One of the Patient Relations team comes to see you with a complaint that one of your staff asked a woman to remove her hiqab in a clinic so he could better communicate with her. The husband and wife demand the staff member be fired for cultural insensitivity. How do you respond to their complaint and deal with the individual?

Patients frequently have concerns about the care they receive, their experiences, or how they were treated. Complaints may come through multiple routes. Ideally these complaints should be managed at an institutional level in a consistent fashion. Many organizations have specific departments, such as a ‘Family and Patient Relations’ team. The focus of these institutional approaches should always be resolution of the issue.

There are several stages to responding to a complaint. First, within 24 hours of receiving complaints, the institution should acknowledge receipt and provide a timeline for response to the concern(s). While major or egregious complaints (e.g. sexual/criminal harassment, Competency issues, and Disruptive behaviour) should be dealt through other formal processes, most patient complaints are a result of poor communication and/or misunderstanding. These later patient concerns are usually resolved by understanding the situation both from patient/family but also the clinicians’ perspective. Thus, the second step is usually to understand the complaint and speak to the clinician involved. With this understanding, complaints can usually be resolved at a low level. Finally, the responsibility to resolve the complaints usually falls to the division or department head/chief. The family should be contacted directly. In most cases the clinician with appropriate guidance, and often an apology to the family, can resolve the issues(s).

If the situation is more complex and/or family does not want to deal directly with the clinician, a meeting or conversation between a senior leader and the family may be needed. In complex situations, bioethics consultation and involvement may be helpful. Throughout the entire proceedings patients’ health must be protected. In some cases, an alternative caregiver(s) is the appropriate solution if the relationship between family and caregiver cannot be repaired.

In summary, patient complaints need to be acknowledged and resolved in a timely fashion.