Workshop 4 New Zealand Aged Care Conference 13 September 2018 The Journey of a Complaint Communication skills for Effective Complaints Management
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
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
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
Medico-legal context Consumer Harmed Other concerns with health and disability services Compensation Complaint Resolution Provider Accountability Quality Improvement Malpractice litigation
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
A charitable Trust, contracted to provide the Advocacy Service since 2008
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
Complaints to HDC
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
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 81 0 50 100 150 200 250
Complaints per year 3000 2500 2211 2498 2315 2000 1784 1901 1880 1910 1958 2007 2015 1500 Received Closed 1000 500 0 2013/2014 2014/2015 2015/2016 2016/2017 2017/2018
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%)
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%)
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%)
Complaints to The Advocacy Service
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)
1,200 1,000 800 600 400 200 0 DHB GPs Residential Facilities Prison Health Services
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
2017/18 survey results show: 90% of consumers; and 87% of providers were satisfied or very satisfied with the complaint resolution service
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
An explanation of what happened An apology where appropriate Changes to be made
Consider whether a consumer or complainant would benefit from the support of an advocate to clarify and present their concerns
Managed well complaints can: help us learn from mistakes identify gaps in services provide trend data restore trust and mend relationships