Abstract
BackgroundThe management of complaints in the setting of intensive care may provide opportunities to understand patient and family experiences and needs. However, there are limited reports on the structured application of complaint analysis tools and comparisons between healthcare complaints in the critical care setting and other settings.MethodsFrom the complaint management database of a university-affiliated medical center in Taiwan, we retrospectively identified the records of healthcare complaints to the intensive care units (ICUs) from 2008 to 2016. Complaints to the general wards in the same period were randomly selected from the database with twice the number of that of the ICU complaints. We coded, typed, and compared the complaints from the two settings according to the Healthcare Complaint Analysis Tool.ResultsWe identified 343 complaints to the ICUs and randomly selected 686 complaints to the general wards during the 9-year study period. Most (94.7%) of the complaints to the ICUs came from the family members, whereas more complaints to the general wards came from the patients (44.2%). A total of 1529 problems (441 from ICU and 818 from general wards) were identified. Compared with the general ward complaints, in the ICU there were more complaints with multiple problems (25.1% vs. 16.9%, p = 0.002), complaints were referred more frequently to the nurses (28.1% vs. 17.5%, p < 0.001), and they focused more commonly on the care on the ICU/ward (60.5% vs. 54.2%, p = 0.029). The proportions of the three domains (clinical, management, and relationship) of complaints were similar between the ICU and general ward complaints (p = 0.121). However, in the management domain, the problems from ICU complaints focused more on the environment than on the institutional processes (90.9% vs. 74.5%, p < 0.001), whereas in the relationship domain, the problems focused more on communication (17.9% vs. 8.0%) and less on listening (34.6% vs. 46.5%) (p = 0.002) than the general ward complaints.ConclusionsA structured typing and systematic analysis of the healthcare complaints to the ICUs may provide valuable insights into the improvement of care quality, especially to the perceptions of the ICU environment and communications of the patients and their families.
Highlights
The management of complaints in the setting of intensive care may provide opportunities to understand patient and family experiences and needs
By comparing the administrative data on complaints issued by the family and surrogates (327 to the intensive care unit (ICU) and 304 to the general wards), we found that the ICU complaints were more often made using feedback sheets (59.6%) but fewer phone calls (19.6%) than ward complaints (42.8% and 30.96%) (p < 0.001)
At the individual category level, we found that in the domain of management problems, there were significantly fewer problems identified with the institutional processes among the ICU complaints (p < 0.001), whereas in the domain of relationship problems, the ICU complaints were more related to communication and less to listening (p = 0.002)
Summary
The management of complaints in the setting of intensive care may provide opportunities to understand patient and family experiences and needs. Researchers and institutions have advocated the assessment of healthcare complaints as a complementary tool based on the views and perceptions of the patients and their families about the care and services. Similar to the evolution of surveys, the provision of complaints has evolved to include multiple channels, such as e-mail and other electronic messaging services, and in-person contact with the patient relations office. This tool provides valuable information about people’s experience of the care and services received and their understanding of hospitals, patient safety, and healthcare quality [11, 12]. The Healthcare Complaint Analysis Tool (HCAT) advocated by Gillespie et al [20] provides a reliable tool for coding complaints and measuring the severity of complaints, to facilitate service monitoring and organizational learning and assessment of healthcare complaints as an indicator of poor service outcomes [20]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
