Library Header Image
LSE Research Online LSE Library Services

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

Van Dael, Jackie, Reader, Tom W., Gillespie, Alex ORCID: 0000-0002-0162-1269, Neves, Ana Luisa, Darzi, Ara and Mayer, Erik K. (2020) Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights. BMJ Quality & Safety, 29 (8). 684 - 695. ISSN 2044-5415

[img] Text (bmjqs-2019-009704.full) - Published Version
Available under License Creative Commons Attribution.

Download (900kB)

Identification Number: 10.1136/bmjqs-2019-009704


Introduction: A global rise in patient complaints has been accompanied by growing research to effectively analyse complaints for safer, more patient-centric care. Most patients and families complain to improve the quality of healthcare, yet progress has been complicated by a system primarily designed for case-by-case complaint handling. Aim: To understand how to effectively integrate patient-centric complaint handling with quality monitoring and improvement. Method: Literature screening and patient codesign shaped the review's aim in the first stage of this three-stage review. Ten sources were searched including academic databases and policy archives. In the second stage, 13 front-line experts were interviewed to develop initial practice-based programme theory. In the third stage, evidence identified in the first stage was appraised based on rigour and relevance, and selected to refine programme theory focusing on what works, why and under what circumstances. Results: A total of 74 academic and 10 policy sources were included. The review identified 12 mechanisms to achieve: patient-centric complaint handling and system-wide quality improvement. The complaint handling pathway includes (1) access of information; (2) collaboration with support and advocacy services; (3) staff attitude and signposting; (4) bespoke responding; and (5) public accountability. The improvement pathway includes (6) a reliable coding taxonomy; (7) standardised training and guidelines; (8) a centralised informatics system; (9) appropriate data sampling; (10) mixed-methods spotlight analysis; (11) board priorities and leadership; and (12) just culture. Discussion: If healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this.

Item Type: Article
Official URL:
Additional Information: © 2020 The Authors
Divisions: Psychological and Behavioural Science
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 26 Feb 2020 12:54
Last Modified: 04 Jul 2024 22:12

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics