Content area
Full text
Introduction
In 2014-2015, the number of emergency calls coming into UK ambulance service control rooms was nine million, which was an increase of 515,506 (6.1 per cent) over the previous year’s 8.49 million calls (Health and Social Care Information Centre, 2015); a demand which is envisaged to increase still over the next 15 years (Association of Ambulance Service Chief Executives, 2015).
It is known that high demand such as this, in addition to rapid triage, diagnostic uncertainty, communication challenges, and unpredictable workload can contribute to medical errors and complaints in emergency departments (ED) (Källberg et al., 2013; Bongale and Young, 2013). Similarly, it is known that errors in diagnosing conditions, poor treatment, and a lack of communication were among the top reasons for UK hospitals complaints investigated by the Parliamentary and Health Service Ombudsman (2014-2015). Despite many of these attributes also being present within the prehospital setting there is relatively little literature available specifically focussing on causes and contributing factors to complaints made to UK ambulance services.
Complaints form an important element of clinical governance and quality assurance processes as they provide a method by which mistakes, challenges, and patient safety concerns can be highlighted. Healthcare professionals and organisations can critically reflect upon their practices and processes and make improvements where needed (Brady, 2013).
According to freedom of information (FOI) requests submitted to all 15 UK NHS/Public Ambulance Services, the top three themes of complaints received about their emergency and unscheduled care ambulance services (excluding routine patient transport services) for the last three years are:
delay/response/time;
attitude/conduct/behaviour; and
clinical outcome/error/mistakes/quality.
Whilst such data (presented in Table I) does not show the amount of complaints which were upheld by the investigating trust or health authority, it clearly shows recurrent themes in causes or perceived causes of poor quality healthcare. What is less clear, however, is to what extent these themes have been researched and methodically understood as opposed to just being internally investigated by ambulance trusts.
Understanding as much about the nature, causes, contributing factors, and frequency of complaints is important in this process, and learning should not be confined to single departments of organisations, but rather shared internationally.
To this end, this author set out to review the research literature on the top three...