Emergency department complaints: A 12-Year study in a university hospital

Study objectives: The emergency department (ED) is an important department because it is the “front door” to the hospital. However, there is an apparent perception that the ED is one of the most difficult departments in a hospital to work in because it appears to receive complaints from patients directed at the medical staff: long waiting time, possible misdiagnosis, and poor communication with the patients. We analyze the types of complaints received during a 12-year period in a university ED. Methods: This was a descriptive, retrospective study. The study took place in the ED of a 1,000-bed tertiary teaching hospital in Barcelona, Spain, with a more than 90% bed occupancy rate and with a population in the metropolitan area of 1.5 million, which attends about 120,000 emergency visits per year, excluding pediatrics and obstetrics. Included in the study were all complaints received by the ED from January 1, 1992, to December 31, 2003. It was done by reviewing the formal written complaints and the verbal complaints received by the Customer Affairs Service. Most of the complaints were divided into 4 broad categories: medical, physician-patient relationship, patient flow/logistics at ED, and in-house complaints. Results: There were 1,469 complaint cases out of 1,288,948 ED visits during this period of review, which makes a complaint frequency of 1.14 per 1,000, or 1 complaint per 877 visits. The complaint frequency over the 12 years varied from 0.31 to 1.45. There were no sex differences (50.2% were male patients). Written complaints represented 78.5% of the total. The main reasons for complaints were due to logistics (56.04%; the most important reason was waiting time; 46.35%), attendance (28.47%; the most important reason was dissatisfaction; 14.43%), attitude (8.67%), communication skills (3.35%), catering business (2.39%), and documentation (1.08%). Conclusion: The most common complaints were due to long waiting time before being treated by a physician. Patients complain if any of their expectations are not met at the ED, despite the pressure of a huge crowd at the ED. These expectations include fairly prompt service, being given a correct diagnosis and treatment, being communicated with adequately, and an appropriated attitude perceived by the patient or the family.