Practice guidance: Handling complaints
15 June 2022
Practice guidance is our interpretation of how professional standards apply in a particular situation. It is designed to help practices deal with common issues, using judgement to apply the advice to their own situation. It represents our best efforts at the time of publication but standards and expectations change over time and particular care should be used when reading old advice.
While VCNZ has a complaints process that anyone can access to raise concerns about a veterinarian, we believe that these concerns are almost always best addressed by the practice concerned in the first instance.
Resolving concerns locally has many advantages, including:
- It is likely to be much quicker
- It can be less stressful for both the client and staff
- It is more likely to result in a satisfactory outcome for all parties
- The treating veterinarian is often best placed to answer questions about the care provided
- It can help repair and preserve the relationship between the client and the practice.
This guidance sets out some key principles to help practices develop their own complaints handling processes. It is based on our experience dealing with complaints spanning all types of veterinary practice. We acknowledge that each situation is unique and this guidance should not be seen as prescriptive.
Purpose & outcomes
It is helpful to start with a clear view on what the complaints process is trying to achieve and to communicate that to all involved. A lack of shared understanding of what the process aims to do is one of the key drivers to dissatisfaction with a complaints process.
Some possible goals include:
- Identifying and resolving any shortcomings in service delivery
- Identifying opportunities for learning and improvement
- Determining whether a client’s concerns are valid and, where appropriate, resolving them
- Providing a channel for clients to provide feedback and feel heard.
This is not an exhaustive list and it pays to spend time thinking about purpose and discussing it with staff to ensure that they understand and support the process.
Possible outcomes should also be considered when designing the process. As an example, for many consumers, financial amends is an important gesture but acknowledgement of their concerns and a commitment to doing better can be equally, if not more, impactful.
It can also be helpful to be explicit about what is not in scope so that expectations can be set at the outset.
A sample process
The following is a simplified example of a process a practice might adopt.
A client informs a member of the team that they are unhappy with some aspect of the service.
Initial step for ALL staff:
- Say sorry: “I’m sorry to hear you have had the experience of….”. Expressing personal regret and apologising does not, of itself, imply you are to blame.
- Thank them for raising it: “Thank you for bringing it to my attention …:
- Commit to action: “I’m sure we can do something about it ….”
A designated person (e.g. senior veterinarian or practice manager) could use the following procedure for handling client concerns. Concerns can be raised in person, over the phone, or in writing.
- If not face to face, contact the client as soon as possible and acknowledge receipt of their concern.
- Provide the client with the opportunity to describe their concerns. If in person, take them into a private area out of the public’s view.
- Give the client your full and undivided attention.
- Listen actively and avoid interrupting them.
- Ensure you have the full concern and understand the issues they wish to raise, ask: “Is there anything else?”
- Empathise with the client that a problem exists. Try not to disagree or argue.
- Apologise and empathise: “I’m sorry to hear you have had the experience of…”
- Record the concern, repeat a summary back to the client to ensure everything is covered.
- Thank the client for bringing the complaint to your attention and tell them what steps you will follow and the expected timeframes.
Investigation & resolution
Some concerns may be able to be dealt with satisfactorily when raised by the client, such that the client does not feel the need to take this further. If this is possible, thank the client for raising the concern and be clear with them that you have agreed not to take it any further.
If not, the following investigation process could be followed:
- The Practice Manager either investigates or appoints an investigator. This could be another staff member with appropriate knowledge and skills (e.g. a veterinarian if it is a clinical concern) or someone external. In more serious concerns, it is best to appoint someone independent from the situation.
- The complaint should be kept confidential, as far as possible, with personal information only disclosed if necessary to help the investigation.
- The Investigator gathers enough information to make a decision about what action is needed. In simple cases, this might be a review of the patient history. In more complex cases, it might involve speaking with anyone who was a witness to what happened or canvassing clinical opinions from other experienced veterinarians.
- The Investigator makes a recommendation on what the resolution should be. This could include:
- Acknowledgement to the client that their concern was valid, an apology and financial amends where appropriate.
- Alternatively, informing the client that the investigation did not validate their concerns.
- Training for staff involved or all staff.
- Changes to systems to prevent the issue recurring.
- Where a staff member has seriously breached policies or protocols, further action through an employment process.
- Further support for the client and/or affected staff members.
- The Practice Manager decides whether to accept the recommendations.
- The Practice Manager contacts the client to discuss the outcome with them.
- A final letter or email is sent to the client confirming the outcome in writing.
It is recommended that practices keep a record of complaint information and outcomes and review it periodically to look for patterns and trends. This can be a valuable way to improve service quality and also to minimise complaints, even where the issue is more about perception than reality.
It is also worth closely scrutinising any situation where the investigation points to “human error” as the root cause. In our experience, it can be valuable to consider the surrounding factors and systems that allowed the error to take place and flow through to negative consequences. Human error is inevitable and cannot easily be eliminated from any process so it normally makes sense to create safeguards that protect against error or prevent or mitigate its consequences. Human error is a widely studied topic and those interested can find a wealth of evidence-based information and models on error prevention and investigation (e.g. the five whys methodology, the Swiss cheese model, etc).
Regardless of whether an internal investigation is carried out, and its outcome, the client may decide to take it elsewhere (for example, a complaint to VCNZ or a claim via the Disputes Tribunal). A good resolution locally reduces the risk of this happening.
In any external process, evidence that the practice has carried out a thorough local investigation and of the outcome reached, is likely to help resolve it quickly and effectively.