Friday, July 30, 2010

Complaints and the Laboratory Quality System

Canadians are so darned polite.  We like to stand in lines and wait patiently.  The first word of greeting is not "hello!";  it is "Sorry!".  And we rarely complain (at least not out loud, and rarely if ever directly.  And we never sue.  So why am I writing a posting about complaints?

Part comes from some recent discussions with I-TECH about customer satisfaction, and part comes from a very interesting article on Medscape Today ( entitled "Malpractice Dangers in Patient Complaints: Best Ways to Deal With Complaints" by Lee J. Johnson Esq., a lawyer from NewYork.
Before continuing, I might as well state the obvious.  There are many ways in which Canadians and Americans are similar.  Our attitudes towards litigation is NOT one of them. 

The article is instructive in a number of ways.
Many people complain indirectly.  It is not uncommon for people to be unaware that others are not happy with the service they have been provided.  Sometimes the first time that you learn about the unhappiness is when it is too late. In Canada the result is angry patients, grumbling physicians, and frustrations that spill over from all sorts of indirect directions.  Sometimes it manifests as snide comments in semi-public situations, other times as a lack of support at hospital management meetings.  Rarely is it a good thing.  In the US, the risk of legal escalation is always present.

The article talks about doing a few things that can reduce some of the crisis from complaints, like developing a culture of patient safety; and training staff on how to address complaints, and setting up ways to uncover patient complaints, such as a suggestion box and patient-satisfaction surveys, and importantly, create a procedure for handling patient complaints.
This is all good stuff and is by-and-large consistent with ISO9001:2008 and ISO15189:2007.

But where the article does not go far enough is that after you set up the suggestion box and the satisfaction survey, and the procedure, these have to be monitored and assessed and the results used as part of a continuous improvement.  Otherwise the problems continue to occur, and the liability risk is not controlled.
If complaints monitoring is not incorporated into the continual improvement process, in the same way as internal audits, and quality indicators, and KPIs, and reported incidents, then the process of continual improvement is incomplete, and the problems that lead to complaints never go away.

Seems intuitively obvious.

ps:in most provinces in Canada, this is the beginning of the August 1st long weekend.  Enjoy the break.


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