complaints

Question 1

List contributing factors and reasons for complaints

Answer 1

1) unpredictability of case mix and case load
2) variation in attendance
3) long waiting times
4) insufficient staffing for unexpected peaks
5) junior staff with variable experience and supervision
6) deficiencies in treatment (real or percieved)
7) Poor attitudes lack of profressionalism
8) poo communications lack of information or consent
9) interruptions, multiple concurrent task
10) delay in ix
11) access block to inpatient beds
12) no appropriate follow-up
13) inappropriate or preamture discharge
14) unmet expectations
15) invasion of privacy
16) fees in private hostial emergency
17) litigation for compesnation

Question 2

Discuss an approach to response of a complaint

Answer 2

Ensure patient safety
1)Respond rapidly - accept the complaint and respond

2) apologize for the complainant’s dissatisfaction
- express regret

3) defuse any anger
- be empathetic
- of patient rude or abusive do not mirror

4) record the details
5) determine the issue/undertake to investigate
6) arrange follow-up
7) investigate

8) discuss with staff
- competence or conduce issues should be addressed
- accept that mistakes happen

9) inform admin
10) consider legal implications
11) follow-up with complainant
- attempt to answer complaints within 72 hours

12) resolve complaint
13) lessons to be learnt

Question 3

Discuss prevention of complaints

Answer 3

Systems

1) well equipped ED with adequate numbers of SMO and nursing staff supervising juniour staff all aware of their scope will have lower rates of complaints
2) design can enhance safety with
- good waiting areas,
- resus area visibility,
- patient privacy maintained
- temperate and noise levles comfortable
- easy access to rest rooms and refreshments
3) systems and procedures to follow-up abnormal pathology and imaging results should exist and be audited

PEOPLE

1) a polite well groomed doctor who introduces himself or herself makes eye contact can help avert complatins.
2) communications
3) talking out loud any exam finding as they conduct them can minimize accusations of inadequate exam
4) adequate documentation provides the only means of refuting or resolving a complaint

Question 4

Discuss management of written complaints

Answer 4

1) acknowledge the notification as quickly as possible - ideally within 3 days, together with an apology that they have experienced dissatisfication
2) commitment to investigate and act on finding
3) if clinically significant or may escalate an early phone call in advance of the written response to invite more information or a managed face to face

Question 5

Discuss management of catastrophic adverse events

Answer 5

Open disclosure

Benifits

• limited evidence that disclosure reduces the likelihood of litigation
• most health profressionals fell a moral oblication to dislcose