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Investigation reports

You can read about some of the investigations that have been undertaken by the Health Ombudsman. In accordance with the law, all names and identifying factors of those involved have been removed.


Investigation report – Undoing the knots constraining medicine regulation in Queensland

This report details the investigation undertaken by the Health Ombudsman into the appropriateness and effectiveness of the Queensland regulatory system for scheduled medicines as it applies to health services, in particular the prescribing and dispensing of schedule 8 medicines. The investigation commenced after a number of complaints displaying common trends were received by the Office of the Health Ombudsman relating to prescribing and dispensing of scheduled medicines.

Download the report


Investigation report Gold Coast Hospital and Health Service radiology services October 2016

This report details the investigation undertaken by the Health Ombudsman into the low reporting of radiology services at the Gold Coast Hospital and Health Service (HHS). The investigation commenced as an own-motion investigation as a result of the Health Ombudsman becoming aware of an investigation commissioned by the Department of Health Director-General following the discovery of a backlog of reporting of radiology results in the Gold Coast HHS due to a systemic failure.

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Investigation report Queensland Ambulance Service October 2016

This report details the investigation undertaken by the Health Ombudsman into the drug and complaint management protocols used by the Queensland Ambulance Service (QAS). The investigation commenced as a result of an invitation from the QAS to conduct a systemic investigation in order to review the steps taken by the QAS to address the areas of concern highlighted in a Department of Health internal audit of the QAS’s drug management practices and to advise on any future reporting that the QAS should undertake to satisfy the office that its procedures continue to ensure optimal patient safety.

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Investigation report summary Complaint about decision to grant credentialing privileges to a medical practitioner at a HHS October 2016

This report outlines the investigation conducted by the Health Ombudsman into a complaint about a Hospital and Health Service (HHS) concerning a decision to grant clinical privileges to a medical practitioner. Concerns were raised about the practitioner’s recency of practice and clinical experience.

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Investigation report Friendly Society Private Hospital October 2016

This report outlines the investigation conducted by the Health Ombudsman into the adequacy of systems in place at Friendly Society Private Hospital to ensure the appropriate administration of medication to patients, procedures for responding to adverse drug reactions and procedures for incident reporting.

Download the report


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