Why use a complaint tracking system?
Here’s what you’ll be missing if you don’t!
[Editor’s note: Last month, Hospital Home Health spoke with Nancy Woods, RN, specialty services director of Contin-U-Care Home Health in Chattanooga, TN, and Lorraine Waters, BSN, MA, executive director, Southern Home Care in Jeffersonville, IN, about their agencies’ patient complaint tracking systems. In the second part of the two -part series, HHH looks at the benefits of each system and how you can quickly review your own patient complaint tracking system.]
So you don’t think you can muster the time to create, implement, and manage a patient complaint tracking system? Does the documentation required seem too daunting?
Well, put your nose to the grindstone and jump in. Last month, HHH detailed the six steps that two agencies have created to smooth their complaint tracking process:
1. Patients are continually advised to report complaints.
2. The person on the management team who receives the complaint completes a complaint tracking form and an "opportunities for improvement" (OFI) form.
3. The agency administrator reviews the complaint.
4. The QI coordinator reviews complaints immediately and tabulates complaint data monthly.
5. The QI coordinator provides the tabulations from the OFI forms to the QI manager, then to the QI committee.
6. The hospital’s guest relations committee reviews the complaints.
The benefits of an effective patient complaint tracking system are many and worth the effort, sources say. They are:
• Ownership of patient complaints is defined.
Contin-U-Care Home Health’s patient complaint tracking system prevents problems from getting lost in the shuffle because it identifies the ownership of every reported problem to whoever gets the call, says Nancy Woods, RN, specialty services director, Contin-U-Care Home Health in Chattanooga, TN.
"No one can pass the problem on to someone else, so we’re guaranteed that all complaints will be addressed," says Woods.
• Problem trends are identified quickly.
Top management reviews complaint reports at Contin-U-Care monthly. This makes it impossible for a problem trend to go on for more than a month without top management being aware of it.
So far, Contin-U-Care’s QI coordinator reports haven’t contained any surprises, Woods says. Since the system was put into place, the company has not found any patient complaint trends that require a process change or other big modification.
The new complaint process did, however, validate Contin-U-Care middle managers’ beliefs that upper management was unaware of most patient complaints.
"What was happening was our middle managers were handling all the problems and, because they were handled, that report never made it to the upper level," says Woods. Now the agency not only documents problems but also conducts a follow-up, which confirmed that middle managers were already on top of patient complaints.
"We found that most complaints were already resolved by middle management before upper-level management intervention was needed," Woods says.
Nevertheless, the system gives the company’s top managers a greater sense of security, knowing that they will always learn of problem trends well before they reach a crisis stage, Woods says.
• Individuals involved in patient complaints are more easily identified.
Contin-U-Care Home Health’s opportunity for improvement forms provide better documentation of patients’ complaints, making it easier to correct individual staff who may have contributed to the problem that caused the patient to complain, Woods says. (See sample form, inserted in this issue.)
• The complaint tracking system fosters documentation accuracy.
For example, during a recent state survey, the surveyor told Southern Home Care that a patient had filed a complaint about the company on the state’s toll-free hotline. The surveyor could not release the complainant’s name, though, for confidentiality reasons.
"We were shocked. That had never happened, and we had no idea who might have complained about what," relates Lorraine Waters, BSN, MA, executive director, Southern Home Care in Jeffersonville, IN.
No deficiencies found
By noting which patient charts and patient complaint records the surveyor asked to see, Waters was able to determine which patient had filed the complaint. Then Waters and her staff worried that the problem the patient reported to the state wouldn’t be recorded properly or adequately in their own files.
But when the surveyor looked at Southern Home Care’s record of the patient’s complaint, she found a report of the patient’s complaint that was almost identical to the one the patient made to the state. And both the state’s and the agency’s complaint reports found the same thing: The patient had wanted to complain about the local Council on Aging but had confused it with the home care agency she also used.
"This was perfect. It was exactly what should have happened, and we didn’t have any deficiencies on the survey," Waters says.
• The system facilitates coordination of patient satisfaction efforts with the hospital.
Because the company keeps much better track of patients complaints now, Woods can use the information gathered on the OFIs to bring complaints to the attention of the agency’s affiliated hospital.
"I call the head nurse at the hospital about complaints we get from patients that involve the hospital. For example, a patient might complain to one of my home health aides about something that happened to them in the hospital. I call and let the head nurse know, so she can address the problem," Woods explains.
Patients might complain about other types of care they have received besides home care, and Contin-U-Care Home Health tracks all of these, too.
Contin-U-Care Home Health did not involve the hospital when the new QI program was set up and implemented. Rather, Woods simply began calling the hospital’s head nurse when complaints came up.
"You have to do it carefully, though. We’re not complaining about the hospital. We simply want to make them aware of a situation they may not know about," Woods says.
She also encourages the hospital’s head nurse and other personnel to call her if a patient complains at the hospital about something to do with home care. For example, a home care patient who was hospitalized complained that there were too many caregivers in his home and that he never saw the same nurse or aide twice. The hospital social worker called Woods to alert her to that problem.
Use data to prove your claims
• Data can back up your funding requests.
Patient complaints data have helped Waters prove statistically that her home care department needs more staff nurses.
"When we get a bunch of complaints about patients never seeing the same PRN twice, we then have solid data to show that we have a shortage of full-time PRN and that patient satisfaction is going down as a result," Waters says.
• Accurate and timely patient complaint data can protect your company’s relations with doctors.
If you don’t deal with patients’ complaints about your home care company, eventually patients will complain about you to their doctors, which will affect their referrals to you quickly, Waters warns.
"You have to deal with complaints immediately and on an ongoing basis," Waters stresses.
There is, however, one drawback to these patient complaint tracking systems: The documentation involved is time-consuming, Woods and Waters say.
"The data collection is a lot. There are lots of details to write down, and you can’t really use a checkbox system for this," Woods says.
Computer software programs have been written to help companies track patient complaints, but Woods hasn’t purchased any yet. The existing programs are expensive, with prices all over $1,000. Currently Woods’ QI coordinator uses a general spreadsheet program to set up her own spreadsheets and charts to tabulate and graph the patient complaint data collected.
"It’s tedious and time-consuming, but it works and it’s cheap," Woods says.
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