“What are you complaining about?” – Patients’ critique in care encounters and its potential to improve the quality of care

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How are care encounters affected by patients expressing critique? How can such critique lead to better, safer, and more equal care? These are questions explored within the project “What are you complaining about?”.

Patients’ complaints are increasingly valued in Swedish healthcare as key information for the improvement and democratisation of care. This is exemplified in a range of organisational changes that have followed the introduction of a new system to capture and deal with formal patient complaints that is currently being implemented. Here, more direct communication between patients and care providers is central, and care encounters are identified as key instances to signal a culture in which complaints are welcomed. In this way, it is a goal that patients’ trust in the system and their overall willingness to complain will increase. Yet, how “informal” critique, expressed verbally by patients, impacts care encounters, and how it can improve care quality and equity, is a blind spot in current work on the Swedish complaint system, and in international research.

This blind spot is even more alarming, given earlier tensions that patients and health professionals have reported in relation to active patient involvement in care encounters. Against this background, the current project aims to study what patients’ verbal critique means in Swedish care encounters, and how it can improve care quality and equity.

The project analyses patients’ and care professionals’ experiences of and expectations on how critique is to be expressed; what they complain about; and how patients’ social position matters. We also study how patients’ critique is used in quality improvement at the clinic level and in relation to formal complaint systems.

The project applies a qualitative and interactive design. Material is collected through qualitative interviews with patients and professionals, and observations of innovative drama workshops in two clinical settings. In parallel, we collect policy documents that deal with complaint management at different organisational levels.

The project is a collaboration between researchers from the Department of Thematic Studies and the Department of Health, Medicine and Caring Sciences, both at Linköping University.

Financier

The project is funded by The Swedish Research Council.

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