Patients Should Complain More – Here’s Why And How To Do It Well

Patients need to complain more. Seriously. But, they should learn how.

Someone shared this last week:

I was lying in urine in the ICU.

My nurse said, “How could you do this?”

I couldn’t help it; I felt so bad.

She was so upset.

I wanted to find out her name, but I’m over it.

She didn’t know.

What will happen to her next patient who wets himself?

Doctors, nurses, clerks, security guards, students…everyone in healthcare provides less-than-excellent care some of the time. Your complaint can change the system, but you must do it right.

Many confuse complaining with venting like the photo above.

Venting changes:

1. How you feel.

Ha! I sure told him! You shoulda seen his face…

2. The opinion your listener has of you.

Oh my, she really has issues!

He’s got a point, but he needs to get over it.

Vent a little to those who love you unconditionally. Put most of your energy into crafting a great complaint.

Here’s how:

Be specific – focus on one issue with objective, gritty detail.

Be polite – rudeness discredits you. Your main audience is other providers who will subconsciously be questioning themselves, “Would I have treated this person the same way?”

Be dispassionate – be calm; no emotion; not in the heat of the moment.

Be honest and humble – admit your part in the issue, if any.

Offer solutions – know what you want to see changed and how it might be done.

Address your complaint to someone who can make a difference – do NOT vent to a provider in the moment. It won’t accomplish what you want and could make things worse.

Don’t retaliate – great complaints display genuine desire to improve things. Complaints that start with the CEO, Chief of Staff, Member of Parliament, or regulatory college won’t get the change you are after.

Bonus points:

Apply your case to others. Think beyond yourself.

Address system issues.

Huge hospitals completely change policy for one well written complaint. Learn how to complain well, and you will see the change you hoped for.

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The Secret of Outstanding Clinical Team Performance

How do teams recover when they’re down?

They can’t call in new players.

They can’t increase the number of players on the field.

They can’t quit and go home.

How do they make the best of a losing situation?

Leadership + ‘Coaching with Teeth’

When losers say, “We’ll never win!” Leaders respond with, “We can do this! We’ve beat this team before!”

Leaders speak up. They control the tone on the field.

But what if players drown out positive messages by screaming, “We’ll lose!”

Coaching with Teeth

At some point, a coach owns the outcome. If leadership on the side-lines allows the wrong team on the field, we hold them responsible for the outcome.

Library shelves sag with books on how to inspire teams to peak performance; how to recruit the best in everyone.

Sports teams know the answer:

Wrong attitude? No playing time.

How do you handle this at work?

Who decides which team is on the field in hospitals?

Who decides who gets to play?

Is it even possible to keep certain players off the field?

How do we promote the best?

How do we keep our best players in the game?

Performance Management

We hire staff based on clinical competence, and we manage it on our teams.

We hire staff based on their attitude, but do we manage attitude?

If you steal medications, you get fired. If you bully, you get fired. But, no one gets fired for a bad attitude. You will never lose your job for saying, “We’re going to lose!”

Clinical competence is necessary, but NOT sufficient for outstanding performance. Without a great attitude, your clinical team will never shine.

Attitude must be a key measure in performance management.

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Emegency Departments That Lag

Time to treatment equals quality for much of emergency medicine. It’s also the easiest way to decide whether an ED is any good. Missed diagnoses, errors of judgment, and clinical mistakes can be hard to spot by comparison.

Emergency Departments That Lag

1. Long Line up at triage –

The most at-risk patients stand in the line-up for triage. Every day, patients walk in with a deadly process inside of them. Until they have been seen, they are unsafe. A line up to be seen is indefensible.

2. Long triage process –

Triage should be sorting; not a primary nursing assessment. Patients need a diagnosis and treatment. In most cases, this means getting patients and physicians together as fast as possible. A long triage process does not add value for patients.

3. Long Line up at registration and long registration process –

Registration – getting a chart made – does not add value for patients; it only delays care. It must be short!

4. Packed waiting room –

There is no reason for patients to EVER wait in the waiting room. Please argue in the comment section below if you disagree.

5. Patients must repeat their story over and over and over.

Providers should quickly check what others have recorded, verify the facts and ask additional questions. Starting over with every provider drives patients nuts.

6. No discharge excellence

Patients should leave the ED with copies of lab and radiology reports, written discharge instructions (if necessary), and clear instructions for follow-up and return visits to the ED.

7. Dismissive attitude

Patients should be welcomed to the ED for ANY complaint. No complaint is trivial for a patient. We – healthcare providers, media, government, all of society – seem to think healthcare would be just fine if it weren’t for all the patients. Besides being unwelcoming non-verbally, there’s a big difference between “Why are you hear today?” and “How can I help you?”

Rules in case you get sick:

Don’t go to your family doc unless you’ve tried something yourself first.

Don’t go to your specialist unless you go to your family doc first.

Don’t go to the ED unless you’ve gone anywhere else first.

Don’t go to the ED unless you are nearly dying.

If you are dying, you shouldn’t go to the ED because we can’t do anything for you…

Excuses

But all our beds are full of admitted patients!

Definitely the most popular excuse, admitted patients definitely make it almost impossible to provide emergency care some of the time. But, even with admitted patients blocking beds, patients should still be brought into the ED and seen on exam tables. If they can wait on chairs in the waiting room, they can wait on chairs inside after they’ve been assessed.

Thankfully, Ontario has started to hold hospitals accountable for getting admitted patients out of the ED, and up to the wards.

Who owns morale?

Management owns operations; staff owns morale. Sure, you can crush morale in even the most engaged staff, but blaming management for staff attitudes will mire an ED in under-performance. Staff control their own morale, and it must be part of performance management.

How does your ED stack up? As a patient, have you researched your local EDs to see which ones to avoid?