A mixed method analysis of patients' complaints: Underpinnings of theory-guided strategies to improve quality of care

Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this study is to use a mixed method analysis to a)examine the characteristics and categories of patients'complaints,b)explore the relationships of patients'complaints with professions and units,and c)propose theory-based strategies to improve care quality.Methods:This is a descriptive mixed method study.Data examined are patients'complaints filed at a university-affiliated hospital in China from January 2016 to December 2017.A qualitative content analysis was conducted to categorize complaints.A TwoStep cluster analysis was performed to provide an overall profile of patients'complaints.Chi-Square tests were conducted to investigate the relationships among complaints,professions,and units.Results:838 complaints were filed,with 821 valid cases for analysis.Six categories surfaced from the qualitative analysis:uncaring attitudes,unsatisfactory quality of treatment or competence,communication problems,the process of care,fees and billing issues,and other miscellaneous causes.Physicians received most of the complaints(56.6%).The unit receiving the most complaints were outpatient clinics and medical support units(52.7%).The cluster analysis indicated four distinct clusters.Significant relationships existed between complaints and professions(x2(20)=178.82,P<0.01),and between complaints and units(x2(15)=42.72,P<0.01).Conclusions:Patients'complaints are valuable sources for quality improvements.Healthcare providers should be not only scientifically knowledgeable,but also humanistic caring.Caring-based theories may provide guidance in clinical practice.

Identification of contamination source in water distribution network based on consumer complaints

A new methodology was proposed for contamination source identification using information provided by consumer complaints from a probabilistic view.Due to the high uncertainties of information derived from users,the objective of the proposed methodology doesn't aim to capture a unique solution,but to minimize the number of possible contamination sources.In the proposed methodology,all the possible pollution nodes are identified through the CSA methodology firstly.And then based on the principle of total probability formula,the probability of each possible contamination node is obtained through a series of calculation.According to magnitude of the probability,the number of possible pollution nodes is minimized.The effectiveness and feasibility of the methodology is demonstrated through an application to a real case of ZJ City.Four scenarios were designed to investigate the influence of different uncertainties on the results in this case.The results show that pollutant concentration,injection duration,the number of consumer complaints nodes used for calculation and the prior probability with which consumers would complaint have no particular effect on the identification of contamination source.Three nodes were selected as the most possible pollution sources in water pipe network of ZJ City which includes more than 3 000 nodes.The results show the potential of the proposed method to identify contamination source through consumer complaints.

Blockchain Implications in the Management of Patient Complaints in Healthcare

Blockchain is an emerging technology that has recently been the focus for many researchers who have highlighted its diverse applications including healthcare. Transparency in managing unsolicited patient complaints is important in healthcare for both patients and healthcare providers;in addition, patient complaints analysis is significant to the continued quality improvement. Accordingly, the purpose of this study is to understand the nature of patient complaints management in the healthcare settings, explore the implications of blockchain on the management of patient complaints, and identify limitations in the usage of blockchain. Structured qualitative review and content analysis of the literature methods were used through multiple inclusion and exclusion phases for the scope of this research. Blockchain technology characteristics have been analyzed and approximated with desired features in the patients’ complaint management. Patient complaints provide valuable information to drive continuous improvements in healthcare. Blockchain is described as transparent, decentralized, immutable and anonymous. Results of this research found that a complaint Management system that is built on blockchain technology might have desired features that involve data integrity, security and transparency. Blockchain does have certain limitations that involve cybersecurity, scalability, confidentiality, readiness to adopt it, and is uncertainty about its impact. As a conclusion, implementing a system to manage patient complaints that is based on blockchain technology is promising, due to its desired possible features.

Relationship between Stress and Psychosomatic Complaints among Nurses in Tabarjal Hospital

This research was conducted to examine the relationship between stress and psychosomatic complaints among nurses in Tabarjal hospital. To achieve this aim, the researcher used the descriptive method and selected a sample consisting of (56) nurses working in hospital through the simple random sampling technique. The respondents were requested to complete a questionnaire for rating of stress and the most common psychosomatic diseases. The collected data were analyzed statistically by using SPSS. The results revealed that the stress was dominant among nurses in Tabarjal hospital, the prevalence of psychosomatic complaints was significantly higher in nurses, and there was significant correlation between stress and psychosomatic complaints among nurses. Conclusion: This research confirmed the effect of strains on the prevalence of psychosomatic symptoms among nurses in Tabarjal hospital. Further, implications of the results were discussed on the light of some related researches.

