Healthcare Complaints Analysis Tool
Healthcare ComplaintsAnalysis Tool
Healthcare Complaints Analysis Toolversion 3, 2015LicenseHealthcare Complaints Analysis Tool islicensed under a Creative CommonsAttribution-NonCommercial-NoDerivatives4.0 International License.ContactMore details about the HealthcareComplaints Analysis Tool and supportfor implementing it can be obtained fromthe authors:Dr Alex Gillespie and Dr Tom ReaderDepartment of Social Psychology3rd FloorQueens House,55/56 Lincoln’s Inn Fields,London WC2A 3LJ
CONTENTSIntroduction2Why analyse healthcare complaints?2What are healthcare complaints?2What is The Healthcare ComplaintsAnalysis Tool (HCAT) for?3Overview: The HealthcareComplaints Analysis Tool (HCAT)4Who can use HCAT?5General guidelines5A step-by-step guide7Section A: Identifying problemsand assessing severity7Section B: Specifying the stagesof care complained about12Section C: Level of harm reportedin the complaint13Section D: Descriptive details13References14Healthcare Complaints AnalysisTool (HCAT) Coding Form171
INTRODUCTIONThis manual provides instructions on how to use the Healthcare Complaints AnalysisTool (HCAT) to analyse complaints from patients and families regarding poorhealthcare experiences. HCAT enables organisational listening [1] through aggregatingindividual healthcare complaints so that patient concerns can facilitate servicemonitoring and organisational learning.Why analyse healthcare complaints?Healthcare complaints are often written withthe aim of contributing to the improvement ofservices [2]. However, the tools for harnessingthe potential of these insights have beenlimited [3-6]. Yet, we know that utilisingpatient experiences has the potential toenhance the quality and safety of healthcaredelivery [7-12]. For example, “low-level”problems in caring for patients and followingprocedures have been shown to precedeadverse events and wide-spread failures inhealthcare delivery [13]. Identifying these lowlevel problems is important for ensuring theresilience and safety of healthcare systems [5],and the monitoring of patient experience is anadditional way through which risks to patientsafety can be identified [15]. More specifically,analysing letters of complaints to healthcareinstitutions (“healthcare complaints”) made bypatients and families is a potentially useful wayto assess healthcare safety and quality [3-6].Healthcare organisations can learn fromletters of complaint because patients andtheir families are sensitive to, and able torecognise, a range of problems in healthcaredelivery. Specifically, patients and theirfamilies process a huge amount of data,observing and evaluating all healthcareinteractions [16]. Indeed, they have privilegedaccess to information on continuity of care[17, 18], communication failures [19], dignity2issues [20] and patient centred care [21].Moreover, once treatment is concluded,patients and their families are relatively freeto speak up about their experiences withoutfear of repercussions [22]. Finally, becausepatients and their families are outside thegiven healthcare organisation they provide anindependent assessment of that organisationthat is grounded in the changing norms andexpectations of society [23].What are healthcare complaints?“Healthcare complaint” refers to anexpression of grievance and dispute, typicallywritten and communicated through aletter by a patient or their family, about thereceipt of healthcare [24, 25]. Healthcarecomplaints are usually written to a healthcareorganisation (or regulator) after a thresholdof dissatisfaction with care has been crossed[26], are typically written by patients orfamilies on behalf of patients [27], and areoften written with the intention of improvingfuture service provision [2]. Although thefrequency of healthcare complaints relativeto healthcare episodes is low, the totalnumber of complaints can be substantial [6].For example, the UK National Health Service(NHS) receives over 100,000 annually [28].Complaints can focus on diverse problems(eg, car parking, prescribing errors), describedifferent types of harm (eg, physical,
emotional), and have different underlyingaims (eg, resolving upset, creating change,preventing future issues) [6]. The problemsraised in a patient letter of complaint areoften not identified by traditional systems ofhealthcare monitoring (eg, incident reportingsystems, retrospective case reviews) [29, 30].However, methodologies for researchingpatient complaints are poor, and there is aneed for systematic and rigorous analyticaltool for analysing healthcare complaint letters[3-6, 31, 32].What is The Healthcare ComplaintsAnalysis Tool (HCAT) for?HCAT is the first standardised tool foranalysing healthcare complaints in arigorous and conceptually meaningful way.It is also the first tool that can reliabilityassess problem severity. The tool has beendeveloped equally by Dr Alex Gillespie andDr Tom Reader at the London School ofEconomics and Political Science. The toolis based on an empirically derived andtheoretically guided framework throughwhich information in a healthcare complaintcan be reliably codified and assessed.HCAT is designed to support healthcareinstitutions and national or internationalmonitoring institutions. Results from HCATcan be used to: 1) systematically characterisethe