Understanding complaints made about surgical departments in a UK district general hospital

Abstract

Background: Patient complaints are increasingly recognized to provide a valuable insight into patients' experience of healthcare. Being local and subjective, they can bring to light previously under-appreciated causes of patient dissatisfaction. The focus of surgical care is usually an intervention, and the nature of complaints made about surgical care may vary substantially from that in non-surgical specialties. This may have specific implications for quality improvement in surgical departments. Objective: To investigate the causes of patient dissatisfaction in surgical care. Methods: We retrospectively examined the content and frequency of patient complaints received by surgical departments at a UK district general hospital in the calendar year 2017. Second-hand reports of complaints, documented by the members of the hospital's complaints department, were collated from a prospectively maintained database and categorized by content. Results: Three hundred and ninety-nine complaints were received over the study period. These related to the care of 327 different patients. One complaint was generated for every 111 patient encounters. Ninety-one per cent of the complaints were made by the patient, and 8.8% were made by a family member. Complaints cited communication with hospital staff in 25% of cases, out-of-hospital delays in 24%, clinical issues in 22%, hospital administration in 16% and in-hospital delays in 10%. Post-operative symptoms and complications accounted for only 2% of the complaints. Twenty-six per cent of the complaints resulted in the rescheduling of an operation or a clinic appointment. Seventeen per cent of the complaints prompted internal actions within the surgical department to investigate and learn from the incident. Conclusion: The profile of complaints made about surgical departments is similar to that of non-surgical departments in other studies. Clinical issues represented only the third largest cause of complaints. More complaints implicated patient-staff communication, and around half implicated management-related issues. Improving staff communication training, clinical standards and hospital administration continues to represent opportunities to enhance the patients' overall experience of surgical care.