July New study uses patient complaints data to improve healthcare quality

NUI Galway and HSE collaborate to analyse patient and service user complaints to identify ‘hot spots’ and ‘blind spots’ in healthcare delivery to better target service improvements

A new collaborative project by researchers at NUI Galway and the HSE has evaluated acute healthcare services and complaints to identify growing problems as well as opportunities for improvements in clinical safety and quality.

This study is the first national and systematic study of healthcare complaints, and was conducted during the last quarter of 2019.

Using the London School of Economics Healthcare Complaints Audit Tool (HCAT), an innovative and internationally recognised method of classifying complaints, the study identified key issues that those who use healthcare services complain about.

Analysis of patient complaints about hospital care found that more than one-in-four issues relate to situations while the patient is receiving care on the ward. Other common complaints related to accessing appointments, treatment, safety, and cleanliness of hospital environments.

Dr Paul O’Connor, Senior Lecturer in Primary Care at the College of Medicine, Nursing and Health Sciences at NUI Galway and Research Director of the Irish Centre for Applied Patient Safety and Simulation, said: “By examining trends in complaints our research team has identified where healthcare quality improvement efforts should be focused.

“Using HCAT to analyse complaints helped us to identify hot spots - where problems occur most frequently or cause major impact- and blind spots - where problems occur but cannot be easily observed by healthcare staff. The findings can positively impact healthcare by guiding us and the health service to prioritise the issues in relation to patient safety and focus quality of care improvement efforts.

“The research has shown that there is potential for patient complaints to be used as a source of information for identifying where safety and quality improvement efforts are needed.” 

Welcoming the study Chris Rudland, Assistant National Director, National Complaints Governance and Learning Team, HSE said “Using data such as complaints from patients and family members ensures their voices are represented in service improvements. This joint research initiative with NUI Galway can help develop how the HSE analyses and learns from patient complaints and can guide ongoing quality improvement initiatives in our hospitals to improve patient experience.

“The HSE is committed to ensuring that improving patient experience continues to be a key focus for us all throughout the healthcare system. HSE services encourage patient feedback through our complaints and feedback policy, and through other initiatives such as the National Inpatient Experience Survey. Listening to patients and asking them for feedback is a central tenet of improving patient care and the hospital experience for patients and their loved ones.

“It is encouraging to note that in the most recent National Inpatient Experience Survey findings, 83% of our patients rated their overall hospital experience in hospitals as “good” or “very good”. Many of our hospitals now have patient liaison and patient advocacy services in place to support patients throughout their time in our care.”

The research included a number of recommendations:

• Institutional process issues were the most prevalent in the complaints, and the system/hospitals should focus on improving the issues raised in these complaints.

• High-severity complaints, and those perceived by patients as being of high harm, need to be prioritised and used alongside other data in order to improve patient safety. 

• Stakeholder workshops with healthcare staff and patients should be used to identify useful and feasible solutions to improve safety and quality from issues identified in patient and service user complaints.

Dr Paul O’Connor added: “The next steps will be to work with healthcare providers, managers, and policymakers to support tangible improvements in patient care based on the findings of our complaints analysis.” 

The report is available at: https://www.nuigalway.ie/hse-complaints-report/

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