general and specific problems reportedby patients within a particular healthcareinstitution; 2) differentiate between highand low-performing healthcare institutions(eg, in terms of the severity of problemsreported); 3) identify healthcare institutionswith especially high risk profiles (eg, in termsof patients reporting severe safety problems);4) encourage learning and the sharing ofinformation between institutions, and; 5)provide longitudinal data on complaint trends(eg, to test the effect of an intervention toimprove patient experience).HCAT is available under a Creative CommonsAttribution-NonCommercial-NoDerivatives4.0 International License. It is free forpractitioners and researchers alike to use.Support of varying degrees is available forusing HCAT, and those interested shouldcontact the authors, Dr Alex Gillespie andDr Tom Reader.3
OVERVIEW: THE HEALTHCARECOMPLAINTS ANALYSIS TOOL (HCAT)The Healthcare Complaints Analysis Tool (HCAT) is an analytical tool for codifyingand assessing the problems highlighted by patients and their families or advocatesin letters of complaint. The categories and sub-categories for analysing complaintshave been developed through a systematic review of the academic patient complaintliterature [6], collaboration with relevant specialists, in-depth analyses of healthcarecomplaints, pilot studies, and reliability testing [33].At the centre of HCAT is a coding taxonomywhich can be used to distinguish the types ofproblems raised in healthcare complaints. Thetaxonomy consists of a three-level hierarchyof “domains”, “problem categories”, andexemplar “problem indicators” covering 36sub-categories (for which reliability testingis ongoing). Table 1 outlines the core codingtaxonomy. Using the taxonomy, analystsidentify and code the types of problemsreported by patients in a letter of complaint.Analysts then assess the severity of theproblems reported in the letter of complaint,identify where in the care process problemswere experienced, and report on the level ofharm experienced by patients.Table 1. HCAT Domains and problem category definitionsCLINICAL PROBLEMSIssues relating to quality and safety of clinicaland nursing care provided by healthcare staff(ie, doctors, nurses, radiologists, and alliedhealth professionals)Quality: Clinical standards of healthcare staffbehaviourSafety: Errors, incidents, and staff competenciesMANAGEMENT PROBLEMSIssues relating to the environment andorganisation within which healthcare is provided(for which administrative, technical, facilitiesand management staff are usually responsible)Environment: Problems in the facilities,services, clinical equipment, and staffing levelsInstitutional Processes: Problems inbureaucracy, waiting times, and accessing careRELATIONSHIP PROBLEMSIssues relating to the behaviour of any specificmember of staff towards the patient or theirfamily/friendsListening: Healthcare staff disregard or do notacknowledge information from patientsCommunication: Absent or incorrectcommunication from healthcare staff to patientsRespect and patient rights: Disrespect orviolations of patient rights by staff4
Each of the domains, and the problems thatunderlie them, are conceptually distinct:“Clinical problems” relate to the literatureon human factors and safety [7, 34, 35];“management problems” relate to theliterature on health service management[36-38], and; “relationship problems” relateto the literatures on patient perspectives[39], including issues of communication[40], dignity [20], and patient rights [41].Underlying each category is a number ofsub-categories. These sub-categories can beused to classify the specific types of problemsbeing identified within each complaintcategory (eg, to support organisationallearning). However, although these subcategories are based on a systematic reviewof the literature [6] and iterative coding [33],the reliability for the use of sub-categories isyet to be ascertained.Who can use HCAT?HCAT is free to use. It has been designed tobe used by clinical staff (eg, nursing, medicalstaff), non-clinical staff (eg, administrative,patient experience), and healthcareresearchers (eg, health psychologists, riskspecialists). HCAT has been tested forreliability and accuracy [33]. The results showthat educated users, provided they havebeen trained with the present manual andpracticed with some sample complaints, willbe able to analyse healthcare complaints in asimilar and consistent manner.Prior to using HCAT, assessors should: understand what a healthcare complaint is understand the utility and purpose ofanalysing complaints be familiar with the three-level hierarchyof “domains”, “problem categories,”and “indicators” know how to use the indicators to identifya problem category and severity understand how to apply the codingframework to analyse a patient letterof complaint understand what a “stage of care” is,and how to code it understand the meaning of patient harm undergo a calibration exercise wherebythey use HCAT on pre-coded exampleletters (contact the authors for detailson this training).General guidelinesThe purpose of HCAT is to support the analysisand aggregation of information on the typesof problems experienced by patients andfamilies (as reported in letters of complaint).The purpose of HCAT is not to: 1) assess theveracity of issues raised by patients; 2) detailthe specific clinical problems experienced bypatients; 3) focus on the competencies ofspecific members of healthcare staff, or; 4)support the management of an individualletter of complaint.When using HCAT, the information reportedin a healthcare complaint should be takenat face value, and evaluated in a way thatis non-judgemental of either patients orhealthcare staff. From the perspective ofpatients, information provided in a letterof complaint usually reflect an upsettingor concerning experience, and whilst thesystem makes assessments of the types andseverity of those experiences (in comparisonto the range of problems raised by manypatients), no judgement is made about the5
