University of Cambridge School of Clinical Medicine, Cambridge, UK.
Academic Neurosurgery, University of Cambridge, Cambridge, UK
BMJ Open Qual. 2021 Sep;10(3). doi: 10.1136/bmjoq-2020-001246.
To explore the frequency and nature of complaints and compliments reported to Patient Advice and Liaison (PALS) in individuals undergoing surgery for a chronic subdural haematoma (cSDH).
A retrospective study of PALS user interactions.
Individuals undergoing treatment for cSDH between 2014 and 2019.
PALS referrals from patients with cSDH between 2014 and 2019 were identified. Case records were reviewed and data on the frequency, nature and factors leading up to the complaint were extracted and coded according to Healthcare Complaints Analysis Tool (HCAT).
Out of 531 patients identified, 25 (5%) had a PALS interaction, of which 15 (3%) were complaints and 10 (2%) were compliments. HCAT coding showed 8/15 (53%) of complaints were relationship problems, 6/15 (33%) a management problem and 1/15 (7%) other. Of the relationship problems, 6 (75%) were classed as problems with communication and 2 (25%) as a problem with listening. Of the compliments, 9/10 (90%) related to good clinical quality and 1/10 (10%) to staff-patient relationship. Patients were more likely to register a compliment than family members, who in turn were more likely to register a complaint (p<0.005). Complaints coded as a relationship problem had 2/8 (25%) submitted by a patient and 6/8 (75%) submitted by a relative.
Using the HCAT, routinely collected PALS data can easily be coded to quantify and provide unique perspective on tertiary care, such as communication. It is readily suited to quality improvement and audit initiatives.
探讨慢性硬脑膜下血肿(cSDH)患者向患者咨询和联络处(PALS)报告的投诉和表扬的频率和性质。
对 PALS 用户交互的回顾性研究。
2014 年至 2019 年期间接受 cSDH 治疗的个体。
确定 2014 年至 2019 年期间患有 cSDH 的患者向 PALS 的转介。回顾病历记录,并根据医疗保健投诉分析工具(HCAT)提取并编码有关投诉的频率、性质和导致投诉的因素的数据。
在确定的 531 名患者中,有 25 名(5%)与 PALS 进行了互动,其中 15 名(3%)是投诉,10 名(2%)是表扬。HCAT 编码显示,15 份投诉中的 8 份(53%)是关系问题,6 份(33%)是管理问题,1 份(7%)是其他问题。在关系问题中,有 6 份(75%)是沟通问题,2 份(25%)是倾听问题。在表扬中,有 9 份(90%)与良好的临床质量有关,1 份(10%)与医患关系有关。患者比家属更有可能提出表扬,而家属则更有可能提出投诉(p<0.005)。被编码为关系问题的投诉中有 2 份(25%)是由患者提出的,6 份(75%)是由亲属提出的。
使用 HCAT,可以轻松地对常规收集的 PALS 数据进行编码,以量化并提供对三级护理(如沟通)的独特视角。它非常适合质量改进和审核计划。