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Article
Publication date: 2 October 2009

Julianne Parry and Udul Hewage

This paper aims to make use of patient complaints as a valuable source of information to enable improvements to the quality of health service delivery.

Abstract

Purpose

This paper aims to make use of patient complaints as a valuable source of information to enable improvements to the quality of health service delivery.

Design/methodology/approach

Thematic analysis was used to analyse records of de‐identified patient complaints made about medical or nursing staff or medical or nursing services between January 2006 and May 2008 in the Mount Isa Health Service District.

Findings

Three main themes were identified. These themes were labelled: “communication”, “wait times” and “clinical”. The latter related to specific concerns about the care provided to the patient or their relative. There were 101 complaints analysed. The majority (60 per cent) of complaints related to communication. Wait times for appointments (13 per cent), and clinical (28 per cent) were included in the remainder.

Research limitations/implications

The findings of this research are not generalisable beyond the Health Service District within which the data were collected. However, the principle of systematically using complaints information to improve practice and develop policy can be applied within all health services.

Practical implications

Recommendations to develop policies and improve practice that will address the matters identified in the complaints are made. Changes to complaints data records to assist future research are suggested. The need to facilitate indigenous patients' contribution to suggestions for service delivery improvement is highlighted.

Originality/value

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

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 7
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 24 January 2020

Pradeep Kumar

This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also…

Abstract

Purpose

This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.

Design/methodology/approach

This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.

Findings

In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.

Research limitations/implications

The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.

Originality/value

This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.

Details

Journal of Asia Business Studies, vol. 14 no. 2
Type: Research Article
ISSN: 1558-7894

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Article
Publication date: 1 June 2005

Sophie Y. Hsieh, David Thomas and Arie Rotem

To explore and evaluate how hospital staff respond to patient complaints.

Abstract

Purpose

To explore and evaluate how hospital staff respond to patient complaints.

Design/methodology/approach

A teaching hospital with 1,500 beds in Taiwan was purposefully chosen as a case study of hospital response to patientscomplaints. Data was obtained through interviews with quality surveying managers (n=53), government managers (n=4), staff of non‐government organizations (n=3) and a senior social worker, as well as analysis of documents (September 2001‐April 2002).

Findings

Using the managerial‐operational‐technical framework developed by the researchers, the study demonstrated problematic aspects of handling complaints at the case hospital. It was revealed that: complaint handlers were not sufficiently empowered, information sharing was limited within the organization, communication among professional staff and with management was inadequate, the physical safety of workers had been threatened, and improvements could not be sustained. Moreover, it became apparent that the case study hospital generally responded to patient complaints in a reactive and defensive manner.

Originality/value

It is evident that the hospital did not use patient complaints as a source of learning that could have promoted higher standards of care. The case study reveals some of the constraints and identifies requirements for appropriate use of information and feedback from patients. The study raises some issues requiring further research to ensure more appropriate use of patient complaints to improve quality of care.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 4 May 2010

Camilla Haw, Jeanette Collyer and Philip Sugarman

Little is known about complaints made by psychiatric patients. The aim of this study is to analyse complaints made by, or behalf of, inpatients at a large independent…

Abstract

Purpose

Little is known about complaints made by psychiatric patients. The aim of this study is to analyse complaints made by, or behalf of, inpatients at a large independent psychiatric hospital.

Design/methodology/approach

The hospital's complaints register was used to identify and study complaints made during 2006. A descriptive analysis was performed.

Findings

Of the 392 complaints, 39 per cent related to staff behaviour, 26 per cent to clinical matters, 18 per cent to the behaviour of other patients and the remaining 16 per cent to the physical environment and facilities. Action as a result of complaints was mainly taken at unit level but in 9 per cent of cases organisation‐wide improvements were made, for example to enrich patient treatment programmes, rectify staff shortages and improve the quality of meals.

Research limitations/implications

The study took place in a specialist hospital and so the findings cannot be generalised to the wider NHS. Important differences exist between complaints made in psychiatric as opposed to general hospital settings.

Practical implications

Complaints are a valuable source of organisational learning for mental health services.

Originality/value

Given the paucity of literature on complaints in psychiatry, this study describes some in detail the nature of patients' complaints and one organisation's actions to improve patient services as a result of these complaints.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 11 July 2016

Erik Masao Olsson

– The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care.

Abstract

Purpose

The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care.

Design/methodology/approach

Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients’ Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis.

Findings

Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient.

Research limitations/implications

Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed.