intentions of the complainant, their right tocomplain, or the importance attached by thecomplainant to the issues they describe (ie,both low and high severity complaints canprovide crucial information on safety-relatedissues). Conversely, because healthcarecomplaints are written from the perspectiveof patients and families, relatively littleinsight can be provided on the perspectiveof healthcare staff who feature in acomplaint (eg, on the wider system pressuresinfluencing their behaviour), and thus thebehaviour of specific staff members or groupsis not examined.6The coding process should be strictlyempirical, that is, focused on the actualwords used in the letter of complaint (ratherthan extrapolation or interpretation). Centralto the utility of HCAT is the fact that itis reliable (ie, that two people will codethe same letter similarly). This reliability isachieved, in part, by requiring coders tofocus on the text within each complaint(not judgements or inferences). To facilitatesticking closely to the text, assessors shouldbecome familiar with the type of words thatindicate each of the main problem categories(reported below).
A STEP-BY-STEP GUIDEThe data entry for HCAT is most appropriately done via a computer, however, it can alsobe done using pen and paper. The following guide will, for ease of reference, assumethat the pen and paper recording sheet at the end of this document is being used.Coding a healthcare complaint using HCATinvolves four-phases (A-D), each of which aredescribed in the sections below (see table 2for a summary).Table 2. Four phases for coding ahealthcare complaintA. Identifying the presence of problemcategories (and, if required, subcategories) within the letter of complaintusing the coding taxonomy, andassessing their severityB. Specifying the stages of care atwhich problems occurredC. Indicating the level of harm arisingfrom the reported problemD. Providing descriptive informationabout the letter of complaintSection A: Identifying problemsand assessing severityThe first stage in coding a healthcarecomplaint using HCAT is the identificationof problems contained with a letter ofcomplaint, and an assessment of their severity.The healthcare complaint coding taxonomyidentifies three distinct domains (clinical,management and relationship) of healthcarecomplaint, comprising seven problemcategories and 36 sub-categories.To facilitate the identification of problemswithin a healthcare complaint, exemplarindicators have been developed for each.These are specified in greater detail in figuresA1-A3 on the following pages, and are to beused to guide: 1) the identification of problemcategories in a patient letter of complaint, and;2) the assessment of problem severity.Severity ratings should be independent ofoutcomes (ie, harm). The severity ratings arenot comparable across problem categories.Rather severity ratings should be based on theindicators provided in the following pages.These severity indicators, which are basedon the 36 sub-categories, were developedthrough iterative coding of a UK nationalsample of healthcare complaints (n 1081),which entailed mapping severity for eachproblem category, and thus identifyingindependent severity distributions within eachproblem category and sub-category.7
To analyse a healthcare complaint, thefollowing steps should be undertaken:1 R ead through the letter of complaintwithout coding anything2 O n second reading, identify the problemcategory (and, if required, sub-category)being complained about using the problemdefinitions and the keywords.3 F or each problem category identified, usethe severity indicators in figures A1-A3 todetermine the severity level. The indicatorsare exemplars of (1) low, (2) medium,and (3) high severity problems for eachproblem category.i. I f a problem category is not identifiedand attributed at severity score, it isautomatically rated as 0 (not present).8ii. I f one problem category is present atmultiple levels of severity, only the highestlevel of severity should be recorded.iii. I f one event (eg, surgical complication)relates to multiple problem categories(ie, safety, communication) then allrelevant problem categories shouldbe recorded.iv. S hould further analysis be required,problems categories may also be coded interms of the sub-categories that comprisethem. Although each sub-category hasan indicator at each severity level, thereliability of coding severity at this finegrained level has yet to be established.4 Use SECTION A on the HCAT form, at theend of this manual, to record the problemand severity coding.
