Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery.

BACKGROUND: Limited systematic data about complaints related to cancer care are available. Patient complaints related to ambulatory care at a large academic cancer center were examined to better understand patient experiences of care and prioritize opportunities for quality improvement.

METHODS: Content analysis of outpatient complaints made to the Patient/Family Relations Office at Dana-Farber Cancer Institute, Boston, in a two-year period (January 2013-December 2014) were conducted. Narrative complaint records were reviewed independently by two to four reviewers to categorize primary and secondary reasons underlying complaints and to assess complaint severity.

RESULTS: Among 78,668 outpatients seen during the two-year period, 266 complaints (0.3%) were made to the Patient/Family Relations Office. Some 48% of the complaints involved management issues, including finance and billing (10%), service issues (15%), delays (13%), and access and admission (6%); 11% of complaints related to quality and safety, whereas 41% of complaints related to relationships, including communication breakdowns (15%), patient-staff dialogue (5%), and humanness and caring (18%). Twenty percent of the complaints were classified as high severity, including 57% of quality- and safety-related complaints. Eleven percent of the patients involved in complaints ultimately transferred care to another provider or institution; 43% of high-severity complaints resulted in a transfer of care.

CONCLUSION: Most of the concerns represented in the complaints related to humanistic rather than technical aspects of care. A systematic review of complaints would offer the opportunity to improve patient-centeredness of care by identifying areas where care fails to meet patient and family needs.