Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91TK33, Ireland.
Irish Centre for Applied Patient Safety and Simulation, School of Medicine, National University of Ireland Galway, Galway, Ireland.
Int J Qual Health Care. 2022 May 31;34(2). doi: 10.1093/intqhc/mzac037.
Patients and family members make complaints about their hospital care in order to express their dissatisfaction with the care received and prompt quality improvement. Increasingly, it is being understood that these complaints could serve as important data on how to improve care if analysed using a standardized tool. The use of the Healthcare Complaints Analysis Tool (HCAT) for this purpose has emerged internationally for quality and safety improvement. Previous work has identified hot spots (areas in care where harm occurs frequently) and blind spots (areas in care that are difficult for staff members to observe) from complaints analysis. This study aimed to (i) apply the HCAT to a sample of complaints about hospital care in the Republic of Ireland (RoI) to identify hot spots and blind spots in care and (ii) compare the findings of this analysis to a previously published study on hospital complaints in the UK.
A sample of complaints was taken from 16 hospitals in the RoI in Quarter 4 of 2019 (n = 641). These complaints were coded using the HCAT to classify complaints by domain, category, severity, stage of care and harm. Chi-squared tests were used to identify hot spots, and logistic regression was used to identify blind spots. The findings of this study were compared to a previously published UK study that used HCAT to identify hot spots and blind spots.
Hot spots were identified in Irish hospital complaints while patients were receiving care on the ward, during initial examination and diagnosis, and while they were undergoing operations or procedures. This aligned with hot spots identified in the UK study. Blind spots were found for systemic problems, where patients experience multiple issues across their care.
Hot spots and blind spots for patient harm can be identified in hospital care using the HCAT analysis. These in turn could be used to inform improvement interventions, and direct stakeholders to areas that require urgent attention. This study also highlights the promise of the HCAT for use across different healthcare systems, with similar results emerging from the RoI and the UK.
患者及其家属会对医院的护理提出投诉，以表达对所接受护理的不满，并促使医院进行质量改进。人们越来越认识到，如果使用标准化工具对这些投诉进行分析，它们可以成为改进护理的重要数据。为此，国际上越来越多地使用医疗保健投诉分析工具（HCAT）来进行质量和安全改进。之前的研究已经从投诉分析中确定了热点（经常发生伤害的护理领域）和盲点（护理人员难以观察到的护理领域）。本研究旨在：(i) 将 HCAT 应用于爱尔兰共和国（RoI）的医院护理投诉样本中，以确定护理中的热点和盲点；(ii) 将该分析的结果与之前发表的英国医院投诉研究进行比较。
从 2019 年第四季度 RoI 的 16 家医院中抽取了一份投诉样本（n=641）。这些投诉使用 HCAT 进行编码，根据域、类别、严重程度、护理阶段和伤害对投诉进行分类。使用卡方检验识别热点，使用逻辑回归识别盲点。本研究的结果与之前发表的使用 HCAT 识别热点和盲点的英国研究进行了比较。
在爱尔兰医院的投诉中，患者在病房接受护理、初步检查和诊断期间以及进行手术或操作期间，发现了热点。这与英国研究中发现的热点一致。在系统问题方面发现了盲点，患者在整个护理过程中会遇到多个问题。
可以使用 HCAT 分析识别医院护理中的患者伤害热点和盲点。反过来，这可以为改进干预措施提供信息，并引导利益相关者关注需要紧急关注的领域。本研究还强调了 HCAT 在不同医疗保健系统中的应用前景，RoI 和英国的结果相似。
