Service recovery vs. obfuscation in hospice

Let’s talk about patient/family complaints. By doing excellent work (which I hope this website helps you to do), and by working for a good hospice (and they do exist!), you can be fortunate enough to avoid having to deal with complaints too often.

But no level of professionalism will completely protect you from complaints. They’ll happen. You can have a bad day and misread a room and say something someone doesn’t like. Or a colleague could drop a ball. Or a facility can blame you for something that had nothing to do with you. Or you could be working with a family member whose previous experiences makes it hard for them to trust or forgive. There are a lot of reasons that you will, on occasion, have to deal with complaints.

How not to respond to complaints

Responding to complaints with honesty, humility, a commitment to improve and follow through makes service recovery possible in many cases and even easy in some. To illustrate, here’s how NOT to respond, as illustrated by “Mortem Hospice,” the real hospice that served my grandfather (labeled with a generous pseudonym).

I called to speak with an administrator when they failed to respond to my aunt’s request for some crucial information about my grandfather’s plan of care and when team members would be arriving. They had left her hanging, and continued to do so, despite her several attempts at contacting them. I stepped in, made a few calls, and when I got an administrator on the phone, I told her my aunt needed a call. I told her the comfort of my grandfather, my aunt, and myself, all depended now on the family knowing what the plan was. I told her I expected more communication from the hospice.

Thankfully, she got the agency to shift into a higher gear and service improved. And then my aunt got an inexplicable call from another member of their team.

Don’t try to “divide and conquer” the families you serve

Someone in administration called my aunt to tell her that I was calling the hospice to insist that they allow my grandfather to receive hospice care in the hospital indefinitely and that my request wasn’t reasonable.

I had made no such request. It was never what I wanted. We all wanted my grandfather to return home soon as reasonably possible. And I knew what was reasonable to expect: the general inpatient level of care is about short-term symptom management, not long-term care in a hospital. This is something I repeatedly educate my patients’ family members about.

So why did she say such a thing? Maybe there was another patient with our last name or another frustrated family member with my first name, and they were confused. Or maybe they were too busy to really pay attention when my complaint was referred to her and she jumped to a conclusion about what they thought it would be.

Regardless, she had her facts wrong and I had a hard time not feeling offended to learn that this organization that was supposed to be serving our family was confusing things by misrepresenting facts. It felt like they were trying to blame shift or divide us. It was the opposite of comforting.

The positive lesson is the reminder that honesty and accuracy are so very important when attempting to recover when service did not meet expectations. Time after time, I have been asked to speak with family members who are unhappy about something, and they almost always come back with warmth and appreciation when I show them I’m taking their complaints seriously.

This concludes, for now, our short series on Good Lesson from Bad Hospice. May all hospices benefit from the lessons we can learn from the bad ones.

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An open letter to those who work with the Texas OOHDNR

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Religious chauvinism in hospice