Background
Patient dissatisfaction with complaints handling
Patients' motives for complaining
Patients' expectations of complaints handling
Hypothesis and research questions
Methods
Design of the study
Privacy protection
-
Neither the complaints committees nor the hospitals saw the completed questionnaires and neither party knew which patients participated in the study.
-
It was explained in a letter that the complainants were entirely free to decide whether or not to complete the questionnaire; no reminder would follow.
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It was explained in a letter that patients' responses to the questionnaire would and could have no bearing on the conduct or outcome of the complaints procedures.
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Complainants' responses were treated confidentially. A written privacy protocol was used to process the data.
Questionnaire
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The consequences i.e. impact of the complaint.
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Patients' initial expectations regarding the complaints committee, the hospital and the medical professional who gave cause for the complaint.
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Patients' experiences of the conduct of the complaints committee and of the reactions of the hospital and the medical professional.
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Patients' satisfaction with a) the committee, b) the hospital and c) the medical professional, patients' overall feelings that justice was done (dependent variables) and the decision of the committee on the complaint.
Respondents
Analyses
Results
The complainants
Demographic characteristics | |
---|---|
Females | 65% |
With higher professional or university education | 43% |
Age, mean | 52 yrs |
Age, range | 19 – 83 yrs |
Complaint characteristics
| |
Concerned medical treatment | 66% |
Concerned nursing care | 22% |
Concerned lack of information | 41% |
Concerned interpersonal conduct | 57% |
Concerned organisation of care | 38% |
Reported impact of event giving rise to complaint
| |
Gave rise to physical discomfort, pain or handicap | 82% |
Gave rise to mental suffering | 85% |
Had financial consequences | 64% |
Made a claim for financial compensation
| |
Made a claim for financial compensation | 8% |
Procedural
conduct | Expectations very/most important % | Experiences % of patients who considered the item very/most important and reported that their expectations were not met |
---|---|---|
- recommendations to the hospital to make changes | 94 | 53 |
- decision on the validity of the complaint | 83 | 16 |
- rationale for the decision | 82 | 42 |
- investigation into the incident | 80 | 35 |
- clear information about the complaints procedures | 61 | 31 |
- opportunity to give a personal account of what happened | 57 | 30 |
- swift response | 45 | 43 |
Interpersonal conduct
| ||
- impartial attitude and position | 92 | 36 |
- respectful treatment | 84 | 21 |
- patient's account of what had happened was listened to | 75 | 23 |
- understanding shown for the patient's experiences | 74 | 37 |
- sympathy shown for what the patient had been through | 47 | 49 |
Patients' experiences with the complaints committee
Decision on the complaint | % |
- well-founded | 31 |
- well-founded in part/unfounded in part | 36 |
- unfounded | 21 |
- dismissed | 1 |
- other/missing | 11 |
Hospital management
| Expectations very and most important % | Experiences % of patients who considered the item very/most important reporting that their expectations were not met |
---|---|---|
- ensure the complaint is discussed with the employees or department involved | 86 | 61 |
- inform me that corrective measures have been taken | 84 | 77 |
- inform me which corrective measures have been taken | 73 | 88 |
Medical professional(s)
| ||
- admit an error if an error was made | 89 | 79 |
- explain how the incident could have happened | 75 | 79 |
- offer an apology | 45 | 81 |
- show sympathy for what I went through | 44 | 80 |
- make an effort to restore our relationship | 19 | 88 |
Patients' experiences with the hospital and professionals
Patients' satisfaction and the feeling that justice was done
complaints committee | hospital management | medical professional | |
Definitely satisfied | 39 | 14 | 8 |
Moderately satisfied | 24 | 15 | 10 |
Moderately dissatisfied | 11 | 11 | 11 |
Definitely dissatisfied | 26 | 60 | 71 |
Unmet expectations and patient satisfaction
Dependent variable: Satisfaction with complaints committee
| adjusted R2 = 0.51 |
---|---|
Independent variables
| |
Independent variables in the equation |
Beta (standardised) (p-value)
|
- Committee showed an impartial attitude | 0.45 (0.000) |
- Committee showed sympathy for what the patient had been through | 0.13 (0.013) |
- Committee gave clear information about the procedures | 0.14 (0.006) |
- Committee made recommendations to hospital to make changes | 0.16 (0.002) |
- Committee responded swiftly | 0.11 (0.032) |
- Gender of patient (male (1), female (2)) | 0.14 (0.003) |
- Impact of the incident underlying the complaint (0 = no harm to 3 = harm in three areas) | - 0.10 (0.037) |
Independent variables not in the equation |
B if put in model (p-value)
|
- Respectful treatment by committee | 0.07 (0.195) |
- Committee listened to patient's account of what had happened | 0.10 (0.062) |
- Committee investigated the incident | 0.10 (0.068) |
- Committee made a decision on the validity of the complaint | -0.02 (0.678) |
- Committee explained the rationale for the decision | 0.04 (0.480) |
- Committee gave the opportunity to provide a personal account of what had happened | -0.01 (0.813) |
- Level of education (1–5) | 0.01 (0.907) |
- Age (years) | -0.02 (0.686) |
Dependent variable: Satisfaction with hospital management
|
adjusted
R
2
= 0.31
|
Independent variables in the equation |
Beta (standardised) (p-value)
|
- Hospital discussed the complaint with employees | 0.42 (0.000) |
- Hospital reported what corrective measures had been taken | 0.20 (0.001) |
- Impact of the incident underlying the complaint (0 = no harm to 3 = harm in three areas) | - 0.16 (0.004) |
- Gender of patient (male (1), female (2)) | 0.11 (0.045) |
Independent variables not in the equation |
B if put in model (p-value)
|
- Level of education (1–5) | 0.10 (0.087) |
- Age (years) | 0.01 (0.904) |
Dependent variable: Satisfaction with medical professionals
|
adjusted
R
2
= 0.33
|
Independent variables in the equation |
Beta (standardised) (p-value)
|
- Professional showed sympathy for what patient went through | 0.21 (0.004) |
- Professional offered an apology | 0.22 (0.002) |
- Professional explained how things had happened | 0.15 (0.022) |
- Professional made efforts to restore the relationship | 0.17 (0.010) |
- Impact of the incident underlying the complaint (0 = no harm to 3 = harm in three areas) | -0.14 (0.013) |
Independent variables not in the equation |
B if put in model (p-value)
|
- Professional admitted an error if an error was made | 0.10 (0.153) |
- Gender of patient (male (1), female (2)) | 0.61 (0.280) |
- Level of education (1–5) | -0.00 (0.949) |
- Age (years) | -0.05 (0.420) |
Dependent variable: feeling that justice had been done | adjusted R2 = 0.42 |
---|---|
Independent variables
|
Beta (standardised) (p-value)
|
Satisfaction with complaints handling by Committee | 0.32 (0.000) |
Satisfaction with complaints handling by Hospital management | 0.15 (0.009) |
Satisfaction with complaints handling by Professional | 0.21 (0.000) |
The decision on the complaint (1 = complaint was well-founded, 0 = other decisions) | 0.22 (0.000) |