Original Date: January 27, 2010 Reviewed/Last Modified Date: September 15, 2015

Transcription

1 Hme and Cmmunity Care - Feedback Reprting Prcess: Cmplaints, Cmpliments and Inquiries Manual: Administratin Sectin: Risk and Safety Management Subsectin: Original Date: January 27, 2010 Reviewed/Last Mdified Date: September 15, 2015 Apprved By: Vice President, Hme and Cmmunity Care A printed cpy f this dcument may nt reflect the current, electrnic versin f the Central East LHIN Plicy & Prcedure. Any cpies f this dcument appearing in paper frm shuld ALWAYS be checked against the electrnic versin prir t use. Plicy: The Central East Lcal Health Integratin Netwrk (LHIN) emplyees shall manage and electrnically recrd all cmplaints, cmpliments, and inquiries frm custmers using the designated electrnic event management system (REM) using the Feedback frm applicatin. Purpse: T facilitate an effective and respectful prcess fr the management and dcumentatin f cmplaints, cmpliments, and inquiries; in which will als prvide accurate infrmatin and data t enable service imprvements. Definitins: Cmplaint: Feedback regarding an event r experience that is unsatisfactry r negative fr the patient/staff/service prvider and has nt resulted in harm/lss. Cmplaints are divided int the fllwing fur (4) levels alng with impact level: Lw Level Cmplaint: Minimal t n incnvenience fr the patient r individual cmplaining. Minr Impact Level: Feedback received regarding an event r experience that is unsatisfactry r negative fr the patient/staff/service prvider and has nt resulted in harm/lss and patients/custmers are nt directly impacted. Reslutin is straightfrward. Medium Level Cmplaint: Reslutin is straightfrward and requires sme investigatin frm the Central East (LHIN) team r service prvider. Mderate Impact Level: The individual reprting the cmplaint perceives that their experience has a direct effect r impact t his/her verall experience regarding an event. Reslutin requires sme investigatin. This material has been prepared slely fr the use at the Central East LHIN. The Central East LHIN accepts n respnsibility fr use f this material by any persn r rganizatin nt assciated with the Central East LHIN. N part f this dcument may be reprduced in any frm fr publicatin withut the permissin f Central East LHIN. Central East LHIN Page 1 f 8

2 Prcedures: High Level Cmplaint: Investigatin is required. If service prvider is invlved, a Service Prvider/Vendr Risk Event Reprt (CE-RM-10) is required within three (3) business days. Majr Impact Level: The patient r individual cmplaining perceives that their experience has a majr impact t their experience as a result f the event. Reslutin requires investigatin, meeting/cnsultatin with patient/family and ther prviders, minr changes t plicy r prcedures and/r minr crrectin t emplyees. Serius Level Cmplaint: Extensive investigatin is required. If the service prvider is invlved, a Service Prvider/Vendr Risk Event Reprt (CE-RM-10) is required within 24 hurs. A rt cause analysis may need t be cmpleted. Serius Impact Level: A cmplaint whereby there is a pssible legal implicatin r media actin. Reslutin requires extensive investigatins, meetings, majr plicy revisins, and/r reprting r event t regulatry bdy r authrities. Cmpliment: Feedback that cmmends r recgnizes psitive aspects f the rganizatin r an individual assciated with the rganizatin. Custmers: Patients, family members, service prviders, plitical ffices, r ther members f the cmmunity). Inquiry: A request fr clarificatin r infrmatin regarding a specific patient r services prvided by the Central East LHIN. Lng-Term Care Actin Line: A service prvided by the Ministry f Health Lng-Term Care (MOHLTC) t hear cncerns and cmplaints frm Central East LHIN patients. The Lng-Term Care Actin Line was established primarily fr residents f lng-term care hmes (LTCH), hme care patients r thers, such as family members, t reprt any cncerns they had abut their care and the services prvided by either their LTCH and/r the LHIN. Cmplaints thrugh the Actin Line can be received electrnically by an Actin Line Ticket r frm an Independent Cmplaint Facilitatr. Respnsibility Steps Actins Central East LHIN 1. Prvide infrmatin abut the prcess f feedback t the public in a frmat that is accessible t all patients/custmers. The prcess will be psted n the Central East LHIN internet and intranet, and verbal r written dcumentatin will be prvided t patients/custmers. Prcedures: A. Reprting Cmplaint Feedback: Emplyee 1. Receive ntificatin that a cmplainant is nt satisfied with the utcme f the service prvided by the Central East LHIN. 2. Ensure patient has cnsented t sharing f patient infrmatin with cmplainant. Central East LHIN Page 2 f 8

