Filing and Dealing with Patient Complaints

Introduction

The advent of managed care saw the healthcare industry become consumer-oriented. Much focus is now being directed towards the patient than ever before. Similar to professionals in other businesses from various sectors, nurses and physicians are now required to follow a systematic procedure for handling complaints. This procedure is not easy for every professional within the health sector (Reader, Gillespie & Roberts, 2014). The process of handling patient complaints is proving to be very challenging and stressful for healthcare specialists every day. In fact, one study established that 95% of physicians experience stress when allegations are made against them (Abdelrahman & Abdelmageed, 2017). Patients generally complain because of dissatisfaction from their experience, the result of care or seeking information that may not be forthcoming. Therefore, every physician and nurse needs to understand how a patient would file a complaint and the BORN process for handling the complaint.

How a Patient Would File a Complaint

According to the Board of Registration in Nursing, a patient or anyone who believes that a healthcare professional has engaged in any illegal activities associated with his or her responsibilities has the right to file a complaint. The grounds of the allegations range from incompetence or gross negligence to unlicensed operation. An individual who wishes to file a complaint must first access the specific nurse complaint form either from the hospital’s website or from any other sources as required by the organization (Mass.gov, 2018). Additionally, the person should also have all the necessary verifiable information such as the name of the nurse, the license number, the location and date of the incident, the individual’s contact details and any documents that support the complaint such as medical records. After providing as many details as possible, the patient should then describe the nature of the complaint in their own words. However, the description provide should only have necessary and factual information. Patients who wish to remain anonymous must still do their filing in writing. However, anonymous complaints are difficult to review without evidence of the made allegations. With advancements in technology, the process of filing a complaint today is mostly done online through the organization’s website. The individual making this effort only follows the onscreen instructions to submit his complaint (Abdelrahman & Abdelmageed, 2017).

BORN Process for Following through with the Complaint

After a patient has filed a complaint, the body responsible for complaints mostly the Board of a hospital sends written notification to the patient that confirms the receipt of the claim (Abdelrahman & Abdelmageed, 2017). Afterward, the complaints are reviewed and those that contain allegations with the greatest consequences are given priority. Examples of such allegations are patient abuse or gross negligence. An investigation is then launched by the hospital’s division of investigation in collaboration with the nursing consultants of the board. The investigators are responsible for determining if any violation was made. If none can be substantiated, the case is closed, and the body responsible notifies the complainant (Mass.gov, 2018). On the other hand, if the investigations establish that the health professional violated any of the stipulations made in the Nursing Practice Act and proceedings are held to warrant formal disciplinary action. There are instances when the investigation may reveal a criminal activity or unlicensed practices. In such cases, the case is referred to a higher authority most probably the local district attorney where prosecution is done (Reader, Gillespie & Roberts, 2014).

During the investigation, confidentiality is critical. However, keeping the complainant informed on the progress of the case may be essential because lack of response may be an addition to the individual’s grievance. However, while doing this, it is important to remember that the details of the investigation should never be made public before completion of the process because it may jeopardize the entire investigation. However, after the investigators have completed their job, some details about the disciplinary action taken can be revealed to the public. Additionally, if the case is referred to the local authorities following the discovery of criminal activity, the complainant may be required to appear in court as a possible witness (Reader, Gillespie & Roberts, 2014).

Conclusion

From the above discussion, it is clear that every practice should monitor and review complaints presented by their patients. The information gathered from investigations of such complaints is critical to improving the standard of service as well as helping the hospital achieve the ultimate goal of providing better care. Therefore, when a nurse, a physician, or any other professional within the health industry is confronted with complaints, he or she should not become defensive (Mass.gov, 2018). They should not blame the complainant for being hostile, difficult, or non-compliant but instead, they should seek advice and support from their defense organizations. In better circumstances when presented with a direct complaint, they should apologize to the patient and acknowledge any distress that might have triggered. Finally, the management should share the information that they learn after investigating complaints with members of the entire organization so that they can plan changes in procedures and processes that may be problematic (Reader, Gillespie & Roberts, 2014).