Valuable patient feedback often is ignored or disregarded in hectic EDs to the detriment of safety. “Patient complaints are hard to deal with and may be the most difficult aspect of a medical director’s job,” acknowledges David Ledrick, MD, director of observation medicine in the department of emergency medicine at Mercy St. Vincent Medical Center in Toledo, OH.
At Cleveland Clinic, unsolicited patient complaints are categorized by type of issue, unit location, severity, and the employee(s) involved.1 “The most common complaints have to do with communication issues in all settings, including emergency medicine,” says Stephanie Bayer, JD, senior director of patient experience. The database categorizes complaints (such as “communication,” “rudeness,” or “delay”). These steps are taken:
- An employee investigates the concerns, reviews medical records, and reaches out to everyone involved.
- Following the investigation, the department assigns a severity rating to the complaint based on the level of suffering the patient experienced.
- The patient experience team total complaints by 1,000 patient encounters to establish rates for each department.
“This allows large hospital emergency departments to be scaled the same as smaller hospital emergency departments,” Bayer says.
Some providers receive more complaints than their peers. “We offer them shadowing and individualized coaching to help improve their communication skills,” Bayer says.
Importantly, not all patient complaints about the ED are clinically oriented. “We also use complaint data to identify environmental improvements or offer additional comfort measures to patients waiting,” Bayer notes. Some ED patients complained that watching news channels in the waiting room increased anxiety in an already stressful situation. The ED waiting rooms switched to cooking channels.
Patterns of complaints on specific issues, such as dissatisfaction with a particular doctor or nurse, or certain tests constantly delayed, “are relatively easy for EDs to correct,” according to Ledrick. Everyday issues also can reveal underlying problems, such as patient alarms going unanswered for long periods. “Diligently stomping on all patient complaints, no matter how minor, may prevent a major one from occurring and ballooning into a malpractice issue,” says Ledrick. Not all complaints come in the form of a written letter to hospital administrators.
REFERENCE
- Bayer S, Kuzmickas P, Boissy A, et al. Categorizing and rating patient complaints: An innovative approach to improve patient experience. J Patient Exp 2021;8:2374373521998624.
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