Vanessa Perrott, Medical Protection’s Head of Education Development and Delivery, examines how complaints can be used as a learning tool

Read this article to:

• Learn the best way to respond to a complaint
• Discover the danger of unfulfilled patient expectations
• Find out how to manage challenging interactions with patients

How you feel about complaints

When we spoke to attendees at the Acute and General Medicine Conference last year, we found that 91% of you believe patients are more likely to complain now than ten years ago. In addition, over half of respondents think about the possibility of receiving a complaint more than once a week. 

Openness

Medical Protection has always encouraged clinicians to understand that an essential part of responding to any complaint is to demonstrate how you have learned from the mistake, or how you plan to do things differently. Telling the patient, for example, that you have reviewed the reason for their complaint and discussed it with your team to learn from it, can prevent a patient taking the complaint further.

An equally important part of the response is being open and honest about what happened. Patients who make a complaint are most likely looking for a truthful explanation as to what happened. Hiding the truth, or giving that impression, could inflame the situation and increase the likelihood of the complaint escalating.

One of the first key steps in dealing with difficult interactions is realising that “difficult” is a statement about our discomfort rather than a judgment of the patient

As an individual, it may feel like achieving a culture of openness is near impossible. However, there is strong evidence that certain communication strategies can be used to prevent complaints from arising, for example, being able to manage a patient’s expectations. At Medical Protection we see that unfulfilled expectations lie at the root of almost every complaint raised by patients, whether those expectations are realistic or unrealistic. One habit to develop and use in every consultation is to ensure that expectations are elicited and addressed.

Managing challenging interactions with patients

Dealing with challenging patients may impact on the stress levels and morale within your team, which in turn can negatively affect patient care and increase the risk of a complaint. Several factors contribute to making a patient interaction challenging, so understanding the reasons behind these interactions can reduce their frequency.

One of the first key steps in dealing with difficult interactions is realising that “difficult” is a statement about our discomfort rather than a judgment of the patient.

It is therefore more helpful to talk about difficult or challenging “interactions” rather than difficult patients. This is because it helps us consider a broader range of factors that contribute to the difficulty; in particular what we can do to help reduce the perception of that difficulty.

Acknowledging the patient’s position requires skills such as empathy, actively listening and understanding the patient, and reframing: choosing to consider alternative explanations for the person’s behaviour.

It is critical that the patient feels that the clinician fully appreciates their position. This must be done well, even if the clinician does not agree with the patient or feels uncomfortable. 

When informing the patient of your position, you should acknowledge the difficulty in the interaction and explain the relevant personal and professional boundaries. When placing boundaries, it is most important to ensure that your motivation for doing so is in the patient’s best interest.

The final step is discussing a way forward. Discuss the pros and cons of all the options and agree a solution that is acceptable to both the patient and the clinician. The patient should then be empowered to go forward with that solution. 

Find out more

If you have received a complaint or a claim and are in need of advice, contact one of our expert medicolegal advisers on 0800 561 9090 or [email protected]