A1. Clinical Problems. Issues relating to quality and safety of clinical and nursing care providedby healthcare staff (ie, doctors, nurses, radiologists, and allied health professionals)Quality: Clinical standards of healthcare staff behaviour Sub-categories: Neglect – Hygiene & personal care; Neglect – Nourishment & hydration;Neglect – general; Rough handling & discomfort; Examination & monitoring; Making &following care plans; Outcomes & side effects. Keywords: “not provided”, “was not done”, “did not follow guidelines”, “poor standards”,“should have”, “not completed”, “unacceptable quality”, “not successful”.1. Low severity2. Medium severity3. High severityDelay changing dirty beddingPatient dressed in dirty clothesPatient left in own waste in bedIsolated lack of food or waterNothing to eat or drink forone dayPatient dehydrated/malnourishedWound not dressed properlySeeping wound ignoredInfected wound not tended toRough handling patientPatient briefly without painreliefForce feeding baby, resultingin vomitingPatient monitoring delayedPatient not monitored properlyDischarge without sufficientexaminationPatient not involved in care planAspect of care plan overlookedFailing to heed warnings inpatient notesPatient left with some scarringPatient required follow-upoperationPatient left with unexpecteddisabilitySafety: Errors, incidents, and staff competencies Sub-categories: Error – diagnosis; Error-medication; Error – general; Failure to respond;Clinician skills; Teamwork. Keywords: “incorrect”, “medication error”, “did not notice”, “mistake”, “failed to act”,“wrong”, “poor coordination”, “unaware”, “missed the signs”, “diagnosis”.1. Low severity2. Medium severity3. High severitySlight delay in making diagnosisClinician failed to diagnosea fractureClinician misdiagnosedcritical illnessSlight delay administeringmedicationStaff forgot to administermedicationIncorrect medicationwas administeredMinor error in recording patient progressDelay noticing deterioratingconditionOnset of severe sepsis wasnot identifiedNot responding to bell (isolated)Not responding to bell (multiple)Not responding to heart attackA minor error filling-out thepatient notesClinician overlookedinformation (eg, previousexperience of an illness)Clinician overlooked criticalinformation (eg, seriousdrug allergy)Minor misunderstandingamong cliniciansTest results not sharedwith cliniciansFailure to coordinate timecritical decision9
A2. Management Problems. Issues relating to the environment and organisation within whichhealthcare is provided (for which administrative, technical, facilities and management staff areusually responsible)Environment: Problems in the facilities, services, clinical equipment, and staffing levels Sub-categories: Accommodation; Preparedness; Ward cleanliness; Equipment;Staffing; Security. Keywords: “not available”, “shut”, “not enough”, “dirty”, “shortages”, “broken”, “poorequipment”, “soiled”, “used before”, “poorly signed”.1. Low severity2. Medium severity3. High severityNoisy ward surroundingsPatient was cold anduncomfortableFleas, bed bugs, rodentsPatient bed not readyupon arrivalPatient placed in bed in corridorPatient relocated due tobed shortageDirt and cigarette ends onmain floorBlood stains in bathroomOverflowing toilet, faeceson floorParking meter not workingA temporary malfunction in anIT systemMedical equipmentmalfunctionedMidwife repeatedly called awaySpecialist not availableSevere staff shortagesArgument between patientsOne patient bullyinganother patientPatient assaulted byanother patientInstitutional Processes: Problems in bureaucracy, waiting times, and accessing care Sub-categories: Delay – access; Delay – procedure; Delay – general; Bureaucracy;Visiting; Documentation. Keywords: “delayed”, “postponed”, “cancelled”, “lost”, “not admitted”, “administrativeproblems”, “not referred”, “confused notes”, “more paperwork”, “unaware of me”.1. Low severity2. Medium severity3. High severityDifficulty phoning healthcare unit Waited in emergency roomfor hoursUnable to access specialist careNon-urgent medicalprocedure delayedMedical procedure delayedAcute medical procedure delayedPhone calls not returnedComplaint not responded toEmergency phone call notAppointment cancelledand rescheduledChasing departments foran appointmentRefusal to give appointmentVisiting times unclearVisiting unavailableFamily unable to visitdying patientPatient notes not readyfor consultationPatient notes temporarily lostAnother patient’s notes used asbasis for consultationresponded to10
