Healthcare provider complaints to the emergency department: a preliminary report on a new quality improvement instrument.
OBJECTIVE
Patient complaints to the emergency department (ED) have been well studied as indicators of quality. However, no study of complaints from healthcare providers (physicians, nurses and hospital administrators) has been published. Given their experience and expertise, healthcare providers are uniquely positioned to provide informed opinions about patient care. We present 1 year's results from a system initiated to capture healthcare providers' complaints, respond systematically, and integrate them into our quality program.


METHODS
Complaints by healthcare providers to the ED for calendar year 2002 generated a "Care Concern" addressed by the involved emergency physician within 7 days. These were reviewed by two quality managers who assigned one of eight categories to the primary complaint and evaluated the need for formal peer review.


RESULTS
Of 185 complaints, 53 (29%) were from healthcare providers. Of these, 31 (58%) related to medical care: 8 (15%) to diagnostic work-up, 9 (16%) to ED management, and 14 (26%) to consultations. Eleven (21%) related to miscommunication: 7 (13%) to disposition and 4 (8%) concerned infraction of hospital policy. Ten (19%) led to further formal review with two resulting in changes in ED policy.


CONCLUSIONS
Healthcare workers' complaints highlight an aspect of customer care that is sometimes overlooked-that which we provide to other services. The complaints relate primarily to patient care issues, frequently raising concerns requiring intervention. This underused source of information presents a potential wealth of opportunity for quality improvement and customer service in the ED.
Griffey
R T
RT
Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. rgriffey@partners.org
Bohan
J S
JS
D001291:Attitude of Health Personnel; D004635:Emergency Medicine / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D033183:Interdisciplinary Communication; D007857:Leadership; D008485:Medical Audit / Q000379:methods*; D016134:Organizational Policy; D010343:Patient Admission / Q000592:standards; D010348:Patient Care Team / Q000592:standards; D010351:Patient Discharge / Q000592:standards; D010360:Patient Transfer / Q000592:standards; D018024:Peer Review, Health Care; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D017749:Total Quality Management / Q000379:methods*; D014481:United States