Learning from complaints about hospital care

Abstract

Complaints are often seen as a negative experience in healthcare, with patients or family members writing about poor experiences of care, or things that went wrong. These things that go wrong may be small issues or major problems. Patient complaints are usually written with the aim of helping to improve healthcare for future patients. Patients may have a perspective that differs from healthcare providers. For example, providers might not know about how patients dignity was respected, whether they experienced delays, or how they were interacted with. Patients, however, know all of these things. It is known that patient insights into their care can improve healthcare. However, these insights may not be considered to the same extent as staff measures of quality and safety of care. Most assessments of quality of care in Irish healthcare services are focused on healthcare workers’ opinions, statistics about observable events (e.g., how many patients got an infection in hospital), or investigating large errors. Until recently, complaints have not been used by hospitals or the healthcare service in Ireland to make broad improvements to healthcare delivery. While these complaints receive individual responses, there is no focus on analysing these complaints together and using this data to learn about key issues in specific services and the healthcare system. This means that patients’ desire, and ability, to contribute to identifying problems and potential solutions are limited. Researchers at the London School of Economics have developed the Healthcare Complaints Analysis Tool (HCAT)1 that guides the systematic analysis of the cause and severity of complaints. The Health Research Board (HRB) and Health Service Executive (HSE) funded research project utilised the HCAT to analyse complaints received about Irish healthcare organisations. The research involved the collaboration of researchers, HSE managerial staff, healthcare workers, and quality and patient safety professionals in hospitals.