HospitalInspections.org

Based on interview and document review, the facility failed to log one complaint received by a phone call, related to patient care and failed to follow facility policy in one of one patient (#1) complaints resulting in the potential to track patient complaints and failure to have grievances investigated and addressed by the facility. Findings include:

On 02/25/22 at 1500, during a phone interview with Confidential Informant A, it was revealed that Confidential Informant A placed a call to the manager of the Emergency Department (ED), Staff D, on 12/20/21 and left a message regarding their concern over the care of Patient (Pt) #1, who was in the ED on the same date and time. Confidential Informant A stated they left a message regarding "the patient was being abused by staff in the ED". They confirmed the two (2) allegations. They also confirmed that the local police department was contacted. The complainant stated they never knew "if they went out, because they never heard anything back from anyone."

On 03/01/22 at 1515, during an interview with the Nurse Manager of the Emergency Department (ED) Staff D, was asked if an investigation was conducted concerning the grievance from 12/20/21. Staff D stated that the grievance was received by a phone message with a name and a return phone number left. Staff D stated that she did "contact the complainant in regard to her concerns. I did tell her a complete investigation would be completed by me. I did look at charts of related patients, who were the staff for the alleged times, and who the doctor was. I did talk to everyone who I thought could provide me with some insight. When queried in regard to documenting the grievance or reporting it to the "Complaint Grievance Process" Staff D stated, "I did not do that because I couldn't find anything that went wrong."

On 03/01/22 at 1600, during review of the document titled "Complaint and Grievance" it was determined that the patient of concern, Pt#1, was not added to the list. The complaint was called into the ED Manager by phone. It was noted that the rest of the facility, Quality, Risk, Patient relations & Med Staff, did not know about the grievance due to the fact that it was investigated internally in the ED, unsubstantiated and closed through the ED.

On 03/01/22 at 1630 during review of the document titled "Complaint and Grievance Management," policy "8408508" it was determined that a "4. Grievance: A grievance is a formal or informal written or verbal complaint about any aspect of care that is made to (the facility) by a patient or the patient's representative when: c. An issue that requires investigation or further action for resolution greater than 24 hours." Also stated in the "Complaint and Grievance Process, D. Grievances will be forwarded to the Patient Relations, who will record, triage, evaluate and prioritize the issue as a grievance."