How to Deal with Complaints in Healthcare

Complaints are an integral part of ensuring quality healthcare provision.

Knowing how to deal with complaints is crucial for professional growth, but handling the complaints of patients or their visitors can often be complicated and hard to navigate.

This article addresses the best way to manage common complaints in healthcare settings. A common complaint is one that can be mitigated at a local level (i.e. the unit).

The following advice is not applicable for complaints alleging criminal behaviour nor complaints that relate to breaches in code of conduct.

Complaint-Handling Processes

The way in which a practice handles a complaint determines whether or not the practice can claim to be safe and responsive. Providers with efficient complaint-handling processes are best positioned to manage complaints quickly and with ease (HCC 2019).

An effective complaint-handling process creates opportunities to restore confidence in your services, increases quality as a result of feedback and prevents minor issues from escalating into bigger problems (HCC 2019).

Keep in Mind

• Complaints are inevitable – everybody has a right to make a complaint;
• Complaints are not necessarily bad - in some cases, the complaint may reflect more on the processes than the staff. Support for staff in the event of a complaint is crucial, this support may even build trust in the team;
• Complaints are an important aspect of quality improvement – they can be useful in the aim of feedback for improvement; and
• Complaints give individuals a voice.

(Cusack 2019)

Complaints in Healthcare Settings

Of course, blame and complaints occur in most workplaces, but healthcare settings are particularly fraught with emotion and fear, and often high expectations on the part of the consumer (Suter 2017).

Your job isn’t to put consumers in their place, but rather, to learn from and reach closure on the complaint as quickly as possible.

Put yourself in their shoes: attending hospital (or another healthcare setting) is a significant emotional event for both patients and their visitors.

People who are unwell are particularly vulnerable, and visitors and relatives may be anxious and overly protective.

All will consider their complaint issues to be serious, therefore all issues should be dealt with accordingly.

Communication is Key

Generally speaking, handling complaints well is underpinned by engaging with consumers about their concerns and working to understand the resolutions they are seeking.

Communication issues are responsible for the majority of complaints, and in a lot of cases, complainants are simply looking for either an explanation or apology (HCC 2019).

Another common motivation behind complaints is to prevent the same thing happening to others. This is why it is crucial to acknowledge complaints promptly and let people know what is being done to prevent it from happening again (HCC 2019).

Managing the Complaints of a Visitor

When managing complaints from a relative, friend or another visitor of a patient, try to be as approachable as possible.

Consider holding a meeting away from the noise and bustle of the ward somewhere that is conducive to a confidential conversation. Assess whether it is necessary for the patient to also be present in the room.

In case the situation escalates, ensure that other staff members know where you are holding the meeting. Consider whether it may be worth having another staff member, or security, present and position yourself safely, between the complainant and the door.

Turn off pagers and mobile phones if possible, sit at the same level as the complainant and make sure to maintain a calm and even voice.

Communication is key to handling and resolving complaints

• Know how to apologise properly. Keep in mind that under Victorian legislation sorry is not an admission of guilt (Law Institute of Victoria 2019). By saying sorry you are acknowledging that the complainant is upset and that their grievance/issue matters to you.
• Recognise the mistake and the harm it caused; when apologising, refrain from using cliched phrases.
• Outline clearly to the complainant what is being done to address the complaint in order to be proactive and assure them that their feedback is being taken seriously.
• Clarify and be firm in your explanation for what happened and why.

(Cusack 2019)

Consider handling complaints in this order:

1. Offer a genuine apology to the complainant.
2. Request the complaint in writing.
3. Advise the complainant in writing where possible that you will investigate the matter and when you will provide them with an outcome.
4. Send a final letter to the complainant if necessary to advise them that:
   • The investigation has been completed.
   • Steps or processes have been put in place to prevent a recurrence of the same issue, should that be the case.
   • Thank them for bringing it to your attention.
   • Reiterate again that you are sorry for upset caused.

(Suter 2017)

Record all complaints, detailing at a minimum:

• The date it arrived;
• Who sent it;
• What the complaint was about;
• Who did what about it (investigation-wise);
• How it was actioned;
• The outcomes of those actions; and
• A closure date.

(Suter 2017)

Remember that complaints handling is often targeted by accreditation assessors and concise records will be very useful in this situation, especially when an outcome can show an improved process along the way. (Suter 2017).

For managers or supervisors, it is vital that the staff trust that you will treat them respectfully and with discretion when questioning their actions and that you and the staff member plan a suitable improvement plan together. Remind staff of the ratio of complaints to compliments, as in most cases the compliments outweigh the complaints. (Suter 2017).

Additional Resources

The Health Complaints Commissioner (Hcc.vic.gov.au) is the destination for impartial complaints resolution in Victoria, the website provides:

• Information, brochures and fact sheets for providers and consumers; and
• Information on training in:
  • Complaint handling;
  • Health records management; and
  • The new Code of Conduct.

Remember that complaints are to be expected in all healthcare settings, it is not whether you receive complaints, but how you handle them that reflects your practice. Know that there is ample support and resources available to you in the event of receiving a complaint.

References

• Cusack, K 2019, 'Healthcare Complaints and Investigations', Ausmed, 28 February, viewed 7 August 2019, https://www.ausmed.com/cpd/lecture/healthcare-complaints-and-investigations
• Health Complaints Commissioner, ‘Handling Complaints’, viewed 5 August 2019, https://hcc.vic.gov.au/
• Law Institute Victoria 2019, ‘Why Apologise?’, viewed 6 August 2019, https://www.liv.asn.au/Staying-Informed/LIJ/LIJ/December-2017/Why-apologise-
• Royal College of Nursing, ‘Patient Family Complaints’; viewed 5 August 2019, https://rcni.com/hosted-content/rcn/first-steps/patient-family-complaints
• Suter, C 2017, 'Receiving Complaints from a Patient, Relative or Visitor', Ausmed, 6 March, viewed 7 August 2019,https://www.ausmed.com/cpd/articles/receiving-complaints.

(Answers: b, d, c)