1
|
Ammentorp J, Chiswell M, Martin P. Translating knowledge into practice for communication skills training for health care professionals. PATIENT EDUCATION AND COUNSELING 2022; 105:3334-3338. [PMID: 35953393 DOI: 10.1016/j.pec.2022.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/21/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Despite the evidence that person-centred communication underpins all that we do in our interactions with patients, caregivers and team members, the knowledge about the implementation of systematic communication skills training is still in its infancy. This position paper describes some of the main contextual facilitators for translating knowledge about communication skills training for health care professionals (HCP) and recommends ways to guide practical implementation. Based on the literature that has been published over the last two decades, it seems evident that communication skills training programs should be underpinned by clinician self-reflection, be experiential, and focused on behaviour change and implementation of new skills into practice. The programs should be delivered by trainers possessing an understanding of communication micro skills, the skills and confidence to observe interactions, and coach learners through the rehearsal of alternative approaches. Communication skills programs should be flexible to adapt to individual learners, local needs, and circumstances. Interventions should not be limited to the empowerment of individual HCP but should be a part of the organisational quality assurance framework, e.g., by including communication skills in clinical audits. Implementation science frameworks may provide tools to align programs to the context and to address the determinants important for a sustained implementation process. Programs need to be embedded as 'core business', otherwise the culture change will be elusive and sustainability under threat if they are only dependent on provisional funding.
Collapse
Affiliation(s)
- Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Organisational Change in Person-Centred Healthcare, School of Medicine, Deakin University, Geelong, Australia.
| | - Meg Chiswell
- Centre for Organisational Change in Person-Centred Healthcare, School of Medicine, Deakin University, Geelong, Australia
| | - Peter Martin
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Organisational Change in Person-Centred Healthcare, School of Medicine, Deakin University, Geelong, Australia
| |
Collapse
|
2
|
Ronald AA, Sadda V, Rabah NM, Steinmetz MP. Patient complaints in the postoperative period following spine surgery. J Neurosurg Spine 2021:1-8. [PMID: 34653968 DOI: 10.3171/2021.6.spine21637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patient complaints are associated with a number of surgical and medical outcomes. Despite high rates of patient complaints regarding spine surgeons and efforts to study patient complaints across medicine and surgery, few studies have analyzed the complaints of patients undergoing spinal surgery. The authors present a retrospective analysis that, to their knowledge, is the first study to directly investigate the complaints of spine surgery patients in the postoperative period. METHODS Institutional records were reviewed over a 5-year period (2015-2019) to identify patients who underwent spine surgery and submitted a complaint to the institution's ombudsman's office within 1 year of their surgery. A control group, comprising patients who underwent spine surgery without filing a complaint, was matched to the group that filed complaints by admission diagnosis and procedure codes through propensity score matching. Patient demographic and clinical data were obtained by medical record review and compared between the two groups. Patient complaints were reviewed and categorized using a previously established taxonomy. RESULTS A total of 52 patients were identified who submitted a complaint after their spine surgery. There were 56 total complaints identified (4 patients submitted 2 each) that reported on 82 specific issues. Patient complaints were most often related to the quality of care received and communication breakdown between the healthcare team and the patient. Patients who submitted complaints were more likely to be Black or African American, have worse baseline health status, and have had prior spine surgery. After their surgery, these patients were also more likely to have longer hospital stays, experience postoperative complications, and require reoperation. CONCLUSIONS Complaints were most often related to the quality of care received and communication breakdown. A number of patient-level demographic and clinical characteristics were associated with an increased likelihood of a complaint being filed after spine surgery, and patients who filed complaints were more likely to experience postoperative complications. Improving communication with patients could play a key role in working to address and reduce postoperative complaints. Further study is needed to better understand patient complaints after spine surgery and investigate ways to optimize the care of patients with risks for postoperative complaints.
Collapse
Affiliation(s)
- Andrew A Ronald
- 1Case Western Reserve University School of Medicine, Cleveland; and.,2Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Vineeth Sadda
- 1Case Western Reserve University School of Medicine, Cleveland; and.,2Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Nicholas M Rabah
- 1Case Western Reserve University School of Medicine, Cleveland; and.,2Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio
| | | |
Collapse
|
3
|
van Dael J, Reader TW, Gillespie A, Neves AL, Darzi A, Mayer EK. Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights. BMJ Qual Saf 2020; 29:684-695. [PMID: 32019824 PMCID: PMC7398301 DOI: 10.1136/bmjqs-2019-009704] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 12/24/2019] [Accepted: 12/26/2019] [Indexed: 11/19/2022]
Abstract
Introduction A global rise in patient complaints has been accompanied by growing research to effectively analyse complaints for safer, more patient-centric care. Most patients and families complain to improve the quality of healthcare, yet progress has been complicated by a system primarily designed for case-by-case complaint handling. Aim To understand how to effectively integrate patient-centric complaint handling with quality monitoring and improvement. Method Literature screening and patient codesign shaped the review’s aim in the first stage of this three-stage review. Ten sources were searched including academic databases and policy archives. In the second stage, 13 front-line experts were interviewed to develop initial practice-based programme theory. In the third stage, evidence identified in the first stage was appraised based on rigour and relevance, and selected to refine programme theory focusing on what works, why and under what circumstances. Results A total of 74 academic and 10 policy sources were included. The review identified 12 mechanisms to achieve: patient-centric complaint handling and system-wide quality improvement. The complaint handling pathway includes (1) access of information; (2) collaboration with support and advocacy services; (3) staff attitude and signposting; (4) bespoke responding; and (5) public accountability. The improvement pathway includes (6) a reliable coding taxonomy; (7) standardised training and guidelines; (8) a centralised informatics system; (9) appropriate data sampling; (10) mixed-methods spotlight analysis; (11) board priorities and leadership; and (12) just culture. Discussion If healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this.
Collapse
Affiliation(s)
- Jackie van Dael
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Tom W Reader
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK
| | - Alex Gillespie
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK
| | - Ana Luisa Neves
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Ara Darzi
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Erik K Mayer
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
| |
Collapse
|
4
|
Kain NA, Hodwitz K, Yen W, Ashworth N. Experiential knowledge of risk and support factors for physician performance in Canada: a qualitative study. BMJ Open 2019; 9:e023511. [PMID: 30798305 PMCID: PMC6398643 DOI: 10.1136/bmjopen-2018-023511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 01/13/2019] [Accepted: 01/29/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To identify, understand and explain potential risk and protective factors that may influence individual and physician group performance, by accessing the experiential knowledge of physician-assessors at three medical regulatory authorities (MRAs) in Canada. DESIGN Qualitative analysis of physician-assessors' interview transcripts. Telephone or in-person interviews were audio-recorded on consent, and transcribed verbatim. Interview questions related to four topics: Definition/discussion of what makes a 'high-quality physician;' factors for individual physician performance; factors for group physician performance; and recommendations on how to support high-quality medical practice. A grounded-theory approach was used to analyse the data. SETTING Three provinces (Alberta, Manitoba, Ontario) in Canada. PARTICIPANTS Twenty-three (11 female, 12 male) physician-assessors from three MRAs in Canada (the College of Physicians & Surgeons of Alberta, the College of Physicians and Surgeons of Manitoba and the College of Physicians and Surgeons of Ontario). RESULTS Participants outlined various protective factors for individual physician performance, including: being engaged in continuous quality improvement; having a support network of colleagues; working in a defined scope of practice; maintaining engagement in medicine; receiving regular feedback; and maintaining work-life balance. Individual risk factors included being money-oriented; having a high-volume practice; and practising in isolation. Group protective factors incorporated having regular communication among the group; effective collaboration; a shared philosophy of care; a diversity of physician perspectives; and appropriate practice management procedures. Group risk factors included: a lack of or ineffective communication/collaboration among the group; a group that doesn't empower change; or having one disruptive or 'risky' physician in the group. CONCLUSIONS This is the first qualitative inquiry to explore the experiential knowledge of physician-assessors related to physician performance. By understanding the risk and support factors for both individual physicians and groups, MRAs will be better-equipped to tailor physician assessments and limited resources to support competence and enhance physician performance.
Collapse
Affiliation(s)
- Nicole Allison Kain
- Continuing Competence, College of Physicians and Surgeons of Alberta, Edmonton, Alberta, Canada
- Medicine, Univeristy of Alberta, Edmonton, Alberta, Canada
| | - Kathryn Hodwitz
- College of Physicians and Surgeons of Ontario, Toronto, Ontario, Canada
| | - Wendy Yen
- College of Physicians and Surgeons of Ontario, Toronto, Ontario, Canada
| | - Nigel Ashworth
- Continuing Competence, College of Physicians and Surgeons of Alberta, Edmonton, Alberta, Canada
- Medicine, Univeristy of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
5
|
Skär L, Söderberg S. Patients' complaints regarding healthcare encounters and communication. Nurs Open 2018; 5:224-232. [PMID: 29599998 PMCID: PMC5867282 DOI: 10.1002/nop2.132] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/25/2018] [Indexed: 11/05/2022] Open
Abstract
Aim To explore patient-reported complaints regarding communication and healthcare encounters and how these were responded to by healthcare professionals. Design A retrospective and descriptive design was used in a County Council in northern part of Sweden. Both quantitative and qualitative methods were used. Methods The content of 587 patient-reported complaints was included in the study. Descriptive statistical analysis and a deductive content analysis were used to investigate the content in the patient-reported complaints. Results The results show that patients' dissatisfaction with encounters and communication concerned all departments in the healthcare organization. Patients were most dissatisfied when they were not met in a professional manner. There were differences between genders, where women reported more complaints regarding their dissatisfaction with encounters and communication compared with men. Many of the answers on the patient-reported complaints lack a personal apology and some of the patients failed to receive an answer to their complaints.
Collapse
Affiliation(s)
- Lisa Skär
- Department of Health Blekinge Institute of Technology Karlskrona Sweden
| | - Siv Söderberg
- Department of Nursing Sciences Mid Sweden University Östersund Sweden
| |
Collapse
|
6
|
Peprah P, Mawuli Abalo E, Nyonyo J, Okwei R, Agyemang-Duah W, Amankwaa G. Pregnant women’s perception and attitudes toward modern and traditional midwives and the perceptional impact on health seeking behaviour and status in rural Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: 10.1016/j.ijans.2018.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
7
|
Kemp K, Warren S, Chan N, McCormack B, Santana M, Quan H. Qualitative complaints and their relation to overall hospital rating using an H-CAHPS-derived instrument. BMJ Qual Saf 2015; 25:770-7. [DOI: 10.1136/bmjqs-2015-004371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 10/05/2015] [Indexed: 11/03/2022]
|
8
|
Andrissi L, Petraglia F, Giuliani A, Severi FM, Angioni S, Valensise H, Vannuccini S, Comoretto N, Tambone V. The influence of doctor-patient and midwife-patient relationship in quality care perception of italian pregnant women: an exploratory study. PLoS One 2015; 10:e0124353. [PMID: 25905494 PMCID: PMC4408047 DOI: 10.1371/journal.pone.0124353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/02/2015] [Indexed: 11/18/2022] Open
Abstract
Background The study focuses on the perceived nature / technique opposition in pregnancy and delivery emerging from gynaecologist/ midwife/ pregnant woman relationships. We developed a cross-sectional survey to identify, by means of a multidimensional data-driven approach, the main latent concepts structuring the between items correlation correspondent to the different general opinions present in the data set. The obtained results can set the basis to improve patient satisfaction while decreasing healthcare costs. Methods The sample is made of 90 pregnant women within 24-48 hours after natural or operative birth, from three maternity units in Italy. Women filled in a questionnaire about their relationship with gynaecologist and midwife during pregnancy and hospital stay for delivery. Results Participation rate approached 100%. The emerging factorial structure gave a proof-of-concept of the hypothesis of ‘nature vs. technique’ as the main dimension shaping women opinions. The results highlighted the role of midwife as the ‘link’ between the natural and technical dimension of birth. The quality of welcome and the establishing of an empathic relation between mother and healthcare professional was shown to decrease further request of care in the post-partum period. Conclusions The “fault plane” between nature and technique is a very critical zone for litigation. Women are particularly sensitive to the consideration and attention they receive at their admission in the hospital, as well as to the quality of human relationship with midwife. The perceived quality of welcome scaled with a decreased need of additional care and, more in general, with a more faithful attitude towards health professionals. We hypothesize that increasing the quality of welcome can exert an effect on both welfare costs and litigation. This opens the way (through an extension of this pilot study to wider populations) to relevant ameliorative actions on quality of care at practically null cost.
