Griffey R T, Bohan J S
Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Qual Saf Health Care. 2006 Oct;15(5):344-6. doi: 10.1136/qshc.2005.015776.
Patient complaints to the emergency department (ED) have been well studied as indicators of quality. However, no study of complaints from healthcare providers (physicians, nurses and hospital administrators) has been published. Given their experience and expertise, healthcare providers are uniquely positioned to provide informed opinions about patient care. We present 1 year's results from a system initiated to capture healthcare providers' complaints, respond systematically, and integrate them into our quality program.
Complaints by healthcare providers to the ED for calendar year 2002 generated a "Care Concern" addressed by the involved emergency physician within 7 days. These were reviewed by two quality managers who assigned one of eight categories to the primary complaint and evaluated the need for formal peer review.
Of 185 complaints, 53 (29%) were from healthcare providers. Of these, 31 (58%) related to medical care: 8 (15%) to diagnostic work-up, 9 (16%) to ED management, and 14 (26%) to consultations. Eleven (21%) related to miscommunication: 7 (13%) to disposition and 4 (8%) concerned infraction of hospital policy. Ten (19%) led to further formal review with two resulting in changes in ED policy.
Healthcare workers' complaints highlight an aspect of customer care that is sometimes overlooked-that which we provide to other services. The complaints relate primarily to patient care issues, frequently raising concerns requiring intervention. This underused source of information presents a potential wealth of opportunity for quality improvement and customer service in the ED.
患者向急诊科提出的投诉作为质量指标已得到充分研究。然而，尚未有关于医疗服务提供者（医生、护士和医院管理人员）投诉的研究发表。鉴于他们的经验和专业知识，医疗服务提供者在提供有关患者护理的明智意见方面具有独特的地位。我们展示了一个旨在收集医疗服务提供者投诉、进行系统回应并将其纳入我们质量计划的系统的一年成果。
2002日历年医疗服务提供者向急诊科提出的投诉产生了一份“护理关注”，由相关急诊医生在7天内处理。两名质量经理对这些投诉进行了审查，他们将主要投诉归为八个类别之一，并评估了进行正式同行评审的必要性。
在185起投诉中，有53起（29%）来自医疗服务提供者。其中，31起（58%）与医疗护理有关：8起（15%）与诊断检查有关，9起（16%）与急诊科管理有关，14起（26%）与会诊有关。11起（21%）与沟通不畅有关：7起（13%）与处置有关，4起（8%）涉及违反医院政策。10起（19%）导致了进一步的正式审查，其中两起导致了急诊科政策的改变。
医护人员的投诉突出了客户护理中一个有时被忽视的方面——我们为其他服务提供的护理。这些投诉主要与患者护理问题有关，经常引发需要干预的担忧。这种未得到充分利用的信息来源为急诊科的质量改进和客户服务提供了潜在的丰富机会。
