This study aims to investigate the nature and resolutions of patient complaints and further to explore the use of complaints to drive quality improvement in a selected hospital in Taiwan. A teaching hospital (i.e. the Case Hospital) in Taiwan was purposefully chosen for a case study. The author conducted the critical incident technique (CIT) using questionnaires to obtain information about the complaints and the process of their resolutions. To enhance the reliability of the study, the author also conducted non-participant observations as an outsider at the Case Hospital. In this study, 59 complainants registered 87 complaints. The CIT found that care/treatment, humaneness and communication were the most common causes of complaints. The response time of patient complaints averaged 1.76 days, except for five cases in which response time was not reported. The majority of complaints were resolved within three days. Moreover, this study found that of 149 resolutions, 105 taken by the hospital involved an explanation of the facts to complainants (n = 41), investigation of events (n = 33) and empathy with complainants (n = 31). The lack of any systematic use of complaints data was one of the most crucial failures of the Case Hospital. Instead of attempting to use such data as the basis for initiating quality improvement measures, complaints were consigned to a 'black hole' where their existence was conveniently forgotten. Based on this study, the author suggests ways to strengthen the capacity of the hospital in terms of using patient feedback and complaints to improve the quality.

This study aims to explore factors that might hamper the use of patient complaints to improve quality. A teaching hospital in Taiwan was purposefully chosen for a case study based on data triangulation. The study included in-depth interviews with hospital senior managers, senior social workers, government officials and non-government organizations staff; as well as analysis of documents. In the Case Hospital, the organizational responses to complaints appear to be influenced by the interaction between managerial factors, operational factors and technical factors. Externally, there were no national guidelines to regulate how the hospital handled complaints. This was bound to have a major influence on the response of the hospital to complaints. Internally, the hospital itself did not place great importance on complaints. The mindset of the hospital was that patient complaints are not welcome. If the hospital attempts to use patient complaints to improve its quality of care, senior hospital management needs to recognize the values of complaints handling and respond to these in a more constructive manner. Moreover, the government has to set up the protocols of using complaints to improve quality at the policy level. This legal incentive would encourage the hospital to handling complaints effectively.

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.

This paper explores the health care complaints handling reforms enacted in Britain, Australia and Taiwan. A documentary search for policy documents, reports and studies related to the reforms of the health care complaints handling system was conducted. A keyword search was performed within PubMed and ProQuest for the period 1985-2009 to identify relevant articles. The study found that the major difference in health care complaints handling systems between countries, is the mechanism for running a complaints system. Both Britain and Australia have attempted to incorporate patient complaints into their national quality systems. Their intention was to set up mechanisms to create an effective bridge, at a national policy level, between the patient complaints management system and the quality management system.

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.