title: An analysis of 20 years of radiation-related health care complaints in Texas for the purposes of quality improvement.
abstract: In an effort to reveal the possible underlying causes of radiation-related health care complaints in the State of Texas, complaint data were evaluated using historical Texas Department of Health-Bureau of Radiation Control (TDH-BRC) reports. A major aim of the study was to generate a summary of the most commonly reported complaints that might be generalized to health care providers using sources of radiation across Texas. A generalizable list of common complaints would be a valuable tool for education and prevention programs, serving to possibly reduce the overall incidence of radiation-related medical complaints. Descriptive text summary reports of complaints were obtained from the TDH-BRC for the 20-y period inclusive of 1981 to 2001. The information was systematically coded into a computerized database. During the 20-y period of study, 481 health care-related complaints were identified, with approximately 74% consisting of claims of an "uncredentialed technician" (39%), "overexposure" (21%), or "regulatory violation" (14%). The most common categories of complaints imply some patient understanding or knowledge of the credentialing requirements of workers, the applicable dose limits, or the regulatory requirements associated with medical procedures. Since it is unlikely that an average patient would be aware of such issues, the findings suggest the complaints are not actually indications of the inappropriate uses of radiation, but are rather based on the patient's broader perception of services rendered. Most of the complaints levied during the period of study were done so anonymously (58%) and were levied against a generic facility (61%) rather than a specific technician (5%), doctor (4%), or student (1%). Approximately 61% of the complaints resulted in the issuance of a notice of violation upon investigation by the TDH-BRC, but the available data did not permit definitive linkage between the initial complaint and the violation issued. Taken in aggregate, the analysis suggests that improved communications between health care providers and the patients they serve could possibly serve to prevent future complaints. Although the analysis was limited to the data from a single state, the results may be of use to quality assurance programs on a broader scale because of the objective identification of likely common issues. Possible options for improving the means of systematically collecting initial compliant data in the future are also discussed.
authors.affiliation: The University of Texas School of Public Health, 1200 Herman Pressler, Houston, TX 77030, USA. Prince.J.Thommen@uth.tmc.edu
authors.forename: P J
authors.initials: PJ
authors.lastname: Thommen
authors.forename: R J
authors.initials: RJ
authors.lastname: Emery
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D006283:Health Physics / Q000706:statistics & numerical data*; D006801:Humans; D019221:Mandatory Reporting; D011785:Quality Assurance, Health Care / Q000379:methods*; D011832:Radiation Injuries / Q000453:epidemiology*; D011835:Radiation Protection / Q000379:methods; D018788:Radioactive Hazard Release / Q000706:statistics & numerical data*; D012042:Registries; D012308:Risk Management / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology