The use of patient complaints to drive quality improvement: an exploratory study in Taiwan.

This study aims to investigate the nature and resolutions of patient complaints and further to explore the use of complaints to drive quality improvement in a selected hospital in Taiwan. A teaching hospital (i.e. the Case Hospital) in Taiwan was purposefully chosen for a case study. The author conducted the critical incident technique (CIT) using questionnaires to obtain information about the complaints and the process of their resolutions. To enhance the reliability of the study, the author also conducted non-participant observations as an outsider at the Case Hospital. In this study, 59 complainants registered 87 complaints. The CIT found that care/treatment, humaneness and communication were the most common causes of complaints. The response time of patient complaints averaged 1.76 days, except for five cases in which response time was not reported. The majority of complaints were resolved within three days. Moreover, this study found that of 149 resolutions, 105 taken by the hospital involved an explanation of the facts to complainants (n = 41), investigation of events (n = 33) and empathy with complainants (n = 31). The lack of any systematic use of complaints data was one of the most crucial failures of the Case Hospital. Instead of attempting to use such data as the basis for initiating quality improvement measures, complaints were consigned to a 'black hole' where their existence was conveniently forgotten. Based on this study, the author suggests ways to strengthen the capacity of the hospital in terms of using patient feedback and complaints to improve the quality.

The organisational response to patient complaints: a case study in Taiwan.

PURPOSE: To explore and evaluate how hospital staff respond to patient complaints. DESIGN/METHODOLOGY/APPROACH: A teaching hospital with 1,500 beds in Taiwan was purposefully chosen as a case study of hospital response to patients' complaints. Data was obtained through interviews with quality surveying managers (n = 53), government managers (n = 4), staff of non-government organizations (n = 3) and a senior social worker, as well as analysis of documents (September 2001-April 2002). FINDINGS: Using the managerial-operational-technical framework developed by the researchers, the study demonstrated problematic aspects of handling complaints at the case hospital. It was revealed that: complaint handlers were not sufficiently empowered, information sharing was limited within the organization, communication among professional staff and with management was inadequate, the physical safety of workers had been threatened, and improvements could not be sustained. Moreover, it became apparent that the case study hospital generally responded to patient complaints in a reactive and defensive manner. ORIGINALITY/VALUE: It is evident that the hospital did not use patient complaints as a source of learning that could have promoted higher standards of care. The case study reveals some of the constraints and identifies requirements for appropriate use of information and feedback from patients. The study raises some issues requiring further research to ensure more appropriate use of patient complaints to improve quality of care.