In a post-Four Corners world, and with the emphasis on complaints and consumer engagement in the national standards, care providers must have good systems and processes to manage feedback. The approach to feedback should encompass the ‘life cycle’ of prevention, diagnosis, treatment and (hopefully) a cure. Recently, I raised some concerns at my son’s day care centre that gave me pause for thought about how to manage complaints, and (spoiler alert!) it includes an early and genuine apology.
Prevention
Feedback is inevitable when providing care to people’s loved ones and should be actively encouraged to support continuous improvement. However, there are certain things you can do to minimise the severity of complaints and establish strong relationships. It boils down to two things: 1) knowing the person and their family and 2) communication. By knowing what’s important to a person and their family, you can begin to predict what information and support they need and how changes might affect them. Then, it’s a case of ensuring timely communication and consultation in a manner that meets the person and family’s needs and preferences. Is it an email, phone call or face-to-face? Who should be involved? Is an interpreter or advocate required? In my case, I was not informed that my son’s best friend was moving to another room. My son’s friendships are very important to him and not being informed about the change meant that I was unable to answer some of his very difficult questions!
Diagnosis
The next step is recognising the issue or concern as feedback to trigger the right response. The initial reaction by staff will set the tone for the rest of the interaction. For many people (including myself), raising concerns is an uncomfortable experience – particularly when it relates to a loved one – and emotions are running high. Staff should be supported to recognise when someone is expressing dissatisfaction, acknowledge their concerns and direct them to the most appropriate person to discuss further. This should be either a manager or an independent person to reduce any fear of retribution or negative impact on the person in care. The person should be thanked for sharing their concerns and an initial apology should be offered. This can express a genuine dismay that expectations were not met. For me, my concerns were met defensively with the service rushing to explain why the decision was made, rather than taking the time to hear me out and fully review what happened.
Treatment
The person should be informed about how the feedback will be managed and next steps. A feedback policy or process should be shared so the person feels confident in the approach. A timeframe for follow-up and ongoing communication method should be discussed and agreed. The concerns should be logged in a system for tracking/ monitoring and so that common issues and themes can be identified. The events that resulted in the feedback should be reviewed to identify any breakdowns in the service, process or communication. The person providing the feedback should be invited to contribute to the review to the extent that they wish. They should also be asked what outcome they would like to see or how they think the issue or concern could best be resolved. A formal response should be provided that includes an apology and the actions taken by the service in response. My experience lacked any formality and the impact was reduced confidence in the service’s understanding of my concerns and ability to meet my needs in the future.
Cure
When a person raises concerns, it may be an isolated event or emblematic of broader service or system dysfunction. A thorough and open-minded review of the circumstances leading to the feedback should indicate whether it is the former or the latter. Where systemic issues are identified, further work will be required to improve the service, system and/or process involved. This is where a good grasp of continuous improvement and co-design methodologies can assist – it can help you plan, implement and evaluate change and ensure that consumers and their representatives are involved; enhancing the likelihood the change will be embraced and sustained. My concerns highlighted the limited options available for regular, one-to-one communication between myself and the Centre in relation to my son’s care. “Handover” at the beginning or end of the day provided inadequate opportunity to fully discuss where my son is at and how we can best support the service to understand his needs and preferences. A quarterly or biannual face-to-face family-teacher conference would be a great investment of time and resource. Will this happen? Let’s wait and see.
What are the other hallmarks of good complaints management? Have you had an exemplary or poor experience providing feedback? What worked and what didn’t?
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