3 Emplyee 3. Listen t r read and review the cmplaint. T assist in managing a verbal cmplaint, utilize the Appendix A: Guidelines fr Handling Cmplaints. 4. Acknwledge understanding f the cmplainant s cncern. In the event the cmplaint cmes in a written frmat, a verbal acknwledgement f receipt f the cmplaint must be made within ne (1) regular business day cnfirming t the cmplainant that they will receive a respnse with a reslutin/recmmendatin/prgress reprt within a week time frame, r as agreed with the patient. 5. Reslve the cmplaint and address any situatin that requires actin. 6. Dcument in the electrnic event management system within ne (1) regular business day f being ntified f a cmplaint. Dcumentatin t include: a. Demgraphic infrmatin n patient related t the cmplaint b. Identity and cntact infrmatin f persn wh filed cmplaint c. Identificatin f what the issue is abut, persn(s)/grup(s) invlved in cmplaint d. Surce f feedback and, if knwn, desired utcme by patient e. Prgram invlved and Branch where the patient is managed f. Attach any supprting dcuments If during the cmplaint it is identified that a harmful r n harm event ccurs in additin t the cmplaint, a new risk event file will be pened in the electrnic event management system and reference made t the feedback file. 7. Cnsult with apprpriate Senir Manager/Directr if assistance is required with the cmplaint. 8. Cnfirm that the cmplainant is satisfied with the reslutin. If cmplainant are nt satisfied, infrm the cmplainant f the prcess r next steps in reslving the cmplaint and infrm the cmplainant f the name f the designate wh will cntact them regarding fllw-up. 9. Dcument any further fllw-up t the investigatin in the electrnic event management system. Senir Manager 1. Mnitr REM Management dashbard t review pen feedback files. Nte: Senir Management is alerted t majr r serius impact level cmplaints by alerts sent autmatically thrugh the system. Central East LHIN Page 3 f 8

4 Senir Manager 2. Initiate investigatin if unreslved at initial stage f cmplaint. 3. Cntinue investigating and dcumenting investigative findings in the electrnic event management system until the cmplaint is reslved. 4. Cnfirm that the cmplainant is satisfied with the reslutin. If nt satisfied, infrm the cmplainant f the prcess r next steps in reslving the cmplaint and infrm the cmplainant f the name f the designate wh will cntact them regarding fllw-up. 5. Cnsult with apprpriate Directr(s)/Senir Manager(s), if the cmplainant is nt satisfied and assistance is required with the investigatin. 6. Dcument fllw-up investigatin in the electrnic event management system. 7. Sign ff the reslutin page n the Management Review and Summary page f the feedback file nce fllw-up is cmpleted. 8. Change the file status t indicate current status f the file. Vice President/ Directr 1. Mnitr REM Management dashbard t review pen feedback files that may require yur attentin. Nte: Senir Management is alerted t majr r serius impact level cmplaints by alerts sent autmatically thrugh the system. 2. Review feedback file and cnfirm the nature f the cmplaint. If required, fllw-up with cmplainant t review the cmplaint and discuss reslutin. 3. Cntinue t cnsult with the patient and prvide updates n any fllwup in the frmat that the patient/custmer is able t understand r has agreed upn until the fllw-up investigatin is cmplete. 4. Ntify Chief Executive Officer (CEO) and Senir Directr(s) as needed f the current status f the feedback file and cnsult as required until cmplaint is reslved. 5. Cntinue investigating and dcumenting investigative findings in the electrnic risk event management system until the cmplaint is reslved. 6. Advise the cmplainant f their right t appeal the decisin as utlined in the Patient Appeal Prcess plicy, if cmplaint pertains t Patient Services under the Hme Care and Cmmunity Services Act, 1994 and cannt be reslved. Central East LHIN Page 4 f 8

