Patient Relations Consultation Process

Purpose

Date of Last Review 10/14/10

Date of Last Review 9/2/11
SME: Patients Relations Manager

The patient relations consultation process is designed to help answer any questions related to:

Quality care

Patient grievances

Patient rights

	Ethical concerns
	The protective oversight of patients
	The prevention of the escalation of problems
	The promotion of efficiency and quality within the hospital’s delivery of care

Definitions

Patient Grievance- a written or verbal complaint (when the verbal complaint about patient care is not resolved at the time of the complaint by the staff person receiving the complaint) by a patient, or the patient’s representative, regarding the patient’s care, abuse or neglect issues, which is related to the hospital’s delivery of care.

Staff Present- includes any hospital staff present at the time of the complaint or who can quickly be at the patient’s location (i.e. nursing, administration, nursing, supervisors, patient relations etc.) to resolve the patient’s complaint.

Informing Patients

Each unit posts complaint contact information on its bulletin board. Patients shall also be informed of the internal complaint/grievance process with information found in the “Patient Guide”.

Resolutions of patient complaints/grievances

A grievance is considered resolved with the patient is satisfied with the actions taken on their behalf. When the hospital has taken appropriate and reasonable actions of the patient’s behalf in order to resolve the patients’ complaints and the patient or the patient’s representative remains unsatisfied with these actions, the grievance process maybe considered closed for purposes of this policy.

Written response, addressing each item of complaint will be provided to the patient.

Posting

Each unit posts the contact information on its bulletin board.

Contact information

This table lists the contact information needed:

Contact information

Anyone with concerns or grievances about patient care or rights can contact one of the following:

When the patient is...	Then s/he either...
Inside the hospital	Calls or visits the Patient Relations office Fills out the Patient Relations Consultation form (Patient/Family) / Patient Relations Consultation form (Staff) and submits it to the Patient Relations office
Outside the hospital	Writes or calls one of the following: Disability Rights Texas Patient Relations

The process

This table describes the consultation process:

Stage	Description
1	The patient contacts Patient Relations by writing or calling or through the hospital staff. Confidentiality: When staff help a patient contact Patient Relations, the information s/he provides is confidential.
2	This table describes the next stage options: WHEN... THEN... The patient has complaints regarding abuse/neglect/exploitation   Patient Relations staff/designee fills out the UTHCPC Patient Relations Injury/Incident Report A/N/E within 2 hours The complaint involves rights issues Patient Relations does the following: Determines if it is necessary to meet Schedules a meeting within a work day The patient has complaints regarding quality of care The patient may consult the treatment team Patient Relations may schedule a meeting with the treatment team within 1 day to resolve issues The patient has a complaint regarding premature discharge Patient Relations: Contacts the treatment team Refers to Utilization Review for recommendation
3	From the patient's complaint, Patient Relations determines and provides the patient with all the necessary information regarding hospital staff members who are the source to answer the concern.
4	Patient Relations determines the need for further actions based on the information collected during its meetings. Examples: Notification of parents, guardians, or family members
5	Does the complaint involve a hospital staff member? If yes, Patient Relations informs the Medical Director or appropriate Director/Manager of all the relevant information to determine if the complaint involves clinical practice issues. If no, Patient Relations pursues investigation.
6	Upon receipt of a decision, do any unresolved issues remain? If yes, Patient Relations forwards to the appropriate Director/Manager. If no, Patient Relations delivers appropriate information, in writing, to the patient.
7	Patient Relations documents all its services to the patient including the final report, informs patient in writing, within seven (7) days of the resolutions, and maintains the documentation in a locked file and in the Resolve database.

*It is recognizable that variables occur, including complexity and number of complaints received by Patient Relations, which can affect the timeframe for complaint resolutions and written response. While a timeframe of an average of 7 days may be considered appropriate, it may not be required for every complaint.

Non-confidential information

Patient Relations reports non-confidential information to Performance Improvement on a monthly basis or as required. Quarterly reports on abuse/neglect/exploitation are sent to the Health and Human Services Committee of the Texas Legislature.

Complaint Definition
HCPC takes all complaints seriously and recognizes that complaints are associated with individual perspectives. Hence, the definition of a complaint is subjective and based on individual perspective. A situation is not defined as complaint if a patient is simply asking for a commodity that can be supplied.

Discharged Patients or Patients not Currently Receiving Care:
Patient complaints or concerns that are received after the patient has been discharged or while the patient is not currrently receiving care may be addressed in a combination of ways. It is the responsibiltiy of the staff member who is notified of the patient concern to attempt to resolve the issue if it is within their scope to do so. Issues that cannot be easily resolved for the patient or outside of the area of the person receiving the complaint are forwarded to Patient Relations via the Patient Relations Concern Line, 713-741-7859.

Other complaints

Complaints about physician and licensees and registrants of the Texas State Board of Medical Examiners including physician assistants can be reported to the following:

The State Board of Medical Examiners
1812 Centre Creek, Suite 300

Austin, Texas 78754
(P.O. Box 149134, Austin, TX 78714-9134)
1-512-834-7728

Forms

Patient Relations Consultation (Patient/Family)

Patient Relations Consultation (Staff)

UTHCPC Patient Relations Injury/Incident Report A/N/E

Related standards

The Joint Commission: Ethics, Rights, and Responsibilities

Center for Medicare and Medicaid Services (CMS)

Texas Department of Health State Services

If you have questions regarding the contents of this site please contact the Policies and Procedures Committee.
If you experience any technical problems please contact the MIS Department..