A3. Relationship Problems. Issues relating to the behaviour of any member of staff towards thepatient or their family/friendsListening: Healthcare staff disregard or do not acknowledge information from patients Sub-categories: Ignoring patients; Dismissing patients; Token listening Keywords: “I said”, “I told”, “ignored”, “disregarded”, “battled to be heard”, “notacknowledged”, “excluded”, “uninterested” and “not taken seriously”.1. Low severity2. Medium severity3. High severityStaff ignored questionStaff ignored mild patient painStaff ignored severe distressPatient’s dietary preferenceswere dismissedPatient-provided informationdismissedCritical patient-providedinformation repeatedly dismissedQuestion acknowledged, butnot responded toPatient anxieties acknowledged,but were not addressedPatient pain acknowledged, butno follow through on pain reliefCommunication: Absent or incorrect communication from healthcare staff to patients Sub-categories: Delayed communication; Incorrect communication; Absent communication. Keywords: “no-one said”, “I was not informed”, “he/she said ‘X’”, “they told me”, “no-oneexplained”, “contradictory”, “unanswered questions”, “confused”, “incorrect”.1. Low severity2. Medium severity3. High severityShort delay communicatingtest resultsLong delay communicatingtest resultsUrgent test results delayedPatient received incorrectdirectionsPatient received conflictingdiagnosesPatient given wrong test resultsStaff did not communicatea ward changeStaff did not communicatecare planDementia patientdischarged without thefamily being informedRespect and patient rights: Disrespect or violations of patient rights by staff Sub-categories: Disrespect; Confidentiality; Rights; Consent; Privacy. Keywords: “rude”, “attitude”, “humiliated”, “disrespectful”, “scared to ask”,“embarrassed”, “inappropriate”, “no consent”, “abused”, “assaulted”, “privacy”.1. Low severity2. Medium severity3. High severityStaff spoke incondescending mannerRude behaviourHumiliation in relation toincontinencePrivate information divulged tothe receptionistPrivate information divulged tofamily membersPrivate information shared withmembers of the publicStaff member lost temperPatient intimidated by staffmemberPatient discriminated againstUnclear information for consentConsent was obtained justprior to a procedure, giving nodiscussion timeDo-not-resuscitate decisionwithout obtaining consentLack of privacy during discussionLack of privacy duringexaminationPatient experienced miscarriagewithout privacy11
Section B: Specifying the stages of care complained aboutThe second stage in coding a healthcarecomplaint is the specification of the stagesof care to which a patient’s poor healthcareexperience refers. Only code stages when aproblem category is identified within thatstage of care. Healthcare complaints can focuson a single event within one stage of care (eg,an operation), or to multiple events that occuracross an entire institution. Within HCAT, fivegeneric stages of care are identified (and a sixth“other” category). These stages have beendrawn from research on patient “journeys”through healthcare systems [42, 43]. The stagesof care are listed in table 4.Table 4. Stages of care1. Admissions:This refers to when a patient arrives at healthcare unit, and isadmitted to a unit or ward. For example, when initially receivingtreatment at an accident and emergency unit, being referred toa clinician, or first arriving to receive care.2. Examination and diagnosis: This refers to when a patient is examined and diagnosedby clinical staff. For example, when being examined by anacute care ward, receiving a pre-operative diagnosis, or beingassessed by a radiology team.3. Care on the ward:This refers