Collapse
Affiliation(s)
- Laura Andrissi
- Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy
| | - Felice Petraglia
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Alessandro Giuliani
- Environment and Health Dept. Istituto Superiore di Sanità, Rome, Italy
- * E-mail:
| | - Filiberto Maria Severi
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Stefano Angioni
- Division of Gynaecology, Obstetrics and Pathophysiology of Human Reproduction, Department of Surgery, Maternal-Fetal Medicine and Imaging, University of Cagliari, Cagliari, Italy
| | - Herbert Valensise
- Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy
| | - Silvia Vannuccini
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Nunziata Comoretto
- Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy
| | - Vittoradolfo Tambone
- Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy
| |
Collapse
|
9
|
Allan HT, Odelius AC, Hunter BJ, Bryan K, Knibb W, Shawe J, Gallagher A. Supporting staff to respond effectively to informal complaints: findings from an action research study. J Clin Nurs 2015; 24:2106-14. [PMID: 25661674 DOI: 10.1111/jocn.12770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2014] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVE To understand how nurses and midwives manage informal complaints at ward level. BACKGROUND The provision of high quality, compassionate clinical nursing and midwifery is a global priority. Complaints management systems have been established within the National Health Service in the UK to improve patient experience yet little is known about effective responses to informal complaints in clinical practice by nurses and midwives. DESIGN Collaborative action research. METHODS Four phases of data collection and analysis relating to primarily one National Health Service trust during 2011-2014 including: scoping of complaints data, interviews with five service users and six key stakeholders and eight reflective discussion groups with six midwives over a period of nine months, two sessions of communications training with separate groups of midwives and one focus group with four nurses in the collaborating trust. RESULTS Three key themes emerged from these data: multiple and domino complaints; ward staff need support; and unclear complaints systems. CONCLUSIONS Current research does not capture the complexities of complaints and the nursing and midwifery response to informal complaints. RELEVANCE TO CLINICAL PRACTICE Robust systems are required to support clinical staff to improve their response to informal complaints and thereby improve the patient experience.
Collapse
Affiliation(s)
| | | | | | | | | | - Jill Shawe
- University of Surrey, Guildford, Surrey, UK
| | | |
Collapse
|
10
|
Önal G, Civaner MM. For what reasons do patients file a complaint? A retrospective study on patient rights units' registries. Balkan Med J 2015; 32:17-22. [PMID: 25759767 DOI: 10.5152/balkanmedj.2015.15433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 08/04/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In 2004, Patient Rights Units were established in all public hospitals in Turkey to allow patients to voice their complaints about services. AIMS To determine what violations are reflected into the complaint mechanism, the pattern over time, and patients' expectations of the services. STUDY DESIGN Descriptive study. METHODS A retrospective study performed using the complaint database of the Istanbul Health Directorate, from 2005 to 2011. RESULTS The results indicate that people who are older than 40 years, women, and those with less than high school education are the most common patients in these units. A total of 218,186 complaints were filed. Each year, the number of complaints increased compared to the previous year, and nearly half of the applications were made in 2010 and 2011 (48.9%). The three most frequent complaints were "not benefiting from services in general" (35.4%), "not being treated in a respectable manner and in comfortable conditions" (17.8%), and "not being properly informed" (13.5%). Two-thirds of the overall applications were found in favour of the patients (63.3%), and but this rate has decreased over the years. CONCLUSION Patients would like to be treated in a manner that respects their human dignity. Educating healthcare workers on communication skills might be a useful initiative. More importantly, health policies and the organisation of services should prioritise patient rights. It is only then would be possible to exercise patient rights in reality.
