Managing the complaint process - PowerPoint Presentation

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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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