to when patients are receiving clinical or nursingroutine care (eg, food, water, washing, medication, wounddressing), being assessed and monitored by healthcare staff,and post-operative recovery.4. Operation / procedures:This refers to the operations and medical procedures performedon patients by healthcare staff. For example, when patientsundergo surgery, give birth, receive emergency care, or undergoa routine procedure (eg, insertion of a tracheotomy).5. Discharge / transfers:This refers to patients being discharged from the healthcareunit. For example, when patients are discharged from hospitalafter a surgical procedure, or are transferred from an intensivecare unit to a high dependency unit.6. Unspecified or otherWhere it is not possible to determine the stage of care, or itdoes not fit into the above categoriesFor the letter of healthcare complaint, indicatein SECTION B of the HCAT form (at the endof this document) which stages of care theproblems identified in Section A referred to. All12stages of care can be selected if the complaintrefers to them all. In the case that it is notpossible to determine the stage of care, pleaseindicate “other”.
Section C: Level of harm reported in the complaintThe third stage in coding a healthcarecomplaint is to specify the level of harmexperienced and reported in the letter ofcomplaint. Harm is rated on the NationalReporting and Learning System [44] used in theUK to classify harm reported in critical incidentsoutlined in table 5.Indicate in SECTION C of the HCAT formthe level of harm experienced by patients.Assessments of harm should focus on theoverall harm caused to patients by theproblems raised in the letter of complaint.For example, if the patient dies, but thecomplaint is about dignity after death, then theharm relates only to the consequences of thelack of dignity.It is important to note that harm is independentfrom problem severity. For example, a patientdescribing a severe safety problem (eg, amedication error) may not have experiencedharm due to the error being identified.Table 5. Patient harm0. N/ANo information on harm is reported1. Minimal harmMinimal intervention or treatment required (eg, from a bruiseor graze)2. Minor harmMinor intervention required to ameliorate harm (eg, from asprain, anxiety)3. Moderate harmSignificant intervention required to ameliorate harm (eg, from agrade 2-3 pressure ulcer, healthcare acquired infection)4. Major harmPatent experienced, or faces, long-term incapacity (eg, from adislocation, fracture, haemolytic transfusion, wrong medicationside effect, post-traumatic stress)5. Catastrophic harmDeath or multiple/permanent injuries (eg, wrong-site surgery,paralysis, permanent or chronic mental health problems)Section D: Descriptive detailsThe final stage in coding a healthcarecomplaint is to specify basic descriptive detailsin relation to the complaint. These are definedin table 6. Record these details in SECTION D ofthe HCAT form.Table 6. Hospital complaint details1. Who made the complaint?Indicate whether the complaint was made by a patient, familymember, lawyer, or other third-party2. What is the gender ofthe patient?Indicate whether the patient complaining (or being complainedon the behalf of) is male or female3. Which staff groups doesthe complaint refer to?Report whether staffing group or groups complained about areAdministrative, Healthcare assistants, Medical Staff, NursingStaff, Pharmacists, Physiotherapists, or unspecified/other13
REFERENCES141MacArthur CA, Ferretti RP, Okolo CM, et al.Technology applications for students withliteracy problems: A critical review. Elem SchJ 2001;101:273–301.8Basch E. The missing voice of patientsin drug-safety reporting. N Engl JMed 2010;362:865–9. doi:10.1056/NEJMp09114942Bouwman R, Bomhoff M, Robben P, et al.Patients’ perspectives on the role of theircomplaints in the regulatory process. HealthExpect 2015. doi:10.1111/hex.12373[published Online Frist: 7 May 2015]9Koutantji M, Davis R, Vincent C, et al. Thepatient’s role in patient safety: engagingpatients, their representatives, and healthprofessionals. Clin Risk 2005;11:99–104.3Gallagher