Complaints from emergency department patients largely result from treatment and communication problems.

OBJECTIVE Emergency department patient complaints are often justified and may lead to apology, remedial action or compensation. The aim of the present study was to analyse emergency department patient complaints in order to identify procedures or practices that require change and to make recommendations for intervention strategies aimed at decreasing complaint rates. METHODS We undertook a retrospective analysis of patient complaints from 36 Victorian emergency departments during a 61 month period. Data were obtained from the Health Complaint Information Program (Health Services Commissioner). RESULTS In all, 2,419 emergency department patients complained about a total of 3,418 separate issues (15.4% of all issues from all hospital departments). Of these, 1,157 complaints (47.80%) were received by telephone and 829 (34.3%) were received by letter; 1,526 (63.1 %) complaints were made by a person other than the patient. Highest complaint rates were received from patients who were female, born in non-English-speaking countries and very young or very old. One thousand one hundred and forty-one issues (33.4%) related to patient treatment, including inadequate treatment (329 issues) and inadequate diagnosis (249 issues); 1079 (31.6%) issues related to communication, including poor staff attitude, discourtesy and rudeness (444 issues); 407 (11.9%) issues related to delay in treatment. Overall, 2516 issues (73.6%) were resolved satisfactorily, usually by explanation or apology. Only 59 issues (1.7%) resulted in a procedure or policy change. Remedial action was taken in 109 issues (3.2%) and compensation was paid to eight patients. CONCLUSIONS Communication remains a significant factor in emergency department patient dissatisfaction. While patient complaints have resulted in major changes to policy and procedure, research and intervention strategies into communication problems are indicated. In the short term, focused staff training is recommended.

[1]  E J Orav,et al.  Determinants of patient satisfaction and willingness to return with emergency care. , 2000, Annals of emergency medicine.

[2]  P D Cleary,et al.  Benchmarking and quality improvement: the Harvard Emergency Department Quality Study. , 1999, The American journal of medicine.

[3]  E. Boudreaux,et al.  Determinants of patient satisfaction in a large, municipal ED: the role of demographic variables, visit characteristics, and patient perceptions. , 2000, The American journal of emergency medicine.

[4]  D. Holden,et al.  Adding value to the patient experience in emergency medicine: What features of the emergency department visit are most important to patients? , 1999 .

[5]  D. Overton,et al.  Emergency department complaint frequency: variation by patient median household income. , 1992, Annals of emergency medicine.

[6]  S. Ooi.  Emergency department complaints: a ten-year review. , 1997, Singapore medical journal.

[7]  J. Hedges,et al.  Patient satisfaction investigations and the emergency department: what does the literature say? , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[8]  P. Cameron,et al.  Institute for Health Care Improvement Collaborative Trial to improve process times in an Australian emergency department. , 2000, Journal of quality in clinical practice.

[9]  K. Kipp.  Implementing nursing caring standards in the emergency department. , 2001, The Journal of nursing administration.

[10]  B. Fasher,et al.  Patient dissatisfaction in a paediatric accident and emergency department. , 1994, Journal of quality in clinical practice.

[11]  P R Yarnold,et al.  Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department. , 1996, Annals of emergency medicine.

[12]  D T Overton,et al.  Emergency department complaints: a one-year analysis. , 1987, Annals of emergency medicine.

[13]  R. Shaw,et al.  Emergency department satisfaction: what matters most? , 1993, Annals of emergency medicine.

[14]  H. Giles,et al.  The effects of a seamless model of management on the quality of care for emergency department patients. , 2000, Journal of quality in clinical practice.

[15]  M. Hunt,et al.  A review of 7 years of complaints in an inner-city accident and emergency department. , 1991, Archives of emergency medicine.

[16]  T. Brennan,et al.  Impact of language barriers on patient satisfaction in an emergency department , 1999, Journal of General Internal Medicine.

[17]  F. Lau.  Can communication skills workshops for emergency department doctors improve patient satisfaction? , 2000, Journal of accident & emergency medicine.

[18]  V. Chande,et al.  Pediatric emergency department complaints: A three-year analysis of sources and trends , 1991 .