5 Vice President/ Directr 7. Dcument fllw-up investigatin in the electrnic event management system. 8. Sign ff the reslutin page n the Management Review and Summary page f the feedback file nce fllw-up is cmpleted. 9. Change the file status t indicate current status f the file. Risk Management Analyst 1. Review electrnic feedback dcumentatin and as required, fllw-up with emplyee fr clarificatin f infrmatin. 2. Task the Senir Manager, Quality Cmpliance and Risk Officer if reprted cmplaint level shuld be changed. Nte: Senir Management is alerted t majr r serius impact level cmplaints by alerts sent autmatically thrugh the system. 3. Clse cmplaint file if reslutin has been achieved. 4. Track cmplaint files and prepares trending reprts as required. Senir Manager, Quality Cmpliance and Risk Officer 1. Review feedback and change the reprted cmplaint level, as required. Nte: Senir Management is alerted t majr r serius impact level cmplaints by alerts sent autmatically thrugh the system. 2. Review file and fllw-up with apprpriate Manager(s)/Directr(s), if required, until file can be clsed. 3. Cnsult with legal cunsel and ther experts n the management team including the Directr, Strategic Cmmunicatins and Stakehlder Relatins if there is a ptential fr legal r media actin. 4. Clse feedback file, if n further fllw-up is required. Prcedures: B. Reprting f a Cmpliment Emplyee 1. Receive cmpliment and express appreciatin t the patient/custmer fr taking the time t prvide the psitive feedback. Dcument cmpliment and scan/attach any dcuments in the electrnic event management system. Senir Manager 2. Mnitr REM Management dashbard t review pen feedback files. 3. Review and share cmpliment with identified emplyee(s)/service prvider(s) and dcument any fllw-up in the feedback file. Central East LHIN Page 5 f 8

6 Senir Manager 4. Sign-ff the reslutin page n the Management Review and Summary page f the feedback file and change status pending risk review nce fllw-up is cmpleted. 5. Change the file status t indicate current status f the file. Risk Management Analyst 6. Analyze feedback file dcumentatin fr accuracy and cmpleteness and clse file. Prcedures: C. Reprting f an Inquiry 7. Track cmpliment files and prepare trending reprts as required. Emplyee 1. Receive an inquiry and dcument the inquiry in the electrnic event management system. 2. Ensure patient has cnsented t sharing f patient infrmatin with persn making the inquiry if related t a specific patient. 3. Prvide clarificatin r explanatin if able r advise the inquirer that yu will investigate further. 4. Cnsult with apprpriate Senir Manager/ Directr if assistance is required. 5. Dcument further fllw-up in the electrnic event management system. Senir Manager 6. Receive and review electrnic feedback file. 7. Dcument any fllw-up by Senir Manager and reslutin. 8. Sign ff the reslutin page n the Management Review and Summary page f the feedback file and change status t apprpriate level nce fllw-up is cmpleted. 9. Change the file status t indicate current status f the file. Risk Management Analyst 10. Analyze feedback file dcumentatin fr accuracy and cmpleteness and clse file. 11. Track inquiry files and prepare trending reprts as required. Reference: Hme Care and Cmmunity Services Act, 1994 Central East LHIN Page 6 f 8

7 Acknwledgement: Suthlake Reginal Health Centre, Octber 2008 Crss Reference: Relevant Frms/Guidelines: Service Prvider/Vendr Risk Event Reprt (CE-RM-10) Central East LHIN Page 7 f 8

8 Appendix A PATIENT/CUSTOMER FEEDBACK MANAGEMENT GUIDELINES FOR HANDLING COMPLAINTS When cnfrnted with a cmplaint, acknwledging the issue and express regret fr the patient/custmer s experience (e.g. I m srry t hear that ). It is imprtant t LISTEN withut interruptin. Often cmplaints can be reslved at this initial stage if the patient/custmer feels that their cmplaint has been heard and that the persn representing the rganizatin will take steps t reslve the cmplaint. Remain plite, prfessinal and calm when dealing with a cmplaint. If it is nt clear what the prblem is, ask pen ended questins e.g. Wh is the persn yu were talking t? Where were yu when this happened? Keep the interactin impersnal. Avid using statements which are blaming r sarcastic twards the rganizatin r the cmplainant. Use I statements instead f Yu. Fr example, I can see there has been a misunderstanding, rather than yu have misunderstd. Ask the patient/custmer hw they wuld like t see the issue reslved (e.g. What wuld be helpful right nw? ). If pssible, reslve the issue right then. If the cmplaint cannt be reslved immediately, describe hw the cmplaint will be fllwed up. Ensure that the custmer is satisfied with the plan fr fllw-up and the time frame agreed upn t get back t them. If the patient/custmer is nt satisfied and/r wishes t take the cmplaint further, direct them t the apprpriate Manager/delegate. If the patient/custmer becmes abusive r vilent, get assistance frm a Manager. Central East LHIN Page 8 f 8