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From Discipline to Quality of Care: How Neurologists Can Learn from Decisions of Disciplinary Tribunals

Gimbel, Inge; Mostert, Menno; Van Leeuwen, Barend; Van Leeuwen, Roeland

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Authors

Inge Gimbel

Menno Mostert



Abstract

Background: One of the primary aims of medical disciplinary law is to improve the quality of care. However, the decisions of disciplinary tribunals are not sufficiently analysed to identify the learning elements. Aim: This study aimed to investigate the frequency and nature of complaints for the specialty neurology which were upheld by the disciplinary tribunals and to learn from disciplinary law through an analysis of which factors contributed to complaints being upheld. Design: This is a retrospective, observational study. Methods: All upheld complaints in the field of neurology were collected for the period of January 1, 2010, to January 1, 2020. A qualitative analysis of the decisions was conducted using the usual characteristics set out by disciplinary tribunals in their annual reports. The relevant factors which potentially played a role in the complaint being upheld were identified for more detailed analysis. Results: In the 10-year period, a complaint was submitted to the disciplinary tribunals against 299 neurologists. Forty-four complaints were upheld (15%). The most common sanction was a warning (70%). A large majority of cases were directly related to patient care, such as decisions about the patient’s diagnosis and the treatment. Recordkeeping (50%), interpretation and discussion of imaging (30%), and involvement of several consultants of one or more specialties (34%) frequently played a role in the successful complaints. Conclusion: Medical disciplinary cases in the field of neurology are usually about diagnosis- and treatment-related aspects. Recordkeeping, interpretation of neuroimaging, and involvement of several consultants frequently play a role in a complaint being upheld. It is important that specialties evaluate disciplinary decisions on a structural and continuous basis.

Journal Article Type Article
Acceptance Date Dec 3, 2021
Online Publication Date Jan 11, 2022
Publication Date 2022-05
Deposit Date Dec 6, 2021
Publicly Available Date Jan 11, 2022
Journal European Neurology
Print ISSN 0014-3022
Electronic ISSN 1421-9913
Publisher Karger Publishers
Peer Reviewed Peer Reviewed
Volume 85
Issue 3
Pages 202-207
DOI https://doi.org/10.1159/000521391
Public URL https://durham-repository.worktribe.com/output/1220083

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Copyright Statement
This is the accepted manuscript version of an article published by S. Karger AG in European Neurology, 2022;85:3,202-207, 10.1159/000521391 and available on www.karger.com/Article/FullText/10.1159/000521391.






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