Feedback and complaints management

Regular collection of patient feedback to inform safety and quality priorities is an important element of measuring the quality of care. This can be done using feedback forms, informal conversations with patients or follow-up telephone calls. Patient feedback can often be referred to as ‘Patient-reported experience measures’ (PREMs). These are derived from patients’ responses to survey or interview questions about their recent experiences of services received at a healthcare service. 

Similarly, feedback from the workforce about their understanding and use of safety and quality systems indicates a healthcare service’s safety and quality culture and can be used to identify opportunities for improvement. Feedback may be sought through informal conversations, meetings or emails, surveys, performance discussions and information used to identify safety and quality training and development needs.

Links to Actions 1.03 Measurement and quality improvement and 2.08 Partnerships in the planning, design, monitoring and evaluation of services

• How and when is feedback sought from patients about their care?
• How and when is feedback sought from the workforce about their understanding and use of safety and quality systems?
• How has the feedback been used to improve care? 

• Regularly seek feedback from patients and the workforce and use this feedback to identify areas for safety and quality improvements.
• Implement changes to address improvement opportunities.

For certain healthcare services, it may be appropriate to integrate systems to seek and record feedback with other systems to meet safety and quality requirements, legal and business obligations. 

The type and comprehensiveness of evidence used is dependent on each healthcare service context, but could include: 

• Records of feedback, for example, survey responses and reports, notes from discussions with patients or the workforce, meeting or communication records, training and development plans
• Examples of safety and quality improvements made as a result of patient and/or workforce feedback.

Commission resource

• Australian Hospital Patient Experience Question Set – this is available in 20 languages, easy English, large print and braille. While originally designed for the hospital setting, the types of questions that could be used to collect patient feedback are broadly applicable. 

Other resources

• AIHW: Patient experiences in Australia by Primary Health Network (PHN) – a report providing national and primary health network level information on Australian adults’ experiences with the health care system.
• Royal Australian College of General Practitioners (RACGP): Develop your own patient feedback methods and templates – a resource to support general practices implementing the Standards for general practices 5th edition. The methods and examples are broadly applicable. 

Your profession-specific representative organisation may implement surveys for healthcare services to use in collecting feedback from patients.

Complaints from patients provide a unique opportunity to discuss with patients the care they have received, address any gaps in service delivery, and make improvements. 

A well-designed complaints management system includes:

• A clear description of how patients can report complaints
• Opportunities for patients to submit complaints
• A process on complaints reporting, investigation and actions taken 
• Description of the roles, responsibilities and accountabilities of the workforce in complaints management
• Processes for compliance with relevant state and territory mandatory reporting requirements 
• Information on how complaints and complaints resolution are communicated to patients 
• A process to analyse complaints in a timely way and improve safety and quality of care
• Mechanisms that link complaints management with other organisational processes and systems, including measurement and quality improvement, incident management system, open disclosure, risk management and policy development.

Links to Actions 1.02 Policies and procedures; 1.03 Measurement and quality improvement; 1.04 Risk management; 1.05 and 1.06 Incident management and open disclosure; and 2.07 Accessing healthcare service information

• How can patients, carers and families make a complaint in your service?
• How are complaints resolved in a timely manner?
• How are relevant members of the workforce, patients, carers and families involved in the review of complaints?
• How has your service learnt from the analysis of and action following complaints?

• Implement a process for
  • patients to report complaints 
  • your healthcare service to resolve complaints in a timely way 
  • your healthcare service to analyse complaints to identify opportunities for improvement.

For certain healthcare services, it may be appropriate to integrate systems to report and manage complaints with other systems to meet safety and quality requirements, legal and business obligations. 

The type and comprehensiveness of evidence used is dependent on each healthcare service context. The content and complexity of the policies and processes will likely depend on the size of the healthcare service, but could include:

• Information on how patients may make complaints 
• Complaints register that includes detail on the issues identified, people involved and actions taken to resolve complaints 
• Policy documents that describe the processes for reporting, investigating and analysing complaints 
• Examples of improvement activities that have been implemented in response to complaints.

Commission resources

• Australian Charter of Healthcare Rights (second edition) – describes the rights that people can expect when receiving health care. A range of resources are available to support the use of the Charter by healthcare services.
• Your healthcare rights – Key contacts – lists several organisations who may be able to advise or support you if you have a question about healthcare rights.

Other resource

• Australian Health Practitioners Regulation Agency: Concerns about practitioners – information and resources for consumers, registered health practitioners, employers and health education providers.