Patient complaints reflect their unmet expectations and are a valuable resource to understand key drivers of patient experience. It is unclear, however, how patient complaints can be used to improve service quality and guide improvement work
Our objective was to identify a strategy to decrease the number of patient complaints and enhance patient experience in a medicine unit at a large urban academic center. We sought an approach that would utilize a formalized process to review unit specific patient complaint data, augment staff communication and understanding of patient-centered care.
Medical unit leadership partnered with Patient Services to reduce patient complaints using a multi-faceted approach. Complaints collected by patient advocates were aggregated, categorized and placed in a centralized database (RF solution system). To identify trends and areas of improvement, quantitative and qualitative reports including verbatim comments from patients were generated and analyzed during biweekly multi-disciplinary review meetings on the medicine unit. Specific performance improvement interventions were developed around major problem areas including: clinical staff skill building aimed at patient-centered communication through quarterly empowerment sessions, staff education on policies through in service, training on complaint handling techniques and service recovery. Pre- and post-intervention analyses were conducted for number of complaints and patient satisfaction.
Majority of nursing and physician related complaints were on attitude and courtesy (Figure1) and quality of care (Figure 2) respectively.
Data for comparable time periods in 2015 and 2016 revealed significant decrease in the number of patient complaints (101 to 57, p= .02) and number of complainants (70 to 40, p= .03). There was an increase in the HCAHPS score for communication with physicians (score ranged from 58%-79% for 2015 to 85-90% for each quarter 2016) and communication with nurses (score ranged from 51-71% for 2015 to 82-84% for each quarter 2016).
Routine review of unit specific complaint data by front line providers fostered staff engagement and enabled nurses and physicians to identify specific performance issues and develop focused quality improvement strategies to reduce patient complaints and impact patient experience.