Investigating complaints to improve practice and develop policy

Parry, Julianne; Hewage, Udul

doi:10.1108/09526860910995001

Cited by 15 publications

(17 citation statements)

References 10 publications

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“…The rich, unstructured narrative within complaints complicates reliable and meaningful extraction of quality and safety insights 16. Various coding taxonomies have been developed to support complaints teams and researchers in codifying complaints reliably 7 9 11 55 65 68–78. To achieve reliable aggregated analysis, the taxonomy should fulfil the following minimum criteria: the categories in the framework are collectively exhaustive, mutually exclusive and reflect patient voice as reported in complaints (ie, validity) 11 79 80.…”

Section: Resultsmentioning

confidence: 99%

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

et al. 2020

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IntroductionA 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.AimTo understand how to effectively integrate patient-centric complaint handling with quality monitoring and improvement.MethodLiterature 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.ResultsA 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.DiscussionIf 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.

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Section: Resultsmentioning

confidence: 99%

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

et al. 2020

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“…The information obtained from analysing such complaints is an important part of quality assurance and quality improvement for health‐care service delivery. There is surprisingly little data in the literature relating to patient complaints against medical care . To the authors' knowledge, this is the only study in the literature to specifically analyse complaints made against a surgical department in the UK.…”

Section: Discussionmentioning

confidence: 97%

“…A patient safety incident is defined by the National Patient Safety Agency (NPSA) as any unintended or unexpected incident that could have or did lead to harm for one or more patients receiving National Health Service (NHS) care and is a standard process within the NHS framework. A third surrogate marker of health‐care quality is a record of complaints against both individuals, departments and organizations . Complaints have an immediacy about them, in that feedback is rapid and has very much a ‘local’ dimension to it, although it may be difficult to make comparisons between centres.…”

Section: Introductionmentioning

confidence: 99%

One‐year audit of complaints made against a University Hospital Surgical Department

Mann

Howes

Buchanan

et al. 2012

ANZ Journal of Surgery

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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.

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“…Analysis of patient complaints can help healthcare organizations detect trends in patient safety concerns informing the implementation of evidence-based improvement interventions. 1–5 Similarly, trends in patient concerns can assist in the identification of systematic problems in health care delivery that may not be detected when addressing individual concerns. 6 There are also associations between patient concerns and rates of malpractice suits.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Review of Physician-related Patient Complaints from a Tertiary Pediatric Hospital

Chaulk

Krueger

Stang

2019

Pediatric Quality &Amp; Safety

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Background:Trends in patient concerns can identify systematic problems in health care delivery that may not be detected when addressing individual concerns. It can be difficult identifying trends without using a standardized taxonomy. The study objectives were to describe patient complaints from a tertiary care pediatric hospital and categorize them using a standardized complaint taxonomy.Methods:Physician-based patient complaints were compiled from April 2011 to May 2014 from a tertiary pediatric hospital. These complaints were coded independently by 2 reviewers using the Reader taxonomy, a published standardized taxonomy. Complaints were placed into 3 domains: clinical, management, and relationships then organized into categories. Inter-rater reliability for domain classification between the 2 reviewers was calculated using Cohen’s unweighted κ.Results:Eighty-seven patient complaints were identified, representing approximately 1 per 10,000 physician–patient encounters. Half (48/87) were related to care in the emergency department. When adjusted for volume, pediatric hospital medicine had the highest number of complaints, with 12.1 per 10,000 encounters. The majority of patient complaints, 66% (57/87), were of the clinical domain (κ = 0.61). Sixty percent (52/87) were in the relationship domain (κ = 0.68), and 16% (14/87) were in the management domain (κ = 0.65).Conclusions:We found a low overall complaint rate. Our results indicate that interventions to improve patient experience should initially be targeted at emergency and hospital medicine on the clinical and relationship domains. The inter-rater reliability of the Reader taxonomy was moderate with implications for processing patient complaints at a hospital level.

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Investigating complaints to improve practice and develop policy

Abstract: The paper contributes to research that makes use of patient complaints to produce higher standards of patient service delivery.

Cited by 15 publications

References 10 publications

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

One‐year audit of complaints made against a University Hospital Surgical Department

A Retrospective Review of Physician-related Patient Complaints from a Tertiary Pediatric Hospital

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