Good grievance programs will enhance quality
The way complaints are received and addressed demonstrates an important measure of the center’s commitment to quality care and resident satisfaction. A structured complaint and grievance policy is one of the foundations of a resident-centered approach to care.
What is the difference between a complaint and a grievance? A complaint is a minor issue that can be resolved within 24 hours by staff who are present at the time. A grievance is a more serious concern that involves patient care. Complaints should also be processed through your grievance program, as the center can more accurately identify systemic trends and help defend lawsuits that could arise from seemingly minor events.
Research shows that dissatisfied customers and their family members tell, on average, 15 other people about a negative experience. Without a good grievance process, residents and their family members may feel their only outlets for venting their concerns are friends, relatives, doctors, the Agency for Health Care Administration (AHCA) complaint line and the Ombudsman. In 2017, AHCA investigated 4,653 complaints in skilled nursing centers. Most Immediate Jeopardies (IJs) are issued at complaint surveys. An effective grievance program can prevent the situation from escalating to a complaint investigation.
Florida Statue 400.1183 requires skilled nursing centers to have a grievance program. Federal regulation 483.10 also requires a grievance program. The resident has the right to voice grievances to the center or other agency or entity that hears grievances without fear of discrimination or reprisal. Such grievances include those with respect to care and treatment which has been furnished or not furnished, the behavior of staff and of other residents, and other concerns regarding their long term care center stay. The resident has the right to and the center must make prompt efforts to resolve grievances the resident may have. The center must make information available to the resident about how to file a grievance or complaint. The center must establish a grievance policy to ensure the prompt resolution of all grievances regarding residents’ rights.
It is important to follow the regulations, but resolving grievances and using complaints will also improve quality, as this results in better customer satisfaction, systems analysis and systems improvement. Complaints offer the center a chance to enrich its services and show responsiveness to resident concerns. The complaint allows the center to review their procedures through the eyes of the resident and to determine if changes can be made that would benefit residents and staff. Every complaint does not require a change in policy, but a full review may reveal new ways to deliver services that delight your residents and family members.
The benefits and goals of an effective grievance program are improving resident and family communication, improving quality of care, identifying trends and issues, facilitating prompt resolution of concerns and tracking grievances from start to successful resolution. The end goal of an effective grievance procedure seeks to promote transparency regarding the circumstances surrounding the incident, provide validation of the patient’s grievances, resolve the problem through corrective action and improve resident satisfaction and quality of care. An added benefit of having an effective grievance program is that it can be a vital tool for limiting issues in litigation, as the center is developing, gathering and securing evidence when it is fresh.
Turning complaints into compliments can be achieved with a strong commitment by management and staff to continuously improve the quality of service delivered to residents and families. It takes training, patience and a mature attitude toward accepting criticisms. Customer satisfaction can be maximized with an effective complaint process. When staff consistently address resident and family concerns, the center can attain the highest levels of customer service.