Why do patients complain?
- The healthcare provider did not meet the patient’s expectations with respect to medical care.
- The staff treated the patient poorly and/or without compassion.
- The staff didn’t notify the physician or administration of a patient’s concern/issue.
- The patient was discharged too soon or without comprehensive evaluation.
How to keep a complaint from becoming a more serious grievance.Minor complaints need to be addressed promptly. More serious complaints may even require a written response and personal 1-on-1 involvement by administration. Complaints that don’t get addressed – even minor ones – often grow into a much large grievance. Thus, it’s important to take EVERY complaint seriously. Also, never assume a complaint is groundless and be sure to give some type of empathetic and prompt response.
Best Practices for Patient Complaint Management
- Easy place to submit complaints: Patients should have an easy mechanism for submitting a complaint. Select a place that can be easily found and accessible. Making the submission easy often reduces a patient’s frustration right off-the-bat and communicates your good intentions.
- Prioritize serious complaints: Address all complaints regardless of severity, but the more serious issues need to be addressed as soon as possible.
- Keep records: Log complaints and track the status for proper record-keeping and analysis. Create different categories and status codes to make reporting easier to analyze and review.
- Assign responsibility: Each complaint should be assigned to one person for handling and then forwarded to another level of authority for supervision.
- Acknowledgement of Complaints and Defining of Responsibility: Complaints are always acknowledged by talking to the customer on phone or in person. In some cases formal letters are also issued to acknowledge complaints.
- Investigation and Analysis of Complaints: Fairness in analysis of the complaint is demonstrable and documented. Records of all meetings, conversations and findings are maintained in the complaints file.
- Resolution Consistent with Company Policy: The complaint is forwarded to the appropriate level of authority for resolution and the consumer is kept informed about progress reports. A notification of the proposed settlement is sent to the consumer promptly.
- Follow-up with the Customer: If the consumer is not satisfied with the resolution, the problem is addressed again. The complaint is referred to a third-party dispute-resolution mechanism, if necessary.
- Analysis and Summary of Complaints: Complaints statistics and action proposals are circulated to appropriate departments and an action plan for complaints prevention is developed and implemented.
SummarySome of the major drivers of complaints management are:
- Regulatory Compliance
- Customer Litigation