How to Deal with Complaints in Healthcare
Published: 26 November 2023
Published: 26 November 2023
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 difficult to navigate.
All aged care service providers are required to have internal complaints resolution processes under the Aged Care Act 1997 (ACSQC 2021).
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).
Note: The following advice is not applicable for complaints alleging criminal behaviour nor complaints that relate to breaches in the code of conduct.
An effective complaint handling system should:
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 n.d.).
An early resolution has the following benefits:
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 n.d.).
While blame and complaints occur in most workplaces, 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 people will consider their own complaint issues to be serious; therefore, all issues should be dealt with accordingly.
Relatives, friends, and visitors need to know how to make complaints. The less time they spend trying to identify how to lodge a complaint and with whom, the less likely the issue is to be embellished or blown out of proportion.
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 ensure you maintain a calm and even voice.
Anyone who wishes to complain should be able to easily do so. Accessibility is a key component of an effective complaint management system (ACQSC 2021).
Accessibility can be achieved through:
Complaints should be acknowledged in a timely manner. It is important to:
In some cases, a written acknowledgement may be appropriate. If the complaint was received via mail and can be addressed quickly, it may even be possible to provide the complainant with an acknowledgement and resolution simultaneously (ACQSC 2021).
This step involves:
Depending on the specific problem and the complainant’s preferences, some issues may be easier to resolve than others. However, if the complainant’s desired outcome is unachievable, you will need to explain why this is the case and offer them alternatives (ACQSC 2021).
Part of the assessment process is planning, i.e. determining how exactly the complaint will be managed. A plan might identify:
The care recipient, complainant, and staff should be included in the planning process to ensure that a mutually agreed resolution is determined (ACQSC 2021).
Some complaints may also require investigation, i.e. the gathering of relevant information to help inform an appropriate resolution. Remember to uphold the principles of fair investigation: impartiality, confidentiality, transparency, and timeliness (ACQSC 2021).
Once an appropriate resolution has been determined, the next step is to formally communicate this to the complainant and other parties involved. Depending on the situation, this could be through a conversation or written explanation (ACQSC 2021).
At this stage, you may consider offering an apology to the complainant. Apologising demonstrates empathy and may contribute to a more positive outcome, even if you are not completely at fault. An apology may also lead to an improved relationship between the service provider and complainant (ACQSC 2021).
Note: Apologising is not necessarily an admission of fault, depending on your jurisdiction. For more information, see Ausmed’s Training Module on Open Disclosure and Apology.
Ask the complainant for feedback regarding how their complaint was managed. If the complainant is unsatisfied, you may consider internal reviews, mediation, or other options (ACQSC 2021).
When finalising a complaint, always remember that the issue could occur again in the future. It may be beneficial to review policies and procedures or initiate systemic improvements (ACQSC 2021).
Record all complaints, detailing at a minimum:
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 many cases, complainants are simply looking for either an explanation or apology (HCC n.d.).
Another common motivation behind complaints is to prevent the same thing from 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 n.d.).
When engaging with complainants, you should:
(ACQSC 2021; Cusack 2019; LPLC 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.
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.
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 are ample support and resources available to you in the event of receiving a complaint.
Question 1 of 3
True or false: Communication issues are responsible for the majority of complaints.