Case in the Spotlight 16 - Answer & Discussion

The patient has a fractured left distal radius

Further action required

  • Management today – analgesia, plaster, orthopaedic opinion and follow up in the fracture clinic.  Good documentation.
  • Management of the missed fracture


Management of complaints

  • Open disclosure – discussion with the patient, usually involves a senior medical staff member, an apology
  • Complaints management – again, involve a senior staff member, and be aware that all hospitals have a policy that should be followed.
  • Quality improvement – report the incident, and then the supervisor will arrangement follow up with the individual, and perhaps education to the individual +/- include in general education program
  • In Victoria most hospitals have an incident reporting system. Eg RISKMAN.


Systems issues

  • Supervision of the staff, reviewing the films, vs discuss with the liaison radiologist, vs seeing the formal report
  • Did you know that all formal reports are included on a watchlist in the ED, and this provides a safety net for results?

General advice re management of complaints

This is an unofficial guide, based on advice from multiple people

A specific, usually senior, person usually handles complaints in a department.
Complaints to be managed consistently and taken seriously

Enquire about the welfare of the patient

Patience, empathy, and listening skills are important

Each complaint managed thoroughly

  • Acknowledge written and verbal complaints promptly  - often the health service consumer liaison person will arrange this

Gather information

  • Review the medical record
  • Speak to the complainant
  • Speak personally to individuals involved

Answer complaints taking care re judgements and emotions. Apologise sincerely and honestly even if not admitting liability. To apologise that an incident has occurred is common courtesy

Complainants should be thanked for raising their concerns, and reassured that we will review and take any opportunity to learn and improve patient care and communication

Notification and reporting

  • Health service administration – e.g supervisors
  • Medical Defence
  • Media liaison – if appropriate, usually consumer liaison and senior management


Follow up action

  • Feedback to the complainant
  • Feedback to the individual
  • Education or review of systems and processes may be warranted to prevent further events








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