Developing a coding taxonomy to analyze dental regulatory complaints
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(2020) 20:1083
RESEARCH ARTICLE
Open Access
Developing a coding taxonomy to analyze dental regulatory complaints Monika Roerig1, Julie Farmer1* , Abdulrahman Ghoneim1, Noha Gomaa2, Laura Dempster1, Krystal Evans3, Wanda La3 and Carlos Quiñonez1
Abstract Background: 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. 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. Methods: The 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). Results: The 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. Conclusions: The 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. Keywords: Complaint, Quality of Care, Regulation
Background Complaints in healthcare settings are emotive, spontaneous, subjective, and complex, representing an expression of grievance or dispute that describes a service failure or unmet expectation [1–4]. A complaint is often made to seek a response from the accused healthcare provider and/or setting and to reach a resolution, whether it means securing an apology, an investigation * Correspondence: [email protected] 1 Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada Full list of author information is available at the end of the article
and disciplinary action, or changes in practice to avoid future wrongdoing [5]. Complaints themselves are important, as they provide a wealth of information to inform service improvement. For example, through complaints, patients and the public provide an independent assessment of healthcare providers, organizations and systems grounded in the norms and expectations of society [6]. Considering a complainant’s perspective is especially important in gaining insight about patient and/or public expectation
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