Practical implications

Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer’s value creating network, which may also include knowledge and skills from other sources, such as relatives.

Originality/value

Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides aggregated information on cancer patients’ and relatives’ complaints concerning interpersonal issues, which can increase knowledge about patient healthcare service perceptions.

Details

International Journal of Health Care Quality Assurance, vol. 29 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 8 October 2018

Sanna Pauliina Ryynänen and Risto Harisalo

The patient complaint is one of the main procedures of exercising patient’s rights in the Finnish health care system. Such complaints typically concern the quality of care…

Abstract

Purpose

The patient complaint is one of the main procedures of exercising patient’s rights in the Finnish health care system. Such complaints typically concern the quality of care and/or patient safety. The purpose of this paper is to examine the types of patient complaints received by a specialized medical care organization and the kinds of responses given by the organization’s personnel. The organization’s strategy and good governance principles provide the framework for understanding the organization’s action.

Design/methodology/approach

This study’s data comprise patient complaints and the responses from personnel of a specialized medical care organization from the start of 2012 to the end of January 2014. The data were analyzed through qualitative data analysis.

Findings

The results show many unwanted grievances, but also reveal the procedures employed to improve health care processes. The results are related to patients’ care experiences, provision of information, personnel’s professional skills and the approach to patient complaints handling. The integrative result of the analysis was to find consensus between the patients’ expectations and personnel’s evaluation of patients’ needs.

Originality/value

Few prior studies have examined patient complaints related to both strategy and good governance. Patient complaints were found to have several confluences with an organization’s strategic goals, objectives and good governance principles. The study recommends further research on personnel procedures for patient complaints handling, with a view to influencing strategic planning and implementation of strategies of organizations.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 8
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 23 March 2010

Sophie Yahui Hsieh

The purpose of this paper is to explore hospital staff response to patient complaints and the factors influencing the response pathway.

Abstract

Purpose

The purpose of this paper is to explore hospital staff response to patient complaints and the factors influencing the response pathway.

Design/methodology/approach

The paper uses an exploratory study in a large Taiwanese hospital purposefully chosen as a case study site. The critical incident technique (CIT) is implemented, using a questionnaire along with non‐participant observations in which the results have been triangulated. A total of 59 cases were collected.

Findings

The study found when facing “humaneness” complaints, hospital staff attempted to investigate the event and then explain the facts to the complainant or empathise with him/her and then refer the problem to the relevant unit. In response to complaints combining “communication” and “care/treatment and humaneness”, staff tended to investigate the event's details and then directly explain them to the complainant. When complaints involved “care/treatment”, staff tended to empathise with the complainant, investigate the facts and explain them to the complainant. Additionally, the organisational response to complaints was influenced by who made complaints; its type, severity, complaining method and patient status.

Research limitations/implications

The literature revealed that the case study is the most common organisational study method. However, this approach is criticised for not offering findings that can be generalised.

Practical implications

Complaint nature is the major factor influencing the response pathway. If healthcare managers intend to reduce complaint rates then they need to carefully classify the complaint's nature. Different complaints have different handling procedures and guidelines to help managers resolve complaints in the first place.

Originality/value

There are extensive studies focusing on investigating complaints and their resolution. These studies tend not to demonstrate various means of handling patient complaints. Neither do they describe how different complaints might lead to different outcomes. Therefore, this paper explores hospital staff response to patient complaints and the factors influencing the pathways in response to complaints.

Details

International Journal of Health Care Quality Assurance, vol. 23 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 20 April 2015

Nora Hiivala, Helena Mussalo-Rauhamaa and Heikki Murtomaa

The purpose of this paper is to: determine the prevalence and distribution of patient/family-generated, dentistry-related complaints to Regional State Administrative…

Abstract

Purpose

The purpose of this paper is to: determine the prevalence and distribution of patient/family-generated, dentistry-related complaints to Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland from 2000 to 2011, study patient/family safety incident experiences and other reasons for complaints, assess complaint validity and evaluate factors associated with disciplinary processes against dentists.

Design/methodology/approach

Data included closed cases handled by AVIs and Valvira (2000-2011) against dental practitioners or dental practice units (n=782). The authors analysed the complaints distribution and examined the antecedent factors and circumstances.

Findings

This study demonstrated that patients/families can detect many dental treatment hazards, substandard processes and even serious safety risks rather well. The investigation processes revealed some physical harm or potential patient safety (PS) risks in more than half the alleged cases. Many complaints accumulated against certain individuals and statistically significant positive correlations were found between some patient/family complaints, dentist-specific variables and disciplinary actions.

