Service recovery in healthcare: How to prevent medical complaints from becoming medical claims?
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2023-07-04
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en
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Taking into account the complexity of healthcare, analyzing the complaint-handling process is valuable. This in order to provide high-quality care. Analysis shows medical complaints can turn into medical claims. The numerous parties involved, including healthcare organizations, healthcare professionals, patients and their families, are all significantly impacted by this escalation. Based on the value of the process and the parties involved this study examines the topic of service recovery, focussed on complaint-handling in Dutch hospitals. Three students worked together on the research project; however, every student has written their own research report.
The objective of the current study is to learn about the procedure by which complaints turn into claims and determine what efforts might be done to avoid this escalation from happening. In order to learn more about this procedure the focus is on answering the research question, which is as follows: “What factors lead to an escalation of turning a medical complaint into a medical claim and how can this escalation be prevented?”. Extensive literature research served as the foundation for developing a conceptual framework. Next, expectations have been formulated based on the literature review. Various factors were distinguished, namely event factors, organizational factors, characteristics of the healthcare professional, characteristics of family members, characteristics of the patient, and lastly characteristics of the complaint officer. Based on these factors, a qualitative practice-oriented study was carried out. Information from complaint officers working in Dutch hospitals was obtained through semi-structured interviews. The expectations have either been confirmed, partly confirmed, or rejected. As a next step, the researchers have jointly created a prevention escalation tool, formulated as a to-do list, for healthcare professionals, healthcare organizations as well as complaint officers. An example of a recommendation is: “moedig zorgpersoneel aan om actief te benoemen wanneer een patient ontevreden lijkt. Door de onvrede gelijk te benoemen tijdens het contactmoment kan escalatie voorkomen worden.
A significant side point is that all the material obtained through the interviews is based on secondary sources. An element for further research would be to conduct quantitative research to determine the extent of the elements influencing complaint escalation.
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Faculteit der Managementwetenschappen