Collapse
Affiliation(s)
- Gülsüm Önal
- Clinical Research Ethics Committee, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - M Murat Civaner
- Department of Medical Ethics, Uludağ University Faculty of Medicine, Bursa, Turkey
| |
Collapse
|
11
|
Reader TW, Gillespie A, Roberts J. Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf 2014; 23:678-89. [PMID: 24876289 PMCID: PMC4112446 DOI: 10.1136/bmjqs-2013-002437] [Citation(s) in RCA: 205] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background Patient complaints have been identified as a valuable resource for monitoring and improving patient safety. This article critically reviews the literature on patient complaints, and synthesises the research findings to develop a coding taxonomy for analysing patient complaints. Methods The PubMed, Science Direct and Medline databases were systematically investigated to identify patient complaint research studies. Publications were included if they reported primary quantitative data on the content of patient-initiated complaints. Data were extracted and synthesised on (1) basic study characteristics; (2) methodological details; and (3) the issues patients complained about. Results 59 studies, reporting 88 069 patient complaints, were included. Patient complaint coding methodologies varied considerably (eg, in attributing single or multiple causes to complaints). In total, 113 551 issues were found to underlie the patient complaints. These were analysed using 205 different analytical codes which when combined represented 29 subcategories of complaint issue. The most common issues complained about were ‘treatment’ (15.6%) and ‘communication’ (13.7%). To develop a patient complaint coding taxonomy, the subcategories were thematically grouped into seven categories, and then three conceptually distinct domains. The first domain related to complaints on the safety and quality of clinical care (representing 33.7% of complaint issues), the second to the management of healthcare organisations (35.1%) and the third to problems in healthcare staff–patient relationships (29.1%). Conclusions Rigorous analyses of patient complaints will help to identify problems in patient safety. To achieve this, it is necessary to standardise how patient complaints are analysed and interpreted. Through synthesising data from 59 patient complaint studies, we propose a coding taxonomy for supporting future research and practice in the analysis of patient complaint data.
Collapse
Affiliation(s)
- Tom W Reader
- Department of Social Psychology, London School of Economics, London, UK
| | - Alex Gillespie
- Department of Social Psychology, London School of Economics, London, UK
| | - Jane Roberts
- Department of Social Psychology, London School of Economics, London, UK
| |
Collapse
|
12
|
Abstract
Different countries have different complaints handling systems. This study reveals general pathways to handling complaints that provide an overview at the case hospital as well as a general complaints handling picture in Taiwan. It explores hospital complaints and how hospital staff handle them. A large teaching hospital in Taiwan was purposefully chosen as a case study. Data were collected through in-depth interviews, document analysis and interrogating a 3-year complaints archive. The study found that dissatisfaction with 'humaneness' and 'care/treatment' commonly causes the case hospital patients to complain. Understanding complaint patterns, therefore, can help hospital managers improve organizational performance, which shows that certain service provision needs to be prioritized if hospital staff intend to improve service quality.
Collapse
Affiliation(s)
- Sophie Yahui Hsieh
- Department of Healthcare Information and Management, Ming-Chuan University, Taoyuan, Taiwan.
| |
Collapse
|
13
|
Friele RD, Kruikemeier S, Rademakers JJDJM, Coppen R. Comparing the outcome of two different procedures to handle complaints from a patient's perspective. J Forensic Leg Med 2012; 20:290-5. [PMID: 23622476 DOI: 10.1016/j.jflm.2012.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 09/12/2012] [Accepted: 11/04/2012] [Indexed: 11/19/2022]
Abstract
AIM OF THE STUDY To assess differences in patient satisfaction between a complaints procedure designed towards the needs of complainants (referred to here as the 'Committee') and a procedure that primarily aims at improving the professional quality of health care (referred to here as the 'Board'). METHOD Patients' experiences and satisfaction were assessed through a questionnaire completed by 80 patients complaining to a Board and 335 to a complaints Committee. Only complainants with a complaint that was judged to be founded or partially founded were included. RESULTS Only half of the complainants reported being satisfied with the procedure they underwent. After controlling for differences in respondent characteristics, satisfaction with the Board was higher than with the Committee. The level of variance explained, however, was low (3%). The majority of respondents reported favourably on procedural aspects, for example, the impartiality of the procedure, and empathy demonstrated for their situation. Only a minority of complainants in both procedures believed that changes would be made as a result of their complaint. DISCUSSION The absence, in the eyes of most complainants, of tangible results of filing a complaint in both rather formal procedures may serve as an explanation for both the low level of overall satisfaction and the fact that the procedure which was developed specifically for patients did not perform better. To resolve the problem of low satisfaction with complaints handling, procedures should be developed that offer a basic degree of procedural safety. But this procedural safety should not stand in the way of what complainants really want: changes for the better.