Frequency of Hemorrhoidal Complaints in a Real-Life Population and Possible Concomitance between Hemorrhoidal Disease and Chronic Venous Disease: Going Further in Our Understanding of Hemorrhoidal Disease

Introduction: Hemorrhoids, more commonly known as piles, are swollen veins, similar to varicose veins in the lower rectum. Hemorrhoids can develop both inside and outside the rectum, and oftentimes, the cause of hemorrhoids remains unknown. This is an extremely common ailment faced by three out of four adults in their lifetime. Hemorrhoids can cause various kinds of complications, but the most common and serious ones are perianal thrombosis and incarcerated prolapsed internal hemorrhoids with subsequent thrombosis. They are accompanied by severe pain in the perianal region, and possible bleeding. Data on the coexistence of hemorrhoids with other conditions are sparse. Some data are consistent with a common pathophysiological link between straining at stool, constipation, and obstetrical events such as pregnancy and delivery. These events are also involved in the development of Chronic Vein Disease (CVD) or Chronic Vein Insufficiency (CVI). CVI is a condition that occurs when the venous walls or valves in the leg veins stop working properly, causing difficulty in blood returning to the heart from the legs. The present study was conducted with an aim to determine the frequency of complaints in hemorrhoidal patients and to assess the possible concomitance between hemorrhoidal disease and chronic venous disease. Methods: This was a multicenter, cross-sectional, observational study that enrolled patients spontaneously consulting for hemorrhoids in 17 different hospitals of different regions of Bangladesh from 1st June 2018 to 31st July 2018. Patients’ demographic and lifestyle characteristics were recorded, information on hemorrhoidal grade and signs of chronic venous disease was collected. Types of prescribed treatments were also recorded by the physicians. Results: A total of 499 patients were enrolled and analyzed. Reported frequencies of hemorrhoidal symptoms were: bleeding (80.8%), pain (66.3%), swelling (51.7%), prolapse (28.9%), itching (37.7%), soiling (12%), fecal incontinence (13.4%). 13.8% of the hemorrhoidal patients presented concomitant chronic venous disease. The Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification was used to classify the clinical signs and symptoms of the patients as C0—no visible or palpable signs of venous disease (6.2%), C1—telangiectasias or reticular veins (4.4%), C2—varicose veins (1.4%), C3—edema (2.6%), C4a—pigmentation or eczema (2%), C4b—lipodermatosclerosis or Atrophie Blanche (0.2%), C5 & C6—venous ulcer (0.6%). Commonly prescribed treatments were dietary fiber (89.8%), veno-active drugs (74.7%), topical treatments (63.7%), painkillers (11.2%), and surgical procedures (30.3%). Conclusion: The study provides small-scale data on patient profiles, risk factors, and commonly prescribed treatments in hemorrhoidal patients. The concomitance of chronic venous disease in 13.8% of the hemorrhoidal patients highlights the importance

International Trade Barriers Complaints and Structural Employment： A Conceptual and Quantitative Macro-perspective

Free trade is beneficial for all nations. Pareto optimality can be reached by trade without barriers, leading to maximizing total welfare of nations involved. Yet there are clear cases of complaining at the World Trade Organization （WTO） in which home bias is plausibly the reason for complaining, rather than objective criteria of the rules of trade agreements. Next to home bias in individual cases induced home bias leading to complaining at WTO might also be a trend. Using correlation and stepwise regression analysis a dataset on 28 complaining countries is analysed. The number of complaints at the WTO is the dependent variable in exploratory modeling. Independent variables are various variables on economic structure. Structural unemployment （SUN）, agricultural import share, current account balance, international property rights （IPR）, and foreign direct investment （FDI） turned out to be significantly related to the number of complaints. This is a strong indicator that complaining at the WTO is at least partly induced by other than objective factors. One of these factors other than objective factors could be considered as an induced home bias which leads to disruptive trade. The established relationship with one of these factors indicates the existence of induced home bias as an actual trend based on the outcomes of the analysis presented.