TH, Mazor KM. Taking complaintsseriously: Using the patient safety lens. BMJQual Saf 2015;24:352–5. doi:10.1136/bmjqs-2015-0043374Kroening H, Kerr B, Bruce J, et al. Patientcomplaints as predictors of patient safetyincidents. Patient Exp J 2015;2:94–101.5Francis R. Independent Inquiry intocare provided by Mid Staffordshire NHSFoundation Trust January 2005-March2009. Norwich, UK: The StationeryOffice 2010.6Reader TW, Gillespie A, Roberts J. Patientcomplaints in healthcare systems: Asystematic review and coding taxonomy.BMJ Qual Saf cent C. Patient safety. Chchester, UK:John Wiley & Sons 2011.10 Pittet D, Panesar SS, Wilson K, et al.Involving the patient to ask about hospitalhand hygiene: A National Patient SafetyAgency feasibility study. J Hosp Infect2011;77:299–303.11 Ward JK, Armitage G. Can patients reportpatient safety incidents in a hospitalsetting? A systematic review. BMJ QualSaf 2012;21:685–99. doi:10.1136/bmjqs-2011-00021312 Lawton R, O’Hara JK, Sheard L, et al.Can staff and patient perspectives onhospital safety predict harm-free care? Ananalysis of staff and patient survey dataand routinely collected outcomes. BMJQual Saf 2015;:369–76. doi:10.1136/bmjqs-2014-00369113 Reader TW, Gillespie A. Patient neglectin healthcare institutions: A systematicreview and conceptual model.BMC Health Serv Res 2013;13:156.doi:10.1186/1472-6963-13-156
14 Järvelin J, Häkkinen U. Can patient injuryclaims be utilised as a quality indicator?Health Policy 01223 Toop L. Primary c
Healthcare Complaints Analysis Tool version 3, 2015 License Healthcare Complaints Analysis Tool is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Contact More details about the Healthcare Complaints Analysis Tool and support for implementing it can be obtained from the authors:
Dispute resolution: Complaints DISP INTRO Introduction INTRO 1 Introduction DISP 1 Treating complainants fairly 1.1 Purpose and application 1.1A Complaints handling requirements for MiFID complaints 1.2 Consumer awareness rules 1.3 Complaints handling rules 1.4 Complaints resolution rules 1.5 Complaints resolved by close of the third business day
where healthcare complaints are divided into three general domains: Clinical complaints, Relationship complaints, and Management complaints Category Categories represent the second level of the taxonomy, which clarify the types of healthcare complaints under each Domain. Sub-Category Sub-categories represent the third level of the taxonomy,
G:\Member Services\General\Member Relations\ISSUES & COMPLAINTS\COMPLAINTS\Procedures-Policies-Scripts & training tools\ICHP\Internal Complaints Handling Policy ver 7.doc 1 ARSN 094 718 108 ("Club") A.P.V.C. Limited ACN 093 228 141 (“Responsible Entity”) Internal Complaints Handling Policy & Procedure Manual
Best practice for complaints management processes Best practice for complaints management processes are widely reported and include the following: acknowledging complaints promptly [4, 6-8, 10] assessing complaints and assigning them priority [4, 6-8, 11, 13] planning an investigation if one is needed [4, 6, 8]
1. make a complaint to the complaints and client relations Section, or 2. have your bill taxed (see page 10) If you go to the complaints and elations Section, the usual complaints client r procedure is followed. The complaints and client elations Section will determine r whether the solicitor's fee is excessive. The bill must have issued less .
Objectives. Participants will be able to: Define and explain Guests Complaints. Identify the nature and types of complaints. Identify the skills necessary to dealing with complaints. Document the global procedures of Guests complaints handling. Identify each type of customer who complains and how to handle them. Analyze each complaint situation and determine an
Complaints as % of all attendances 0.10 0.11 0.09 0.08 Complaints as a % of Inpatient Activity 1.66 1.63 1.50 1.52 Table 2 below shows the number of complaints received and the method by which they were received. The majority of complaints were received by email.
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