Lynne Anderson FACHE cphrm rhia May 14 2015 1 2 introduction We have all had to deal with some type of complaint patient family staff member Risk management synonymous with complaint management ID: 259136
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Managing the complaint process
Lynne Anderson, FACHE, cphrm rhia May 14, 2015
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introduction
We have all had to deal with some type of complaint (patient, family, staff member)Risk management synonymous with complaint managementUsually not pleasantThere is an art to dealing with complaints successfully
Have to be patient
Have to listen
M
ore than one side of a story
Today we are going to talk about ways to deal with complaints successfully
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objectives
Identify standards for dealing with patient complaintsLearn perspectives on dealing with patient complaintsLearn ways to defuse angry complainersLearn various approaches to managing complaintsLearn to develop safety measures for dealing with difficult people
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Two perspectives
RegulatoryHuman5Slide6
Regulatory perspective
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CMS/State regulations
Must have a process for patient grievances resolution (policy)Patient grievance = complaint (not all complaint rise to level of grievance)Verbal or writtenHospital must inform patient how to file (hospital contact and state agency)
Time frame for review of grievance and provision of response
Written response/follow-up
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The Joint commission or DNV
Expectation for timely resolutionCan lead to complaint investigationsPatient Rights chapter
Policy
Notification of who to contact and how complaint process works
Governing body responsibility for process
Time frames for handling
Referral to Utilization Review, Quality Management, Peer Review, or Quality Improvement Organization (QIO) as appropriate
Written notice to the patient of decision/resolution
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Approaches to complaint management
Centralized (handled by one department)Good control of processGood follow-upNo surprises if complaint investigationDecentralized (handled by the affected department)
Individuals close to situation more connected to resolution
Supervisors of persons involved in complaint more accountable for their employees’ performance
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human
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Human consideration
Consider all sides (usually three: patient; staff; truth) LISTEN to both sides Gather FACTS Ask parties what they would like to see as resolution
*
Some just want someone to listen
*Some
have specific requests that are easy to complyPropose
a resolution
*Tell
people what you CAN do first
*Tell
people what you CANNOT do
second (and why)
Be direct with both
parties
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Safety tips
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Safety first
Identify early on if mental issues Never allow them to be between you and door Have a plan for dealing with “crazies
”
Colleague
Security
Emergency Department
Alarms or code words
Gestures
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Defuse the situation
Stay calm yourselfBreatheRelaxMaintain healthy attitudeAllow angry person to vent (within reason)Demonstrate empathy
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Defuse the situation cont….Empathy…
DOAllow ample time to respondGive short responsesTailor response to situation
Use even voice tone
Try to understand their needs
DON’T
Automatically give advice
Pretend to understand
Respond with clichés
Sound condescending
Jump to conclusions
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Defuse the situation cont…..
Master the art of listeningPay attentionEliminate “buts”Repeat what the tell you for understandingFocus on issues and not on behaviors
Heed warning signs
Always, always, always take threats seriously
Report threats
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Take action
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Action steps
Log the complaint (name, date, investigation, resolutionComplete the investigationDetermine cause of complaintWritten follow-up (letter, email)Work with staff to change processes in order to avoid same issues again
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Educate staff
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Staff education
Always use teaching moments to review what led to the complaintObtain input from staff on their feelings about complaintReview positive ways of dealing with issues so as to avoid complaintsInclude staff in the investigation and resolutionTeach staff how to speak with persons filing complaint in a constructive manner after the complaint
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Staff education cont……general tips on managing anger
fuels angerLacking respect in toneNot looking at person
Needing to be right
Sarcasm, humiliation
Aggressive gestures, pointing
Inflexible
Lack of responsiveness
Reduces anger
Showing respect
Making eye contact
Open mind
Even, calm tone of voice
Neutral open gestures
Active listening skills
Flexible
Positive phrases
Responsiveness
Follow-up
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Follow-up
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Follow-up
Restore order after complaintAt least onceStaff (visit, phone call, email)Person who filed complaint (written, email or letter)Determine if action was effective
Document follow-up
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Restore order??????
Facilitate a discussion with partiesAdvise not to avoid the angry person (complainer or staff member)Provide a non-dramatic return to “patient care as usual”Offer to mediate a follow-up conversation
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conclusion
Two perspectives to complaint management: Regulatory and HumanRegulatory standards for dealing with complaints (CMS, State, TJC, DNV)Human perspective: LISTEN; ask what resolution they desire; tell them what you CAN doApproaches to dealing with complaints: Centralized and decentralizedSafety Tips: Identify mental issues; protect yourself; have a plan
Educate staff
Follow-up (staff, patient, written)
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Quick reference tips
Stay calmDefuse situations quickly; allow person to ventImagine yourself in their placeEncourage others to talk but don’t put them on defensiveAddress issues; not behaviorApologize; make corrections quickly
Allow other person to save face when possible
Give options, choices
Take all threats seriously
Help affected employees get back to normal promptly
Don’t avoid angry person after episode is over
Practice tolerance
Choose behaviors that reduce anger
Be tough and tender
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Questions
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