Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19,3, Odense, Syddanmark 5000, Denmark.
Odense University Hospital, Region of Southern Denmark, J.B. Winsløws Vej 19,3, 5000, Denmark.
Int J Qual Health Care. 2023 Sep 8;35(3). doi: 10.1093/intqhc/mzad062.
Staff observations are the most common source of data for driving improvements in care. However, the patient perspective should also be considered, and healthcare complaints offer concrete details that health organizations might otherwise overlook and that can highlight areas for learning and improvement in the healthcare system. However, because of the diverse nature of patient complaints, systematic analyses can be challenging. This study aimed to identify and prioritize areas for improvement using a data-driven approach to analysing patient complaints. The Danish version of the Healthcare Complaints Analysis Tool was used to categorize the content of complaint letters. All complaints managed by the national complaints authority, compensation claims to the Patient Compensation Association, and locally managed complaints that were filed directly at Odense University Hospital from 2017 to 2021 were included. Proportional reporting ratios (PRRs) were used to measure and display the top five signals of disproportionality and rank them by excess complaints at the hospital level and when divided into department types. The study included 6366 complaints containing 13 156 problems (on average, 2.1 problems mentioned per complaint letter). Surgical departments had the highest number of complaints (3818), followed by medical (1059), service (439), and emergency departments (239). Signal 1 of disproportionality, relating to quality problems during ward procedures, had the highest excess reporting of 1043 complaints at the hospital level and a PRR of 1.61 and was present in all department types. Signal 2, relating to safety problems during the examination and diagnosis stage, had an excess reporting of 699 problems and a PRR of 1.86 and was also present in all department types. Signal 3, relating to institutional problems during admission, had the highest PRR of 3.54 and was found in most department types. Signals 4 and 5, relating to environmental problems during ward procedures and care on the ward, respectively, had PRRs of 1.5 and 1.84 and were present in most department types. The study found that analysing patient complaints can identify potential areas for hospital improvement. The study identified recurring issues in multiple departments, including quality problems during ward procedures, safety problems during the examination, institutional problems during admission, and environmental problems on the ward. The study highlights disproportionality analysis of complaints as a valuable tool to monitor patient concerns systematically.
工作人员的观察是改进护理工作最常见的数据来源。然而，也应该考虑患者的观点，医疗投诉提供了具体的细节，而这些细节可能是医疗机构忽视的，也可以突出医疗系统中需要学习和改进的领域。然而，由于患者投诉的多样性，系统分析可能具有挑战性。本研究旨在使用数据驱动的方法分析患者投诉，确定和优先考虑改进领域。使用丹麦版医疗投诉分析工具对投诉信的内容进行分类。纳入了国家投诉机构管理的所有投诉、向患者赔偿协会提出的赔偿要求以及 2017 年至 2021 年期间直接在奥胡斯大学医院管理的本地管理投诉。比例报告比（PRR）用于测量和显示前五个比例失调信号，并按医院水平和部门类型划分时的过量投诉进行排名。该研究包括 6366 份投诉，共包含 13156 个问题（平均每份投诉信提到 2.1 个问题）。外科部门的投诉最多（3818 份），其次是内科（1059 份）、服务（439 份）和急诊（239 份）。比例失调的第一个信号，与病房手术过程中的质量问题有关，在医院层面的过量报告为 1043 份，PRR 为 1.61，并且存在于所有部门类型中。第二个信号，与检查和诊断阶段的安全问题有关，过量报告了 699 个问题，PRR 为 1.86，并且也存在于所有部门类型中。第三个信号，与入院期间的机构问题有关，PRR 最高，为 3.54，并且存在于大多数部门类型中。第四个信号和第五个信号，与病房手术过程中的环境问题和病房护理有关，PRR 分别为 1.5 和 1.84，并且存在于大多数部门类型中。研究发现，分析患者投诉可以确定医院改进的潜在领域。该研究在多个部门发现了反复出现的问题，包括病房手术过程中的质量问题、检查期间的安全问题、入院期间的机构问题以及病房内的环境问题。该研究强调了对投诉进行比例失调分析是系统监测患者关注点的一种有价值的工具。