Practical implications

Patient/family-generated complaints must be taken seriously and seen as relatively good safety risk indicators. However, more knowledge on how patients might cooperate with dental care providers to prevent errors is needed.

Originality/value

This work provides a unique opportunity to learn from several dentistry-related patient complaints. Despite some limitations, patient complaints appear to be useful as a complementary source together with other PS study methods.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 12 October 2015

Paul Goldsmith, Jackie Moon, Paul Anderson, Steve Kirkup, Susan Williams and Margaret Gray

Error reporting by healthcare staff, patient-derived complaints and patient-derived medico-legal claims are three separate processes present in most healthcare systems. It…

Abstract

Purpose

Error reporting by healthcare staff, patient-derived complaints and patient-derived medico-legal claims are three separate processes present in most healthcare systems. It is generally assumed that all relate to the same cases. Given the high costs associated with these processes and strong desire to maximise quality and standards, the purpose of this paper is to see whether it was indeed the case that most complaints and claims related to medical errors and the relative resource allocation to each group.

Design/methodology/approach

Electronic databases for clinical error recording, patient complaints and medico-legal claims in a large NHS healthcare provider organisation were reviewed and case overlap analysed.

Findings

Most complaints and medico-legal claims do not associate with a prior clinical error. Disproportionate resource is required for a small number of complaints and the medico-legal claims process. Most complaints and claims are not upheld.

Research limitations/implications

The authors have only looked at data from one healthcare provider and for one period. It would be useful to analyse other healthcare organisations over a longer time period. The authors were unable to access data on secondary staffing costs, which would have been informative. As the medico-legal process can go on for many years, the authors do not know the ultimate outcomes for all cases. The authors also do not know how many medico-legal cases were settled out of court pragmatically to minimise costs.

Practical implications

Staff error reporting systems and patient advisory services seem to be efficient and working well. However, the broader complaints and claims process is costing considerable time and money, yet may not be useful in driving up standards. System changes to maximise helpful complaints and claims, from a quality and standards perspective, and minimise unhelpful ones are recommended.

Originality/value

This study provides important data on the lack of overlap between errors, complaints and claims cases.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 8
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 18 July 2008

Alexandra Kent

Over the past decade the Swedish system for dealing with patient complaints has come under increasingly intense scrutiny from both healthcare providers and consumers. This…

Abstract

Purpose

Over the past decade the Swedish system for dealing with patient complaints has come under increasingly intense scrutiny from both healthcare providers and consumers. This article summarizes contemporary Swedish viewpoints on the debate by using sociological theory combined with anthropological field data. Its purpose is to prompt radical reappraisal of some attitudes underlying the current handling of patient complaints in Sweden and perhaps elsewhere.

Design/methodology/approach

The material presented here is partly a collation of literature and contemporary debate articles. A number of cases are explored including material taken from ongoing anthropological fieldwork among patients who are or have lodged complaints. Fieldwork was begun in May 2006 and consists of in‐depth, semi‐structured interviews, thus far with six patients, about their experiences lodging complaints. Contact with patients is ongoing as their stories continue to unfold. Interviews have also been conducted with representatives of patient support organizations and medico‐legal specialists. The material is analyzed using recent sociological theory concerned with trust.

Findings

Patients who lodge complaints about their care are interested in achieving moral redress and trust restoration. The major authorities dealing with patient complaints in this case may, however, be mistrusted by those who have experience of them: practitioners and patients alike. In general, they seem to fail to fulfill patients' expectations of guaranteeing ethical standards within healthcare and they are felt to act as a disincentive to honest reporting of adverse incidents by practitioners.

Research limitations/implications

This study is case specific and the particular findings are not readily generalizable to other countries. However, themes concerned with trust reparation that become evident pose questions about situations elsewhere that are analogous though not identical. Conclusions drawn are, therefore, intended not necessarily to be extrapolated but rather to provoke reflection about similar issues in other cases.

Practical implications

If practices and healthcare regulation structures are to become increasingly sensitive to patients' experience then it is essential that patients' stories and struggles are aired in those forums that influence decision makers' attitudes. This article attempts to bring patients' rights, expectations and perspectives to the fore in discussion about healthcare quality assurance.

Originality/value

By presenting patients as subject rather than object, the article intends to engage the reader in the patient's quest for moral reparation when trust is breached. The use of anthropological method helps give the perspectives or experience of those who are relatively disempowered their rightful place at the heart of discussions about healthcare quality.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

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