This process could eventually involve many facts and documents, so keep an expandable file for all your documentation and notes. Also, read all the steps before starting, as some overlap and/or replace other steps.
First, at every step of how you discuss this matter with others, keep a running record of the names, phone numbers, dates, and substances of the discussions.
Secondly, you should speak directly to the person(s), such as a nurse or nursing assistant, who seem to be improperly providing care. Often, there is a misunderstanding that can be quickly resolved with little fanfare.
Third, If your interaction is unfavorable or if the care still seems improper, you can contact people/offices within the hospital dedicated to resolving precisely this type of issue. Some hospitals use a "Patient Advocate" or a "Patient Complaint Coordinator" or "Patient Relations" or "Guest Relations" or "Ombudsman" or even the generically tried-and-true "Customer Service." Whatever that person/department is called, you can expect to find one in a hospital because hospitals prepare to handle complaints regularly. If you don't know the name and location of this person/department, ask at the information desk and keep asking until you get the name/location of that person/department. Then, go to the person/department and tell him/them that you wish to file a grievance about patient care. Typically, these people/departments have hospital-approved complaint procedures that you are required to follow. Don't take it personally – they must adhere to specific guidelines; therefore, follow the in-hospital complaint procedures. Be as detailed and as thorough as possible about the facts of your grievance. The hospital is required to review, investigate and successfully resolve your grievance, usually in a matter of days. You will receive a written response from the hospital telling you the steps the hospital took to investigate and resolve the problem, along with a contact person who may or may not want to discuss the grievance with you. The grievance is usually deemed "closed" when the grievance is resolved; however, there may be times when the hospital believes the grievance is resolved, but you are still unhappy with the results.
Fourth, if you do not receive satisfaction from the in-hospital grievance procedures, you can contact your health plan. Health plans want your satisfaction, and they carry some weight with hospitals, so your health plan will often be happy to help you solve the issue of improper care. Again, you should expect to follow the health plan's procedures for addressing complaints about health care. Be as specific and as thorough as possible about the facts of your complaint.
Fifth, if the improper care persists or you are otherwise dissatisfied with the results of the previous steps, you can contact the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). JCAHO, often referred to by a nickname that sounds like "JAY-CO," is a powerful, nationwide, independent, not-for-profit organization granting accreditations and certifications significant to hospitals. The Joint Commission is dedicated to maintaining a high level of care. It periodically inspects hospitals and investigates complaints. JCAHO can fill a hospital administrator with dread because its inspection/investigation is the corporate equivalent of a colonoscopy. Visit the website at https://www.jointcommission.org, type "complaint" in the home page's search function, and follow its complaint procedures. Be as specific and as thorough as possible about the facts of your complaint.
Sixth, your State's medical association probably monitors hospitals within your State for quality of care. In California, for example, the Institute for Medical Quality (an arm of the California Medical Association) monitors accredited hospitals to ensure that those hospitals provide a certain standard of care. Visit the website at http://www.cmanet.org, type "complaint" in the home page's search function, and follow its complaint procedures. If you live in a state other than California, use Google to find your State's Medical Association's web site and look for that Medical Association's complaint procedures. Be as specific and as thorough as possible about the facts of your complaint.
Seventh, you can also contact your State's department of health to register a complaint about a hospital that is improperly caring for your loved one. In California, for example, you can file a complaint with the California Department of Public Health (CDPH). Complaints can be filed online at http://www.cdph.ca.gov/Pages/DEFAULT.aspx with a consumer complaint form or via the CDPH Licensing and Certification District office governing your hospital's district. Once more: be as specific and as thorough as possible about the facts of your complaint.
Eighth, whether or not your doctor's acts/omissions occurred in the hospital, search for your County's and State's medical associations online and offline. Contact both associations, find the person(s)/department(s) for filing complaints against physicians and follow those procedures. Other doctors or committees can review the doctor's acts/omissions to address this kind of problem.
Ninth, when none of the above procedures resolves the problem to your satisfaction, find the contact information for your State's Medical Board, ask about procedures/forms for filing complaints against doctors and follow those procedures. A state's medical board licenses doctors and can take actions to include revocation of a doctor's license. Not only will this board deal directly with this doctor, but it might also contact your State's Attorney General for additional actions against the doctor.
DO'S AND DON'TS
- DON'T be intimidated by the process or the people.
- DO be as specific and as thorough as possible about the facts of your complaint.
- DO keep a running record of the names, phone numbers, dates, and substances of the discussions whenever you discuss this complaint with an "official" such as the caregiver, hospital official/department, health care plan, JCAHO, or government agency.
- DO keep copies of all documents involved in your complaint.
- DO speak directly to the person(s), such as a nurse or nursing assistant, who seem to be improperly providing care.
- DO contact people/offices within the hospital dedicated to resolving precisely this issue and following their procedure(s) to file grievances.
- DO contact your health plan and follow its procedures for filing complaints.
- DO file a complaint with the Joint Commission (JCAHO) and follow its procedures for filing complaints.
- DO file a complaint with your State's medical association and follow its procedures for filing complaints.
- DO file a complaint with your State's department of health and follow its procedures for filing complaints.
- DO contact your County's and State's medical associations and follow their procedures for filing complaints.
- DO contact your State's Medical Board, which governs doctor's licenses, and follow its procedures for filing complaints.
- DO cooperate fully with your State's Attorney General if contacted for information and/or documentation to pursue further actions against the doctor.
Source: Handelonthelaw.com Staff Writer
Note from HandelontheLaw.com: This article is to be used as an educational guide only and should not be interpreted as a legal consultation. Readers of this article are advised to seek an attorney if a legal consultation is needed. Laws may vary by state and are subject to change, thus the accuracy of this information can not be guaranteed. Readers act on this information solely at their own risk. Neither the author, handelonthelaw.com, or any of its affiliates shall have any liability stemming from this article.
