When a Patient, Relative or Visitor Complains
Patients, relatives and visitors need to know how to make a complaint.
The less time they spend trying to identify how to lodge the complaint and with whom, the less time the issue can be embellished or blown out of proportion.
Early resolution has the following benefits:
- Feelings of dissatisfaction with the service are less likely to intensify if the process is short
- It may be less likely that the subject of the complaint will be discussed in the community
- A quicker beginning of the complaints process usually means a quicker resolution
- The service and staff are demonstrating they take the complaint seriously
Responding to a Complaint
The discussion below refers to the general run-of-the-mill complaint that can be handled at the local level: the unit. The steps are not applicable to complaints of a criminal nature, for example stealing money from a patient or striking a resident in an aged care facility; nor are they applicable to complaints related to breaches in codes of conduct, for example a staff member smelling of alcohol.
Attending hospital as an outpatient or a visitor of an inpatient, or being an inpatient, is a significant emotional event. People who are not well are vulnerable and visitors and relatives may be over anxious and protective. To them, their issue is ‘serious’ and should always be dealt with as so.
The first thing to do is say sorry. By saying you are sorry you are acknowledging they are upset and that their grievance/issue matters to you. An apology is not an admission of guilt. It does not mean that you are agreeing with them for example; “that Nurse Smith was rude” or “the doctor was a bit ‘rough and impatient’ when inserting an IV line.”
Secondly, it is necessary to get the complaint in writing and in the complainant’s own words describing the issue, noting date, time and unit, and who was involved. If the complaint arrived by mail, well and good.
Thirdly, it is necessary to advise the complainant in writing where possible that you will investigate the matter and get back to them with an outcome.
Fourthly, a final letter again to the complainant is necessary to advise them at a minimum:
- The investigation is 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
- You are again sorry for any upset caused; and
- Provide your contact details for any further discussion should it be required.
At no time should the details of any discussion with the staff member being complained about, be provided to the complainant. The staff member is entitled to confidentiality and must be given the opportunity to address the actions that caused the complaint and be assisted to improve performance where necessary.
Further Learning: Managing Relatives’ Concerns Video Learning Activity
It may well be that the issue is a storm in a tea-cup that in any other profession would not cause a blink, however as previously stated, healthcare is fraught with emotion and sometimes fear, and often in tandem with unusually high expectations on the part of the consumer. Our job, however, is not to argue or put consumers in their place. Our job is to reach closure on the complaint as quickly as possible.
Points to Remember When Dealing with Complaints Include:
- Keep a register of 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) and how it was actioned, the outcomes of those actions and a closure date. Remember, complaints handling is nearly always targeted by accreditation assessors and concise records go a long way in pleasing them, especially when an outcome can show an improved process somewhere along the way.
- It may also be that processes are at fault rather than people, so refrain from jumping too quickly on the staff member, for example, lack of a workplace instruction on labelling clothes in a residential care facility, which eventually just disappear – we all know this story!
- Leaders and managers value their staff even when they slip up. It is essential that the staff trust that you will treat them respectfully and privately when questioning their actions and that you and the staff member plan a suitable improvement plan together.
- Discuss the de-identified complaints (and compliments) at your monthly all-of-staff meeting, reassuring them that a complaint is a necessary form of consumer feedback and of course tell them what good came out of it.
- Let the staff know the ratio of complaints to compliments, as in most cases the compliments outweigh the complaints.
Christine (RN, BN, MPHC) is an RN with 40 years experience, traversing the profession as an AIN, EN, RN, RM N.ED. to DON. She is currently in transition-to-retirement and working as a casual RN on the floor in a small rural hospital with an aged care facility attached. Her interests are aged care and particularly nurses; their working relationships, team dynamics and how nurse leaders and managers deal with the day to day complexities of leading and managing.