Complaints

Complaining about faulty goods or bad service isnever easy. Most people dislike making a fuss. But ifsomething you have bought is faulty or does not do whatwas claimed for it, you are not asking for a favour toget it put right. It is the shopkeeper’s responsibilityto take the complaint seriously and to replace or repair afaulty article or put right poor service, because he is

Development of Patient Rights and Analysis of Patient Complaints in Turkey

The aim of this study is to identify the development of patient rights in Turkey and to analyze patient complaints in the country. An attempt was made to determine how the issues discussed in patient rights committees are differentiated from the applications made to the patient rights units of the hospitals within the body of Ministry of Health in 2009, depending on variables such as branch, province, region, hospital type, title, gender, and subject of application, 18,634 applications were content analysed after they were classified in terms of subject, unit, title, branch, province, and region, and were transformed into numerical codes to prepare the data for analysis. The results show on a regional basis that Marmara is in the first place with 34.9% and East Anatolia is in the last place with 4.6%. The unit receiving the most complaints is outpatient services with 43.1%. Regarding position title, specialists ranked first with 37.9% and managers ranked next with 11.3%. When reviewing the subjects of the applications, they are ranked as follows： （1） lack of benefiting from the services （44%）; and （2） lack of receiving respect and comfort （26.8%）. Patient rights violations were detected in 12.7% but not in 51.6% of the applications made.

Stress and quality of life in dermatological patients: Are out-patients' needs different?

The debut, progression and maintenance of skin disease are related to stress(acne, alopecia areata, atopic dermatitis, lichen planus, psoriasis, urticaria, vitiligo, herpes, hyperhidrosis, pemphigus, rosacea or seborrheic dermatitis). Environmental, socio-professional, life events are representing external factors. Personality, previous experiences, traits of anxiety are individual factors influencing the state of stress. Perceived stress could be more harmful especially in "high reactors" to stress. Coping abilities to stress could be increased in social programs. There was a recent interest in measuring the quality of life in the last years. There are dermatology and disease specific questionnaires that could help. Out-patients have less time to wait for very sophisticated procedures. They expect faster results. For simple, acute diseases it is important to have a good communication and good understanding of the instructions to get results as soon as possible. For chronic diseases a strong long-term alliance is needed, so the patients should revisit for his benefit and not for giving up. Small questions regarding potential stressful events, impact on the quality of life, stigmatization, the level of symptoms(pruritus), psychiatric comorbidities(anxiety, depression), short questionnaires for quality of life give us a better picture, personalize the doctorpatient relationship and could influence the choice of treatment. Many skin disorders could be seen from a psychosomatic point of view and the final goal, especially for the chronic diseases, is to improve through our treatments the impact on the quality of patient's life.

Topic-Aware Abstractive Summarization Based on Heterogeneous Graph Attention Networks for Chinese Complaint Reports

Automatic text summarization(ATS)plays a significant role in Natural Language Processing(NLP).Abstractive summarization produces summaries by identifying and compressing the most important information in a document.However,there are only relatively several comprehensively evaluated abstractive summarization models that work well for specific types of reports due to their unstructured and oral language text characteristics.In particular,Chinese complaint reports,generated by urban complainers and collected by government employees,describe existing resident problems in daily life.Meanwhile,the reflected problems are required to respond speedily.Therefore,automatic summarization tasks for these reports have been developed.However,similar to traditional summarization models,the generated summaries still exist problems of informativeness and conciseness.To address these issues and generate suitably informative and less redundant summaries,a topic-based abstractive summarization method is proposed to obtain global and local features.Additionally,a heterogeneous graph of the original document is constructed using word-level and topic-level features.Experiments and analyses on public review datasets(Yelp and Amazon)and our constructed dataset(Chinese complaint reports)show that the proposed framework effectively improves the performance of the abstractive summarization model for Chinese complaint reports.

US Action on China Subsidies May Invite Cotton Co Complaints

News that the U.S. will allow companies to pursue anti-subsidy action against Chinese imports paves the way for companies within the textile industry to seek trade protection,though it remains to be seen how the situation may affect the U.S. cotton industry,analysts

People's Complaints System in China——Chinese way of human rights relief

The people＇s complaints system is a mechanism of democracy and human rights relief under the traditional legal system of China. It has displayed positive roles during different historical periods after 1949 when the new China was founded.

