How to resolve patient complaints effectively – first time

A prompt, professional, and empathetic response to complaints is the surest way to prevent them from escalating, according to Dr Michael Devlin

Every doctor aims for the best outcome for their patients, but inevitably, some will be dissatisfied – and it’s often the treating doctor who hears about it first. While it’s dispiriting and worrying to receive a complaint, being the first responder gives you a golden opportunity to resolve the patient’s concerns.

The following advice from the Medical Defence Union can help you resolve complaints informally within 48 hours under stage 1 (point of contact) of the HSE’s four-stage complaints process – and even turn a difficult interaction into a positive one.

Respond to signs that a patient is unhappy

Listening to patients and being aware of their body language during an interaction should give you a clear sign that all is not well. So take this as your cue to find out more.

By showing concern, expressing sympathy, and asking open questions such as “How has this affected you?” and “What can I do to put this right?”, you encourage the patient, or their representative, to share their experience and feel heard. This should put you in a better position to deal with low-level concerns straight away.

Listening to patients and being aware of their body language during an interaction
should give you a clear sign that all is not well

Empathise with the patient

Try not to take a complaint as a personal criticism and instead ask yourself how you’d want to be treated if you were the patient or if it was a member of your family?

It can also help to think back to a situation when you have had cause to complain. It’s likely you were motivated by the wish to find out what had gone wrong and prevent someone else from having a bad experience rather than a desire to cause trouble or a payout – why should it be any different for the patient?

An empathetic approach, combined with a calm and professional manner, will give you a better chance of establishing a rapport with the patient and resolving their complaint. Reacting defensively will almost certainly make things worse.

Find a quiet place to talk, as long as it’s safe

It’s important to give the patient the time and privacy to talk about their concerns rather than putting them on the spot in a busy public area of the hospital. Once you’ve ensured their immediate healthcare needs have been met, find a quiet room where you can listen to them without interruption and clarify the details of what happened without being drawn into speculation or blame. A calmer environment will lower everyone’s stress levels and should make it easier to agree on a solution.

At the same time, don’t accept behaviour that makes you feel unsafe – if an aggrieved patient is behaving aggressively, report this under the hospital’s zero tolerance policy.

Take notes

It’s important to take notes of your conversation with the patient. This will act as a reminder for you but also help your line manager and the hospital complaints team if it comes to a formal complaint. The HSE says you should record:

• What happened and when;

• Who was involved;

• The name of the service;

• What they want to happen;

• The name and contact details of the patient (or their representative).

It’s also a good idea to write down a factual account of your own involvement in an adverse incident while the details are still fresh in your mind, in case a formal investigation is required.

Be prepared to say sorry

As the HSE points out, “When things go wrong, saying sorry, apologising, or expressing regret is the right thing to do.” But you must ensure “your apology is genuine, sincere, empathetic, and meaningful”. You can find a list of apology dos and don’ts on the Executive’s website.

Contrary to the fears of many doctors, an apology is not an admission of wrongdoing but a recognition that things could have been done differently – even when the overall care was exemplary.

Seek help promptly from your line manager

Time is of the essence, so contact your line manager instantly if you can’t find an immediate solution to the complaint, or if it’s too complex, serious, or requires investigation. In this situation, you’ll need to reassure the patient and explain what is happening next, so they aren’t left in limbo. The HSE says you should get their agreement to your plan and give them your contact details in case they have questions later. You should also give them details of support services such as the HSE or Patient Advocacy Service.

Your line manager should try to find a solution within 48 hours or seek consent to refer the matter to a hospital complaints officer.

Help the patient make a formal complaint

Don’t try to make it difficult for a patient, or their representative, to make a formal complaint. Not only is this unprofessional, it’s likely to be counterproductive. Instead, support them by finding out if they’d prefer to complain directly to the HSE (this can be in English or another language), if they want to contact a complaints officer, or for you to escalate it on their behalf. The HSE says it’s best for complaints to be in the patient’s own words, but if someone needs help completing a feedback form, you’re obliged to do so.

Seek advice

Being involved in complaints, even informal ones, can be stressful and it helps to get expert advice from your medical defence organisation or your line manager at the outset if you’re unsure how to handle the situation.

Complaints which can’t be resolved at stage 1 might then be escalated through another three stages (complaints officer, review, and external review by the Ombudsman) so it’s much better for the patient and healthcare staff if concerns can be addressed informally. The good news is that most patients and their doctors want the same thing – a safe and well-run hospital – so it’s usually possible to find common ground.

MDU membership gives State-indemnified doctors access to expert guidance with medico-legal dilemmas like prescribing concerns. We can support you with patient complaints, Medical Council investigations, inquests and criminal matters. To find out more see www.themdu.com/ireland