The use of patient complaints to drive quality improvement: an exploratory study in Taiwan
The use of patient complaints to drive quality improvement: an exploratory study in Taiwan
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DOI：
10.1258/hsmr.2009.009011
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发表时间：
2010-02-01
影响因子：
2.1
通讯作者：
Hsieh, Sophie Y.
中科院分区：
文献类型：
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作者：
Hsieh, Sophie Y.
本研究旨在探讨台湾某医院病患抱怨的性质与解决方法，并进一步探讨如何利用抱怨来推动品质改善。本研究选择台湾一所教学医院（即个案医院）作为个案研究。作者进行了关键事件技术（CIT）使用问卷调查，以获得有关投诉和他们的解决过程的信息。为了提高研究的可靠性，作者还作为个案医院的局外人进行了非参与性观察。在这项研究中，59名投诉人登记了87起投诉。创新科技署署长发现，护理/治疗、人道和沟通是最常见的投诉原因。除5例未报告响应时间外，患者投诉的响应时间平均为1.76天。大多数投诉在三天内得到解决。此外，这项研究发现，在149项决议中，医院采取的105项决议涉及向投诉人解释事实（n = 41），调查事件（n = 33）和同情投诉人（n = 31）。没有系统地使用投诉数据是凯斯医院最严重的失败之一。而不是试图使用这些数据作为启动质量改进措施的基础，投诉被委托到一个“黑洞”，在那里他们的存在被方便地遗忘。在此基础上，作者提出了如何加强医院的能力，利用病人的反馈和投诉，以提高质量。
This study aims to investigate the nature and resolutions of patient complaints and further to explore the use of complaints to drive quality improvement in a selected hospital in Taiwan. A teaching hospital (i.e. the Case Hospital) in Taiwan was purposefully chosen for a case study. The author conducted the critical incident technique (CIT) using questionnaires to obtain information about the complaints and the process of their resolutions. To enhance the reliability of the study, the author also conducted non-participant observations as an outsider at the Case Hospital. In this study, 59 complainants registered 87 complaints. The CIT found that care/treatment, humaneness and communication were the most common causes of complaints. The response time of patient complaints averaged 1.76 days, except for five cases in which response time was not reported. The majority of complaints were resolved within three days. Moreover, this study found that of 149 resolutions, 105 taken by the hospital involved an explanation of the facts to complainants (n = 41), investigation of events (n = 33) and empathy with complainants (n = 31). The lack of any systematic use of complaints data was one of the most crucial failures of the Case Hospital. Instead of attempting to use such data as the basis for initiating quality improvement measures, complaints were consigned to a 'black hole' where their existence was conveniently forgotten. Based on this study, the author suggests ways to strengthen the capacity of the hospital in terms of using patient feedback and complaints to improve the quality.