Communication at root of patient complaints

Member of high-level review board said most issues he sees relate to Interior Health's patients feeling unheard or misunderstood

Retired Dr. Randall Fairey

Retired Dr. Randall Fairey

Most concerns about Interior Health stem from simple miscommunication, according to a member of a high-level board tasked with reviewing select patient complaints.

“Complainants generally have a problem with the health-care system because either they don’t feel heard or understood,” said Randall Fairey, a retired Kelowna oncologist.

He’s one of six people who sit on the Interior Patient Care Quality Review Board, which was established in 2008 and reports directly to the Ministry of Health. Three other boards cover the remaining B.C. health authorities.

In 2012-13, the Patient Care Quality Review Office for Interior Health received 870 patient complaints. Just 15 unresolved issues were accepted by the board for further review, according to its latest annual report.

Following an investigation, which can include staff interviews and a review of medical records, the board can then make recommendations.

“Although we can’t compel any action, our recommendations are taken very seriously by the Interior Health Authority,” said Fairey. “The health authority knows that the minister of health is looking directly at this. I think that they take it very seriously.”

The annual report contains very basic details of the cases in which it made 15 recommendations in 2012-13, including:

— Regarding a concern about medication administration at an acute-care facility, the board recommended Interior Health  ensure “adequate investigation of the complainant’s concern that a nurse tried to force medication into the mouth of her mother,” and report back to the complainant.

— After looking into a complaint about the discharge process from a mental-health facility, Interior Health was advised to review extended leave procedures under the Mental Health Act and make sure staff are trained to follow it.

In response to a concern about excessive wait and inadequate care in the emergency department of an acute care facility, the board recommended Interior Health remind staff to follow Canadian Emergency Department Triage and Acuity Scale guidelines, and that if treatment is delayed that regular communication with patients occurs to keep them informed and aware of delays.

Patty Garrett, the director of Interior Health’s Patient Care Quality Review Office, said those summaries and her statistics show pure communications complaints are relatively uncommon.

“The types of complaints that are going forward, the majority would still be care, but then what’s happened is the review board has made a recommendation to somehow strengthen the communication process (because) that’s what actually broke down and led to the care issue,” she explained.

Garrett said her office “is always interested in receiving feedback, if not from the review board then some other interested party.”

Most recommendations are stand-alone items, she continued, although others have resulted in system-wide changes, including one that suggested the authority create information sheets to explain that patients may be expected to provide some of their own medication in hospitals, which don’t stock every drug in existence.

“It was a different concept to explain to the patient that not everything is in our formulary,” Garrett said, adding the resultant pamphlets are now available in most hospitals.

Fairey admitted the work of his board is not well understood by the public.

As for those who do have a complaint accepted for review, he continued, “I think the patients see they’ve had a really thorough vetting of their issues with the health authority.”