CPPA Seminal Articles

Latest Research and Publications


In this retrospective study reviewed unsolicited patient complaints (UPCs) associated with US otolaryngologists from 140 medical practices from 2014 to 2017. Five percent of otolaryngologists were associated with 23% of all UPCs. Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention (P= .049). Twenty otolaryngologists (69%) categorized as "responders" reduced the number of complaints an average of 45% in the first 2 years following intervention. Read the full study or listen to the podcast.

In this video, William O. Cooper, M.D., M.P.H. explains how patients whose surgeons had a history of higher numbers of patient complaints had an increased risk of surgical and medical complications, according to a study published by JAMA Surgery. 

In collaborations with 144 U.S. hospitals, healthcare systems and medical groups, we performed a nested case-control study using PARS data of 33,814 physicians. This study, published in The American Journal of Geriatric Psychiatry, examined words contained in unsolicited patient complaints and their alignment with physicians who may have cognitive impairment disorders. The findings in Unsolicited Patient Complaints Identify Physicians with Evidence of Neurocognitive Disorders suggest a methodology for determining which physicians might warrant additional assessments without imposing testing burdens on all older physicians.

Unprofessional behavior threatens patient and coworker safety. Measuring unprofessional behavior can be challenging. The Vanderbilt University Medical Center (VUMC) Center for Patient and Professional Advocacy’s (CPPA) has created a Co-Worker Observation Reporting System (CORS) that allows organizations to monitor and provide meaningful feedback to the small proportion of healthcare providers whose colleagues report concerns about unsafe or unkind conduct. CORS gives such professionals an opportunity to self-reflect and modify behavior. In CPPA’s recent study of CORS reports, we developed and tested the reliability and validity of a novel taxonomy for coding co-workers' narrative reports of colleagues’ unprofessional behavior. The CORS process enhances organizations’ ability to provide medical professionals actionable, peer-comparative feedback and indicates areas where safer, kinder, more reliable healthcare may be promoted and enhanced. This topic has started important conversations in the healthcare community, including the Agency for Healthcare Research and Quality Highlights. Read more about this follow up study on professionalism in the workplace and coworker observations.


Representing a collaboration between Vanderbilt’s CPPA, Ophthalmology and Biostatistics departments, and MPH program, the study found that older ophthalmologists were less likely than younger colleagues to be associated with patient complaints. Our findings reinforce the importance of patients’ observations, which can provide actionable information for individual physicians and leaders committed to providing high quality care. Furthermore, complaints may signal a need for physical, mental and/or skills assessments, especially for older physicians who previously had few or no complaints, but then manifest rapid increases.

In October 2017, leading healthcare professionals from academic medical centers, regional health systems, and rural communities came together to discuss and develop the best practices for addressing the professional who does not respond to guided interventions. Using an interactive approach including simulated cases and graphic recordings, the roundtable produced tools and resources to support authority figures as they consider their critical role in professional accountability. See some of the amazing graphic recordings from the research roundtable. 

The Cognitive Institute is now offering courses in the Promoting Professional Accountability Program in partnership with Vanderbilt CPPA as part of their Speak Up for Safety initiative. The full article by Dr. Lynne McKinlay in the Royal Australasian College of Medical Administrators Quarterly, Now is the Time, explores the role of human error in patient safety and how understanding and addressing unprofessional behavior can impact safety at every level.

Six years of PARS interventions at Sanford Health is now published on the AHRQ website. Advances in Patient Safety and Medical Liability looks t the planning, implementation and positive return on investment.


View our research Publications on PubMed Here

Center for Patient and Professional Advocacy
Vanderbilt University Medical Center

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