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Standards for health services in Australian prisons

Criterion 2.1.2 Patient feedback

Our health service seeks and responds to patient feedback.


Indicators

A. Our health service has a process for receiving and responding to feedback and complaints from patients (document review).

B. Our staff can describe the processes for receiving and responding to feedback and complaints from patients (interview).

C. Our health service makes contact information for the Australian Human Rights Commission, Commonwealth Ombudsman and the relevant state/territory health complaints agency available to patients on request (interview, document review).

D. Our health service can describe an improvement we have made in response to patient feedback or complaints (interview).

E. Our process for seeking feedback from the patients of our health service gathers information on the following areas (document review):

  • whether patients are satisfied with the health service’s process of scheduling care
  • whether health service staff discuss health promotion and illness prevention
  • whether patients are treated with respect and in a culturally appropriate manner by health service staff
  • whether patients receive sufficient information about the purpose, importance, benefits and risks of investigations, referrals or treatments proposed by the health service staff to enable them to make informed decisions about their healthcare
  • whether patients are confident that any feedback or complaint to the health service will be handled properly and will not affect their ongoing healthcare
  • whether patients were asked for prior consent to allow a third person to be present during a consultation
  • whether patients are offered the use of an interpreter
  • whether patients find it is easy to contact the health service
  • whether patients are satisfied with the facilities in the consultation area
  • whether patients understand the separation between the health service and the prison and think the health service makes adequate provision for their privacy and confidentiality.

Explanation

Unique information about patient needs and the quality of care provided by a health service can be gained from patients. Discussing patient feedback openly helps staff to understand strengths in their health service, potential problems, and how to improve. It is helpful to know what patients think about a health service and what they are likely to tell other people. The more feedback a health service receives, whether it be complaints, compliments or suggestions, the better it will be able to provide safe, high quality and cost efficient healthcare.

The ‘Turning wrongs into rights: learning from consumer reported incidents’ project,37 a national project funded under the auspices of the ACSQHC, has undertaken research on complaints management in Australian healthcare organisations and has developed guidelines on complaints management in healthcare.

The importance and value of effective complaints management was expressed by the ACSQHC in its publication Better practice guidelines on complaints management for healthcare services.38

Consumers (including patients and carers) have a unique expertise in relation to their own health and their perspective on how care is actually provided. Consumer complaints are therefore a unique source of information for healthcare services on how and why adverse events occur and how to prevent them. As well as reducing future harm to patients, better management of complaints should restore trust and reduce the risk of litigation, through open communication and a commitment to learn from the problem and prevent its recurrence.

The complex challenge of providing healthcare to patients in prisons means it is important that health services be transparent about their relationships with other parties including the prison (see Criterion 1.2.1: Health service information).

It may be of benefit for a health service to declare that feedback being sought from patients is only for the quality improvement of the health service. The health service needs to explicitly encourage and support patients to provide feedback or make a complaint. To this end, it is suggested that patients who wish to make a complaint to the health service are encouraged to do so with the assistance of independent advocates who may be able to clarify the nature of the complaint and work to find a resolution. In some prisons, there are prisoner committees that may act as patient advocates. It needs to be made clear by the health service that anonymous feedback can be provided, or complaints can be made without fear of negative repercussions for a patient’s healthcare.

It is important that a health service have some kind of structured mechanism to gain feedback from patients. It is recognised that gaining feedback from patients in prisons can be challenging. However, health services need to determine the most appropriate way of gaining meaningful feedback about the health service for their patient population. This might be through the use of a patient survey about the health service, or it could be through the use of focus group discussions where patients are invited to come together to discuss their views on the health service. Given the challenges in gaining feedback from incarcerated people, at the very least, health services need to be able to demonstrate they are working toward a mechanism for seeking patient feedback that can drive quality improvement.

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