Collapse
Affiliation(s)
- Roland D Friele
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
| | | | | | | |
Collapse
|
14
|
Veneau L, Chariot P. How do hospitals handle patients complaints? An overview from the Paris area. J Forensic Leg Med 2012; 20:242-7. [PMID: 23622468 DOI: 10.1016/j.jflm.2012.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 06/19/2012] [Accepted: 09/07/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND The incidence of complaints about health care has been rising. Reviewing the reasons why patients complain and how hospital staff respond to them can participate in an evaluation of quality in health care. There is a dearth of published information on complaints handling. METHODS In order to analyse complaints handling, we surveyed complaints referred to hospital managers in two French hospitals over one year: characteristics of complaints and characteristics of responses made to complainants. We used a scale for 10 criteria evaluating the responses to complaints. RESULTS A total of 115 complaints were analysed. Complaints mainly concerned the communication, the quality of medical care, waiting delays, and inadequate bills. Consequences of dissatisfaction included loss of confidence and refusal to pay the bill. Complainants wanted an explanation, their bill to be reduced, or something to change after the complaint. Most complainants wrote to the hospital manager. Hospital managers answered, using medical information as a basis for their responses. Median response time was 23 days. Interobserver agreement on evaluation criteria was almost perfect, substantial or moderate for 8 of 10 criteria. Major weaknesses of the responses were their lack of comprehensiveness (52%), the absence of intention to investigate (50%) and to act (77%), and of practical support (51%). The response of hospital managers misinterpreted the medical information given by the physician concerned in 5 (11%) of 45 cases. CONCLUSION We suggest that quality of complaints handling should be improved, possibly through the systematic reception of complainants by a physician not involved in the patient's care.
Collapse
Affiliation(s)
- Laurence Veneau
- Unit of Forensic Medicine, Hôpital Emmanuel-Rain, 95500 Gonesse, France
| | | |
Collapse
|
15
|
Mann CD, Howes JA, Buchanan A, Bowrey DJ. One-year audit of complaints made against a University Hospital Surgical Department. ANZ J Surg 2012; 82:671-4. [PMID: 22946902 DOI: 10.1111/j.1445-2197.2012.06240.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is relatively little in the medical literature relating to complaints about the healthcare process. The aim of this study was to report the frequency and content of patient complaints against a University Hospital Surgical Department. In particular, the study aimed to relate the number of complaints to the number of health-care episodes and to determine the frequency of patient safety incidents and subsequent medico-legal action. METHODS Retrospective interrogation of a prospectively maintained Complaints Department database at a University Hospital for the calendar year 2009. RESULTS Complaints relating to 360 aspects of the health-care journey in 113 patients were made. This translated into one complaint per 400 health-care episodes. Concerns about clinical care were cited in 31%, delays in the health-care process in 30%, communication issues in 19%, the institutional environment in 8% and poor discharge planning in 6%. Overall, 16 complaints (4%) were raised as patient safety incidents. Eighty-three per cent of complaints were addressed by a telephone conversation or a single letter response, 13% by a face-to-face meeting. Two per cent resulted in subsequent medico-legal action. CONCLUSIONS Although perceived in a negative way by health-care professionals, only 1 in 400 health-care episodes resulted in a complaint. Only a small number related to patient safety incidents or resulted in medico-legal instructions. Attention should focus on developing effective strategies to improve patient satisfaction with all aspects of the patient journey.
Collapse
Affiliation(s)
- Chris D Mann
- Department of Surgery, Leicester Royal Infirmary, Leicester, UK
| | | | | | | |
Collapse
|
16
|
Abstract
This study aims to explore how hospital organizations can use complaints to drive quality improvement. A teaching hospital in Taiwan was purposefully selected as a case study. Data were collected from a variety of sources, including interview with key managers and social workers, questionnaire survey of managers (n = 53), interview with government organizations (n = 4) and nongovernment organizations (n = 3), document collection and review, and the Critical Incident Technique using a questionnaire and nonparticipant observation (n = 59). This study revealed that the case hospital attempted to resolve complaints on a case-by-case basis. But it did not act on these complaints as a collective group to identify systemic problems and deficiencies. This approach provides single-loop learning, which may be sufficient to handle the problem on hand but is not enough to prevent such problems occurring again in the future. This study suggests some implications in regard to a best practice system for using complaints to improve quality.
Collapse
|
17
|
Investigating Patient Wait Times for Daily Outpatient Radiotherapy Appointments (A Single-Centre Study). J Med Imaging Radiat Sci 2010; 41:145-151. [DOI: 10.1016/j.jmir.2010.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 06/01/2010] [Accepted: 06/10/2010] [Indexed: 11/19/2022]
|