Environmental complaint insights through text mining based on the driver,pressure,state,impact,and response(DPSIR)framework:Evidence from an Italian environmental agency

Individuals,local communities,environmental associations,private organizations,and public representatives and bodies may all be aggrieved by environmental problems concerning poor air quality,illegal waste disposal,water contamination,and general pollution.Environmental complaints represent the expressions of dissatisfaction with these issues.As the timeconsuming of managing a large number of complaints,text mining may be useful for automatically extracting information on stakeholder priorities and concerns.The paper used text mining and semantic network analysis to crawl relevant keywords about environmental complaints from two online complaint submission systems:online claim submission system of Regional Agency for Prevention,Environment and Energy(Arpae)(“Contact Arpae”);and Arpae's internal platform for environmental pollution(“Environmental incident reporting portal”)in the Emilia-Romagna Region,Italy.We evaluated the total of 2477 records and classified this information based on the claim topic(air pollution,water pollution,noise pollution,waste,odor,soil,weather-climate,sea-coast,and electromagnetic radiation)and geographical distribution.Then,this paper used natural language processing to extract keywords from the dataset,and classified keywords ranking higher in Term Frequency-Inverse Document Frequency(TF-IDF)based on the driver,pressure,state,impact,and response(DPSIR)framework.This study provided a systemic approach to understanding the interaction between people and environment in different geographical contexts and builds sustainable and healthy communities.The results showed that most complaints are from the public and associated with air pollution and odor.Factories(particularly foundries and ceramic industries)and farms are identified as the drivers of environmental issues.Citizen believed that environmental issues mainly affect human well-being.Moreover,the keywords of“odor”,“report”,“request”,“presence”,“municipality”,and“hours”were the most influential and meaningful concepts,as demonstrated by their high degree and betweenness centrality values.Keywords connecting odor(classified as impacts)and air pollution(classified as state)were the most important(such as“odor-burnt plastic”and“odor-acrid”).Complainants perceived odor annoyance as a primary environmental concern,possibly related to two main drivers:“odor-factory”and“odorsfarms”.The proposed approach has several theoretical and practical implications:text mining may quickly and efficiently address citizen needs,providing the basis toward automating(even partially)the complaint process;and the DPSIR framework might support the planning and organization of information and the identification of stakeholder concerns and priorities,as well as metrics and indicators for their assessment.Therefore,integration of the DPSIR framework with the text mining of environmental complaints might generate a comprehensive environmental knowledge base as a prerequisite for a wider exploitation of analysis to support decision-making processes and environmental management activities.

基于TF-IDF算法的运营商客户投诉原因研究

针对运营商人工处理客户投诉工单高成本低效率问题,提出了一种基于TF-IDF算法的定量研究方法,旨在高效精准地识别客户投诉原因。选用Jieba分词,导入自定义词典和停用词列表,对运营商客户投诉工单进行关键词抽取,获取各类问题中TF-IDF值排名前6的关键词,输出关键词集。提高了关键词抽取的准确性和效率。此外,对比仅对文档集使用TF进行统计和使用TextRank算法的情况,突显了IDF的重要性及算法原理的差异。实验结果表明,光猫、路由器、机顶盒问题广泛存在于各类投诉中。针对这三类问题,为运营商提供了改进产品、服务的相关建议,对运营商集中治理、解决问题具有一定的实用价值。

公立医院党建引领“接诉即办”创新机制实践与探索

党建引领基层社会治理,聚焦群众急难愁盼问题,让人民群众满意,是党建引领公立医院高质量发展的制高点、出发点和落脚点。当前公立医院党建引领“接诉即办”工作模式尚需进一步探索。本文将TRIZ科学管理理论和方法引入党建研究,探索“接诉即办”的创新工作机制和考核机制,打造公立医院“接诉即办”党建品牌,为党建引领“接诉即办”向纵深发展、促进医院高质量发展和形成公立医院解决人民群众急难愁盼问题的长效机制提供借鉴。

