generated items/complaint codes in the taxonomy. Second, an anonymized sample of complaint letters made by the public to the RCDSO (n = 174) were used to refine the taxonomy. This sample was further used to assess the feasibility of use in a larger content analysis of complaints. Inter-coder reliability was also assessed using a separate sample of letters (n = 110).ResultsThe resulting taxonomy comprised three domains (Clinical Care and Treatment, Management and Access, and Relationships and Conduct), with seven categories, 23 sub-categories, and over 100 complaint codes. Pilot testing for the feasibility and applicability of the taxonomy’s use for a systematic analysis of complaints proved successful.ConclusionsThe resulting coding taxonomy allows for reliable documentation and interpretation of complaints made to a DRA in Canada and potentially other jurisdictions, such that the nature of and trends in complaints can be identified, monitored and used in quality assurance and improvement.

Highlights

As part of their mandate to protect the public, dental regulatory authorities (DRA) in Canada are responsible for investigating complaints made by members of the public
Safety issues may be highlighted in complaints, like clinical mistakes made by a healthcare professional and factors that contribute to failures, including policies, procedures and training
The goal of this study was to develop a taxonomy for use in the reliable documentation and interpretation of complaints made to the Royal College of Dental Surgeons of Ontario (RCDSO), Canada’s largest dental regulatory authority (DRA), so that the nature of and trends in complaints can be identified, monitored and used in quality assurance and improvement

Summary

Introduction

As part of their mandate to protect the public, dental regulatory authorities (DRA) in Canada are responsible for investigating complaints made by members of the public. A review by Hiivala et al [9] of the dental literature regarding detectable safety incidents revealed that issues from various countries and dental disciplines share similar themes [9] These themes relate to: treatment (e.g., errors, complications and poor skill); diagnostic and clinical assessments (e.g., faulty diagnosis, incomplete radiographic assessment); medications (e.g., adverse drug events); practice processes (e.g., infection control, documentation); consent and confidentiality; practitioner behaviour; and the health of the practitioner. This thematic grouping mirrors patient and public perceptions about the quality of care; that is, quality is influenced by factors inclusive and exclusive of clinical abilities

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