Feedback always precedes improvement. While praise is a powerful motivator, criticism is more likely to provoke introspection and the discovery of new approaches. In the current era of accountable care, statistically-valid performance measures are being incorporated into value-based purchasing decisions. Like it or not, hospitals and providers are being measured and compared more than ever by patients and payers according to their ability to produce a great experience.
All types of service industries experience complaints of varying severity. Minor issues have a frequency of about one in every four customer interactions. [Complaint Management Excellence: Creating Customer Loyalty through Service Recovery by Sarah Cook (2012)] Through addressing issues promptly and effectively, businesses often turn negative experiences into positive ones. Customers appreciate being heard especially when they believe their voice will result in system improvement. Applying this paradigm to health care demonstrates the importance of patient engagement.
Interestingly, only a small minority of dissatisfied patients outwardly complain about shortcomings during their healthcare encounter. Reasons cited for being silent include uneasiness with criticizing medical professionals, the belief that complaining won’t make a difference, and even some fear of retribution. However, most dissatisfied patients readily share negative experiences with friends and neighbors and, nowadays, many will post indelible comments on a myriad of social media websites.
Agile complaint management prevents the escalation of anger and resentment. The secret is quickly uncovering issues and then finding effective ways to address issues. This can be a significant advantage for risk management as half of malpractice lawsuits are frivolous and originate as a misperception or mishandled grievance. Even cases deemed non-meritorious by a panel of experts exact tolls on physicians and hospitals because lay juries often side with plaintiffs that develop debilitating complications despite proper medical care. When a diagnosis or treatment mistake does occur, there should be an immediate admission, sincere apology, full disclosure, and every possible effort made to improve the outcome. Preventable medical errors represent a small fraction of complaints.
Most complaints relate to a communication or service gap. A common example of a communication gap is failing to explain why an antibiotic is unhelpful (and potentially harmful) in treating a viral syndrome. A frequent service gap is waiting too long to see a doctor due to surge of critical cases. So, the sooner opportunities for improved communication and service recovery are seized, the more likely the situation will be amicably resolved.
Contacting patients after a hospital encounter affords the provider a second chance to demonstrate caring or to discover dissatisfaction. For many, sharing details about a bad experience by phone or email is less intimidating than telling the medical team in person. When they feel that their complaint has been understood, that staff is truly concerned, and that the feedback will help with process improvement, patients are more accepting of the occurrence.
The acronym, LAST, embraces a simple approach to complaint handling. L reminds us to listen attentively. As Stephen Covey described, highly effective people seek first to understand, then to be understood. A is a prompt to apologize. Stating “I am sorry that you had such an upsetting experience” can help deescalate the situation. S is the go-ahead to speak in order to clear up any misperceptions and explain any unusual circumstances. Finally, T reminds us to thank patients for the time they took to share their experience and their willingness to participate in making the system better.
Next-day contact is a vital patient engagement opportunity that improves satisfaction, decreases risk, and ultimately forges bilateral patient-hospital loyalty.