2020年北京市控烟检查和投诉现状分析

目的 了解北京市控烟检查和投诉情况,评价《北京市控制吸烟条例》落实情况,为完善政府控烟政策提供依据。方法 以北京市2020年6个城区的全部街道作为研究对象。收集2020年北京市街道控烟检查和控烟投诉数据,计算控烟检查得分、万人控烟投诉率。结果 共纳入北京市134个街道,控烟检查得分为(89.3±6.5)分、万人控烟投诉率的均值为(9.7±9.3)/万人,且在各区之间的差异均有统计学意义(P<0.001)。餐馆(58.7%)、室内农贸市场(52.5%)、网吧或娱乐场所(40.8%)、公共卫生间(47.3%)控烟检查项目全部合格的比例较低;餐馆(28.6%)、写字楼(28.1%)、办公场所(13.1%)为常见的控烟投诉场所。结论 北京市城区各街道的控烟状况总体良好,但是部分地区仍有待加强。

诉源治理下农村土地承包经营纠纷仲裁制度的实践反思——以广东S市为例

以广东省S市农地承包经营纠纷仲裁制度实证调查为基础,深入探究我国《农村土地承包经营纠纷调解仲裁法》在具体运作中存在的缺陷。结合诉源治理将社会纠纷“源头预防、前端化解”的要求,提出厘清制度的性质定位,明确仲裁机构独立性,赋予仲裁“一裁终局”效力,尝试构建仲裁与调解相结合、仲裁与诉讼相衔接的良性互动机制等一系列解困建议,以重现公正、及时解决农村土地承包经营纠纷,提升矛盾纠纷预防化解法治化水平,完善中国特色多元化纠纷解决机制。

急诊预检分诊患者主诉标准化术语库的构建及应用研究

目的建立患者主诉标准化术语库并观察其在急诊预检分诊中的应用效果。方法以加拿大急诊信息化系统主诉列表为基础,增补各大疾病系统和近5年该院急诊分诊系统中主诉信息,根据标准医学术语集进行规范的表达,通过专家函询确定主诉列表(主主诉模块),辅以疾病持续时间(子主诉模块)和国际疾病分类10(International Classification of Diseases 10,ICD10)诊断列表(主诉辅助模块)形成主诉标准化术语库,联合信息部门将主诉标准化术语库应用于急诊预检分诊系统。选取2023年9月应用主诉标准化术语库分诊的急诊患者为试验组,2022年9月同期应用常规自由文本形式录入主诉的急诊患者为对照组;比较两组患者的分诊时间、分诊符合率及72 h非计划重返率。结果应用主诉标准化术语库后,分诊时间从(327.33±44.32)s缩短至(174.23±49.02)s,预检分诊符合率从应用前的95.27%提高至98.34%,差异有统计学意义(P<0.001)。72 h非计划重返率均是零。结论将主诉标准化术语库用于急诊预检分诊,对主诉规范、分诊时效、急诊急救效率起到了促进作用,有助于医学数据统计和分诊质量控制,以及提高急诊工作效率。

Citizen-Centric Complaint Reporting and Analyzing Mechanism

The “Citizen-Centric Complaint Reporting and Analyzing Mechanism” project is designed to create an online complaint system, called “e-Complaint”, to allow citizens to file complaints related to crime and misconduct in a secure and user-friendly way. The proposed system aims to address the challenges of the current complaint system, ensuring transparency and accountability in the police force. The “e-Complaint” system aims to increase police accountability and transparency and has significant benefits for both citizens and police departments.

“下交群评”:迈向人民主体性的基层治理——以北京市平谷区接诉即办改革为例

以人民为中心的发展思想日益成为主导基层治理的逻辑,在北京市接诉即办工作不断深化改革的基础上,以北京市平谷区“下交群评”工作为例,探索党建引领多元主体参与社会治理的机制,并重点关注如何引导群众成为基层治理的主体。研究发现,“下交群评”通过治理主体的组织嵌入化、治理单元的熟人社会化、治理规则的崇公抑私化、治理机制的交互整体化形塑了新时代“三治融合”的实践机制,为系统治理和源头治理提供了重要保障;从接诉即办的倒逼式治理到主动性治理,再到自主性治理,人民群众真正成为治理问题的发起者、治理过程的参与者、治理成效的获得者、治理情况的监督者。这是全过程人民民主的生动实践,体现了基层正在从被动的市民诉求驱动迈向人民主体性的治理。