Are complaints key to delivering better outcomes for older Australians? Are complaints key to delivering better outcomes for older Australians? Are complaints key to delivering better outcomes for older Australians?

Best practice | Organisational culture | Complaints management | Innovation | Contact | Subscribe

Throughout the Royal Commission into Aged Care Quality and Safety (Royal Commission), many stories of neglect or substandard care heard, started with a complaint. Aged care providers reported to the Royal Commission that they had received over 79,000 complaints in relation to substandard care over a five-year period.¹

During the hearings, witnesses stated complaints were often dealt with inappropriately and resulted in ongoing issues around quality of care within aged care services. Consumers felt that they had not been heard, were fearful of repercussions and had limited autonomy with the delivery of their care and support. In many stories, if the complaint had been managed appropriately, the likely outcome would have been vastly different for the consumer, their families, as well as the provider.

Given these challenges, it is unsurprising that the Commissioners identified ‘complaints’ as a key focus area in their recommendations, for both the regulator and providers.

Complaints was mentioned 34 times within 13 separate recommendations. Specifically, Recommendation 90 in relation to a new governance standard for aged care providers specifies that all approved providers should have a system for receiving and handling complaints.

Given the importance of complaints, both at a provider level, regulatory level and the potential for greater public reporting of complaints, it is critical that aged care providers consider how their complaints function aligns with best practice, and identify areas for improvement to meet the expectations of older Australians, their families as well as the Australian Government.

These negative experiences impact the individual aged care provider as well as the aged care sector more broadly. During the Royal Commission, significant concerns were raised that a complaint would in fact be detrimental to the care and support of the older Australian at the centre of the complaint. It is critical that aged care providers develop a mature complaints function that allows consumers to have trust in the system and that assures consumers that there are no consequences when making a complaint.^2,3

Whilst negative experiences impact on the perception of an aged care provider, studies have shown that the way an organisation responds to a complaint has a positive effect on the organisation prior to the complaint. Nurses and aged care service managers agree that complaints are viewed as quality markers and quality enhancers for the organisation and are crucial assessing a resident’s well-being, quality of care and the possibilities for improvement.⁴

Complaints management is a critical component of operations for aged care providers and integral to delivering better outcomes for older Australians within the aged care sector.

Providers who want to ensure they are leading organisations in the sector need to treat complaints management as an organisation-wide priority and responsibility. This ensures transparency, accountability and stimulates a culture and desire for continuous improvement throughout the organisation.

Organisations, including aged care providers, that excel in excel at customer and complaints management do not perceive complaints as an isolated activity. Rather, complaints are embedded into consumer service disciplines and consumer journey designs.

Complaints are recognised and valued as opportunities to rectify issues at the cause, drive continuous improvement throughout the organisation and ultimately provide better outcomes for older Australians.

• Focus on first point of contact resolution – handle complaints at source.
• Organisational transparency of complaints – drive accountability throughout the provider, from the care workers through to Board and Executives.
• Proactive identification and management of vulnerable older Australians – prevent vulnerable consumers from reaching a state of risk.
• Use root cause analysis to drive continuous improvement – identify and fix complaint drivers.
• Recruit complaint team members for attitudes, not technical proficiencies – recruiting team members with an aptitude for empathy, problem solving and a willingness to challenge the status quo.
• Encouraging innovation and adopting new technologies – improve the consumer experience and drive efficiency using innovative technologies.

The key components of an organisation that embraces a complaints culture within their organisation include:

• There is full executive oversight and responsibility for complaints.
• Leaders, managers and staff value complaints and view complaints as an opportunity to improve and learn.
• Complaints are managed in a centralised operating model, with a dedicated, independent team, supported by specialists.

As people age and develop comorbidities and complications, older Australians can become one of the most vulnerable groups in our community.

Staff must be well-trained to identify vulnerable older Australians under their care and understand how to empower vulnerable consumers to make complaints.

Staff should also have direct access to internal sources of expertise to train and assist with managing complaints from this vulnerable group, especially if they are experiencing any form of abuse.

In order to appropriately manage complaints raised by this vulnerable group, it is crucial address the ageist assumptions and attitudes amongst the broader community and health professionals who interact with older Australians.⁵ This will enable providers to listen intently to the dissatisfaction and concerns of their consumers.

These systems need to facilitate high volumes of complaints and long cycle times for redressal of complaints. Technological innovations can be used to improve the customer experience or drive efficiency and productivity in the organisation following a complaint, including:

• Predictive analytics on consumer trends and behaviours to execute proactive operational responses before complaints arise or issues mature. 
• Predictive analytics on complaint outcomes to help businesses target cases with escalation potential. 
• Machine learning applications to decipher consumer sentiment and help customer service agents respond appropriately and efficiently.
• Fit for purpose relationship management system that is utilised by all aged care services for complaints management.
• Inbuilt complaint prioritisation and channelisation logic to allow automate processes across the complaint’s life cycle for efficiency.
  

Overall, complaints need to be perceived as opportunities to improve an aged care service and/or organisation, not as a negative attribute.

Providers need to have an accessible and transparent complaints system with strong executive sponsorship to drive improvement in delivery of care in aged care services to their consumers.

• Safety and quality >
• Customer-centricity >
• Legislative considerations >
• Workforce and culture >
• Elder safeguarding >
  
• Data and technology >
• Governance and risk considerations >
• Virtual care >
  
• Digital transformation >