The problem with using patient complaints for improvement

Vos, Marit S. de; Hamming, Jaap F.; Mheen, Perla J Marang-van de

doi:10.1136/bmjqs-2017-007463

Cited by 31 publications

(42 citation statements)

References 25 publications

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“…Although using patients' perspective for improvement is still debated [76], the attempt to use their feedback for simple and practical solutions is an ongoing preoccupation [77]. Given the nature of our results, our recommendations are rather concrete.…”

Section: Practical and Managerial Implicationsmentioning

confidence: 93%

Combining Direct and Indirect Measurements to Assess Patients’ Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

Druică

Mihăilă

Burcea

et al. 2019

IJERPH

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Introduction: Patients’ satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients’ feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients’ satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients’ perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares—path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients’ experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients’ satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients’ satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.

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Section: Practical and Managerial Implicationsmentioning

confidence: 93%

Combining Direct and Indirect Measurements to Assess Patients’ Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

Druică

Mihăilă

Burcea

et al. 2019

IJERPH

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“…Previous research suggests that patients and families who make a formal complaint primarily desire two outcomes: a patient-centric response (eg, an explanation of how the incident could have happened) and system-level quality improvement (eg, to prevent errors from happening to others) 18–26. The existing literature suggests, however, that healthcare complaints practice has not yet been successful at achieving the complex dual role of case-by-case handling and system-wide improvement 16 17 27. Combining organisational learning and complaint handling has previously been suggested in non-healthcare organisations, yet remains conceptual in nature, and existing literature gives little insight into how this would work in practice 28.…”

Section: Introductionmentioning

confidence: 99%

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

et al. 2020

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IntroductionA global rise in patient complaints has been accompanied by growing research to effectively analyse complaints for safer, more patient-centric care. Most patients and families complain to improve the quality of healthcare, yet progress has been complicated by a system primarily designed for case-by-case complaint handling.AimTo understand how to effectively integrate patient-centric complaint handling with quality monitoring and improvement.MethodLiterature screening and patient codesign shaped the review’s aim in the first stage of this three-stage review. Ten sources were searched including academic databases and policy archives. In the second stage, 13 front-line experts were interviewed to develop initial practice-based programme theory. In the third stage, evidence identified in the first stage was appraised based on rigour and relevance, and selected to refine programme theory focusing on what works, why and under what circumstances.ResultsA total of 74 academic and 10 policy sources were included. The review identified 12 mechanisms to achieve: patient-centric complaint handling and system-wide quality improvement. The complaint handling pathway includes (1) access of information; (2) collaboration with support and advocacy services; (3) staff attitude and signposting; (4) bespoke responding; and (5) public accountability. The improvement pathway includes (6) a reliable coding taxonomy; (7) standardised training and guidelines; (8) a centralised informatics system; (9) appropriate data sampling; (10) mixed-methods spotlight analysis; (11) board priorities and leadership; and (12) just culture.DiscussionIf healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this.

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“…Over the years, various systems to collect quality and safety data, such as incidents, AEs and complaints, have been implemented in different periods and isolated from each other 22. Consequently, co-occurrence cannot be evaluated and relations between events may remain obscured, such as cascades or clusters of seemingly unrelated events.…”

Section: Discussionmentioning

confidence: 99%

“…For example, not all hospitals have digitalised patient complaints 22. Hospitals could start by providing a clear overview of a patient’s AEs and incidents in the medical record (integrating safety systems into electronic records), because this may support the ability of (rotating) staff to anticipate future problems for these patients.…”

Section: Discussionmentioning

confidence: 99%

Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint data

et al. 2018

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The problem with using patient complaints for improvement

Abstract: 'The Problem with…' series covers controversial topics related to efforts to improve healthcare quality, including widely recommended, but deceptively difficult strategies for improvement and pervasive problems that seem to resist solution.

Cited by 31 publications

References 25 publications

Combining Direct and Indirect Measurements to Assess Patients’ Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

Combining Direct and Indirect Measurements to Assess Patients’ Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint data

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