Workshop 4 New Zealand Aged Care Conference 13 September The Journey of a Complaint Communication skills for Effective Complaints Management

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1 Workshop 4 New Zealand Aged Care Conference 13 September 2018 The Journey of a Complaint Communication skills for Effective Complaints Management

2 The Journey of a Complaint Part One: Complaints about health and disability services in New Zealand, HDC and the Nationwide Health and Disability Advocacy Service Jessica Mills: Director of Advocacy & Senior Legal Advisor at HDC Part Two: Communication skills for effective complaints management; creating an effective, resolution-focused culture Diane Adamson: Adamson & Associates

3 The Journey of a Complaint: HDC and the Nationwide Health & Disability Advocacy Service Jessica Mills Director of Advocacy & Senior Legal Advisor at the Office of the Health and Disability Commissioner

4 Purpose of HDC To promote and protect the rights of consumers and, to that end, to facilitate the fair, simple, speedy, and efficient resolution of complaints HDC Act 1994

5 Medico-legal context Consumer Harmed Other concerns with health and disability services Compensation Complaint Resolution Provider Accountability Quality Improvement Malpractice litigation

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7 HDC Approach HDC contributes to the achievement of a safe consumercentred system in a unique way: Complaints resolution Promote and protect consumer rights Safety and quality improvement Strengthen the system so that it continually improves Public protection Watchdog role

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9 A charitable Trust, contracted to provide the Advocacy Service since 2008

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11 Kaitaia Whangarei Auckland Central North Shore West Auckland South Auckland Auckland Hamilton Rotorua Thames Tauranga Turangi New Plymouth Wanganui Palmerston North Napier Gisborne Nelson Lower Hutt/Porirua Wellington Christchurch Timaru Dunedin Invercargill

12 Complaints to HDC

13 The Complaint Process Complaint resolution method: Complaint received & triage assessment Outside jurisdiction Seek further information: From the consumer Provider response Obtain clinical advice (where required) Referral Advocacy Referral Provider No action No action with recs Referral other agency Investigation

14 Primary issues complained about 2017/18 Missed/incorrect/delayed diagnosis 235 Inadequate/inappropriate treatment/procedure 220 Disrespectful manner/attitude 129 Failure to communicate openly/honestly/effectively consumer 122 Unexpected treatment outcome 119 Inadequate/inappropriate examination/assessment 106 Lack of access to services 105 Inadequate/inappropriate care (non-clinical) 90 Delay in treatment

15 Complaints per year Received Closed / / / / /2018

16 Group providers 2017/18 DHB (42%) Medical centre (24%) Residential aged care facility (6%) Prison health services (4%) Disability provider (3%) Home care services provider (3%) Pharmacy (3%) Dental clinic (3%) Other (12%)

17 Individual providers 2017/18 General practitioner (32%) Midwife (8%) Nurse (8%) Obstetrician & gynaecologist (4%) Psychiatrist (4%) Psychologist (4%) Orthopaedic surgeon (4%) Dentist (4%) Internal medicine specialist (3%) Other (29%)

18 Outcomes 2017/18 Breach (3%) No further action with follow-up or education (18%) Referred to registration authority (4%) Referred to other agency (3%) Referred to provider (20%) Referred to Advocacy (13%) No further action (28%) Withdrawn (2%) Outside jurisdiction (7%)

19 Complaints to The Advocacy Service

20 Receives complaints & supports consumers to resolve those complaints with providers (approx. 2,800 pa) Responds to enquiries (approx. 10,000 pa) Gives presentations on the Code to consumers and providers (approx. 1,500 pa) Carries out thousands of networking visits and meetings (approx. 3,500 pa)

21 1,200 1, DHB GPs Residential Facilities Prison Health Services

22 84% of complaints are closed within three months and 99% within six months 90% of complaints managed by the Advocacy Service are resolved or withdrawn

23 2017/18 survey results show: 90% of consumers; and 87% of providers were satisfied or very satisfied with the complaint resolution service

24 The consumer is at the centre of the process Advocates guide consumers to clarify the issues and the outcomes they are seeking The provider then has the opportunity to respond to the consumer openly and directly Often the process supports consumers and providers in rebuilding relationships

25 An explanation of what happened An apology where appropriate Changes to be made

26 Consider whether a consumer or complainant would benefit from the support of an advocate to clarify and present their concerns

27 Managed well complaints can: help us learn from mistakes identify gaps in services provide trend data restore trust and mend relationships