Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

Abstract

Background: Information from patient complaints – a widely accepted measure of patient satisfaction with services – can inform improvements in service quality, and contribute towards overall health systems performance. While analyses of data from patient complaints received much emphasis, there is limited published literature on key interventions to improve complaint management systems. Objectives: The objectives are two-fold: first, to synthesise existing evidence and provide practical options to inform future policy and practice and, second, to identify key outstanding gaps in the existing literature to inform agenda for future research. Methods: We report results of review of the existing literature. Peer-reviewed published literature was searched in OVID Medline, OVID Global Health and PubMed. In addition, relevant citations from the reviewed articles were followed up, and we also report grey literature from the UK and the Netherlands. Results: Effective interventions can improve collection of complaints (e.g. establishing easy-to-use channels and raising patients’ awareness of these), analysis of complaint data (e.g. creating structures and spaces for analysis and learning from complaints data), and subsequent action (e.g. timely feedback to complainants and integrating learning from complaints into service quality improvement). No one single measure can be sufficient, and any intervention to improve patient complaint management system must include different components, which need to be feasible, effective, scalable, and sustainable within local context. Conclusions: Effective interventions to strengthen patient complaints systems need to be: comprehensive, integrated within existing systems, context-specific and cognizant of the information asymmetry and the unequal power relations between the key actors. Four gaps in the published literature represent an agenda for future research: limited understanding of contexts of effective interventions, absence of system-wide approaches, lack of evidence from low- and middle-income countries and absence of focused empirical assessments of behaviour of staff who manage patient complaints.

An Analysis of Complaints in Two Large Tertiary University Teaching Hospital ENT Departments: A Two-Year Retrospective Review

“…Furthermore, this issue has been also flagged up in a recent literature review which reiterated the need for comprehensive and integrated patient complaint systems in order to allow learning from complaints data. is has also noted the poor public awareness of complaints channels and the lack of official standardised training available to staff in regards to complaint management [14].…”

How do patient feedback systems work in low- and middle-income countries? Insights from a realist evaluation in Bangladesh.

“…Awareness of feedback channels and people's trust in the health systems are important determinants of people's citizenship identity and willingness to exercise their agency. Awareness and trust are, however, insu cient and need to be bolstered by recognition of rights to provide feedback, accessibility of feedback channels, clear policies and guidelines, and appropriate incentives and sanctions to ensure staff compliance (1,5,23). In line with published evidence (1,5,8,59), a key determinant of decisions to provide feedback is people's con dence not to be disadvantaged after providing feedback.…”

“…Combining the citizenship and PA theories has allowed us to gain insight into the logics underpinning the three steps of patient feedback management processes (23). People's use of available feedback channels entails people expressing their citizenship and agency, within the context of interpretations of one's identities and power relations and information asymmetries between patients and healthcare providers (10,12,13,16).…”

“…Second is the health system's ability to adequately respond to, and act upon feedback (1,6,8). Substantial research covers patient feedback systems, their typologies, assessments and contributions to service quality improvement (1,6,9,(19)(20)(21)(22)(23). Most of this evidence comes from high-income countries and hospital settings with less research from lower-income countries and frontline health facilities.…”

Towards a multilevel governance framework on the implementation of patient rights in health facilities: a protocol for a systematic scoping review

“…22 Efficient and functional patient complaints and grievance redressal systems offer critical lessons for the structural improvement of the health system. 23 Evidence from UK, New-Zealand and Canada show that the recommendations of patient rights and safety ombudsmen have the potential to influence policymakers at the highest level. [24][25][26] From an ethical perspective Patient rights are deeply interwoven with the four core principles of medical/healthcare ethics, that is, beneficence (do good), non-maleficence (do no harm), justice and autonomy.…”