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Complaints and quality of service

Examining complaints to improve quality

According to the two most senior officials in CIUSSS West-Central Montreal who handle complaints—Rosemary Steinberg, the Commissioner of Complaints and Quality of Service, and Dr. Paul Warshawsky, the Medical Examiner—the ultimate goal of the complaint process is to improve the quality of the care and services that are provided by the CIUSSS. Each complaint that crosses the desks of Ms. Steinberg and Dr. Warshawsky offers the potential for enchancing care.

During 2015-2016— a period of substantial change and adaptation—the priority was to assure continuity of access to care, as well as building coherence into the management of complaints across all the CIUSSS facilities.

 

Complaints

Assistance

Interventions

Consultations

2015-2016

334

1,213

(includes 961 that involved services)

7

30

2014-2015

573

1,054

25

29

 

Complaint by type of facility

 

General or specialized hospital (JGH)

Long-term care

CLSC

Rehabilitation centre

2015-2016

256

33

36

(intellectual)

(physical)

2014-2015

398

55

96

7 (intellectual)

12 (physical

4 CRD (intellectual/physical)

 

 

Reason for complaints

Quality of care: 32 per cent

Interpersonal relations: 27 per cent

Access: 19.5 per cent

Physical environment: 8.5 per cent

Financial: 6.5 per cent

Personal rights: 6.5 per cent

The complaints process offers two types of corrective measures—those focusing on an individual and those dealing with the system in general. In total, 78 of the 334 complaints resulted in corrective measures being taken.

Of all corrective measures, 84 per cent were individual and included such activities as:

·         review and revision of a care plan, the most frequent individual measure (46 per cent)

·         reimbursement of contested fees

·         provision of services

·         mediation with a staff or team

·         guidance to an employee

Systemic measures included activities such as:

·         improvement of handicapped access

·         updating policies and procedures

·         review of the eligibility of users for certain programs, including confirming the responsibility of managers to ensure that eligible users were given access

 

Complaints reviewed by the Medical Examiner

Total for 2015-2016: 80

Total for 2014-2105: 95

Complaint by type of facility

 

General or specialized hospital (JGH)

Long-term care

CLSC

2015-2016

75

4

1

2014-2015

82

7

6

 

Reason for complaints

Quality of care: 71 per cent

Interpersonal relations: 20 per cent

Access: 9 per cent

Since the complaints are reviewed by the medical examiner are, by their nature, individual, the corrective measures are most often individual. Communication is a central difficulty in most complaints, involving the manner in which information is shared. In several situations at the Jewish General Hospital, the Medical Examiner suggested that the Humanization of Care Committee offer communication workshops to improve communication skills, increasing sensitivity and preventing repeated complaints. 

The Medical Examiner also identified three areas where a systemic insufficiency contributed to complaints, requiring a more comprehensive approach:

·         management of severe pain in the Emergency Department

·         providing better summaries of care, including specific indications for follow-up with patients who had been seen in the Emergency Department or had been hospitalized for a period of time, or had received a sustained period of rehabilitation

·         nighttime medical coverage in acute-care settings