Transforming the Patient Grievance Review Process by Addressing Both Patient and Physician Well-Being.

Abstract

Patient grievances are an inevitable part of health care delivery, yet existing review processes do not focus on the unforeseen harms that grievances can have on the health care team. At a large academic children's hospital, a human-centered approach was used to redesign the grievance review process. Through listening sessions with frontline physicians and the formation of a multidisciplinary work group, the authors developed and implemented a novel approach to responding to patient concerns related to physician care, while also supporting the physicians. The redesigned process focused on communication and process, which over time evolved to approaches that were human-centered and systems-focused. Postimplementation physician feedback demonstrated an improved experience with the revised grievance review process, a marked improvement in their understanding of the process, and a reduction in feelings of being unsupported. The feedback also highlighted the importance of sharing available wellness resources with the hospital's physicians. This human-centered redesign preserved accountability to patients while creating a more just culture for physicians. The authors' experience suggests that patient grievance processes can and should still serve as opportunities for learning, rather than occasions for blame that could sow harm; the authors offer a replicable framework for institutions seeking to support both patients and the physicians who care for them.