Background:
Traditionally the patients were able to complain personally or
in written over a provider directly to the practice manager but
only a few did it so. Many of the complaints got forgotten because
of the "insignificant" content. Early detection of problems
can improve doctor patient communication and diminish serious
complaints or even suits. Patients should be empowered to communicate
their experiences through complaint procedure.
Aim:
The objective of the project is to enable patients to communicate
their experiences and use of them for quality improvement efforts
in an easy and acceptable manner.
Methods:
Boxes for collecting complaints were installed at all major patient
areas in health centres in the district Gorenjsko which cover
primary care for 200.000 patients. Patients were instructed to
deliver their complaints and comments signed or unsigned. Short
instructions for patients are available on the posters and on
the leaflets which contain form for delivering comments. Responsible
persons were appointed in each of 6 health centres. If the patient
delivers signed comment he receives reply from the person responsible
for handling complaints. Data are gathered from complaint boxes
on a monthly basis. Complaints are sorted by the type of the problem.
Technical problems are addressed by a group of experts, other
are used for planing CME and other activities to improve doctor
patient communication.
Results:
In a half year period one complaint over the technical aspect
of care arrived and was settled by internal audit procedure. One
complaint was about the organisation of out of hours services
because the doctor was not in the office when she should be. There
were also five complaints over the provision of appointments for
specialist services and unavailability of the doctor during the
afternoon hours. In three health centres we did not receive any
complaint.
Conclusions:
Patients express positive attitude towards the possibility to
provide their opinions in such an easy manner. The number of comments
received from the patients is still very low due to cultural differences
in ECC, but the first steps have been made. Further empowering
of patients to communicate their views is needed. The staff has
to be reassured the complaint system is not aimed to victimise
them but to improve their performance especially in interpersonal
aspects of care.
