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Turning a Negative into a Positive: Managing Patient Complaints

Increasing concerns about the quality of healthcare have arisen as a result of the public perception that cost-cutting measures have caused premature discharge and clinical mismanagement of patients. Changes in healthcare coverage have generated concerns that medical care has become a profit-motivated business instead of a caring professional service. In response to these changes, medical offices should develop methods of dealing with patient complaints to positively impact patient satisfaction and potentially uncover hidden flaws in daily processes.

Every medical office should have a plan to address complaints by a patient or patient’s family. At a minimum, medical offices should have in place mechanisms to inform patients of the complaint process; to receive and respond to complaints in a timely manner; to implement corrective action as necessary to resolve complaints; and to reassure the person filing the complaint that future care will not be compromised because of a registered complaint.

It’s important that your patients know you’re genuinely interested in patient feedback in order to improve the patient experience and respond appropriately to issues. One mechanism that can be used to inform patients of the complaint process is to include it in the practice’s “new patient” brochure or on the practice’s website. The brochure should be given to each new patient at their first appointment or mailed to the patient prior to their first appointment. Having response cards ­is a method to garner potential complaint information from patients.

Upon receipt of any complaint, the staff should relay the complaint in a timely manner to the appropriate person. Complaints about medical care should go directly to the physician or provider involved; billing concerns should be referred to the account representative; and other concerns should be given to the administrator or designee.

Verbal complaints should receive a courteous response at the time they are presented. If possible, move the conversation to a private location. The person making the complaint should be given ample opportunity to discuss concerns without interruption. Do not argue or be tempted to place blame on the patient or the practice. Reassure the patient that you appreciate the opportunity to hear him/her out, you take concerns seriously and will promptly investigate the matter. Written complaints should be acknowledged and the response should include a message that the complaint will be treated as an opportunity to collect more information and attempt to resolve the concern. After a thorough investigation, the findings should be communicated in an empathetic but concise manner. The complainant should be advised when corrective action has been taken. However, any corrective action that involves staff performance should not be communicated to patients or family members. Knowing that action has been taken on concerns brought to the attention of the practice improves the patient’s perception of quality of care and confidence in the practice. Physicians and providers should be cautious to maintain confidentiality when the response is communicated to someone other than the patient.

All discussions with the complainant should be documented and retained in a file separate from the medical record. The patient or patient’s family should be reassured throughout the complaint process that future care will not be compromised. In the rare situation when complaints become unreasonable or abusive, the physician retains the right to terminate the physician-patient relationship. SVMIC should be notified if the physician thinks the complaint may lead to a potential malpractice claim.

Be sure to document the entire process and use the following techniques, as appropriate, during the complaint process:

  1. Treat the complaining patient with dignity, courtesy and due regard for privacy during the complaint-handling process.
  2. Adopt a listening posture, i.e. making eye contact, sitting if possible, arms relaxed and not folded.
  3. Allow the patient to state the problem completely, without interruption or argument.
  4. Thank the patient for bringing the concern to your attention.
  5. Accept the patient’s feelings, and if appropriate, offer a statement of empathy such as “I understand your frustration” or “I’m sorry that your wait time today was longer than expected”, without admitting fault or placing blame.
  6. Obtain as much additional information as possible to facilitate investigation of the complaint and reassure the patient that attention will be given to the concern.
  7. Provide information regarding steps which will be taken with an expected timetable.
  8. Follow timetables promised whenever possible; if delays arise, inform the patient of the change.
  9. Conduct a thorough investigation; interviews with physician or staff involved; and medical record review may be necessary.
  10. Determine resolution of the matter and inform the patient accordingly.

Patient complaints are an opportunity to learn important information about the practice. Some complaints will be frivolous; but even frivolous complaints sometimes reveal more important issues that may be difficult for patients to articulate. Other complaints may point out a system weakness that if left unattended could lead to patient harm. If ignored, even minor complaints can become the foundation for a lawsuit. Prompt and thorough attention to complaints may mitigate the escalation of emotions and pay off for both the patient and the practice.

About The Author

Julie Loomis is Assistant Vice President of Risk Education for SVMIC where she develops educational programs and assists policyholders and staff with risk management issues. Ms. Loomis is a member of the Tennessee Bar Association and American Society of Healthcare Risk Managers (ASHRM). She serves on the Risk Management/Patient Safety Committee of the Medical Professional Liability Association. Ms. Loomis is a speaker on risk management and professional liability topics at industry seminars, medical schools and residency programs.

The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time.

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