Managing Disgruntled Employees and Patients

Patients complain about treatment errors, slow response times, grumpy staff, and violations of confidentiality and privacy. Family members threaten to complain to superiors, go to the media or sue. Staff struggle with challenging patient assignments, cost-containment initiatives, conflicts between clinicians and administrators and, sometimes, failing equipment and short supplies.

These unhappy customers and employees may use social or conventional media to air their complaints, providing your organization with unwanted attention. So, how do you avoid negative publicity? What tools do you have for these kinds of situations?

Ombudsmen have an increasing presence in Fortune 500 companies, where they listen to customers and employees, solve problems, and help identify organizational behaviors that undercut productivity and quality. Health care has a long and rich history of using ombudsmen for patients, but unhappy employees also want to be heard. In the absence of a complaint handling system they may be tempted to alert the conventional media or to express themselves via blogs or Twitter. The ombudsman can help senior managers address these issues.

Ombudsmen's Function

Ombudsmen are found in diverse settings: they may help employees, customers or clients. Some are specialized, working only in health care or universities, or government agencies. Thousands are at work all over North America and Europe. Some solve problems informally while others investigate in a quasi-legal fashion.

 In general, ombudsmen serve five functions:

• They receive and handle complaints.
• They provide tools to help people solve problems themselves.
• They serve as a safety valve for disgruntled employees who otherwise would complain online or to the media.
• They educate professionals and employees on codes of conduct and regulatory guidelines.
• They act as consultants to health care professionals and to senior managers.

For example, in receiving a complaint from an employee, the ombudsman may coach the employee on how to approach a manager on her own, or may direct the employee to an appropriate resource within the organization. At the same time, the ombudsman collects anonymous data on patterns of complaints that can help administrative and clinical leaders target interventions and fine-tune its training programs (consulting/advising).

The Many Advantages of Using Ombudsmen

Management teams should consider the advantages of using ombudsmen. Below is an example of a brief management team discussion about whether to hire one. Five senior managers expressed their first thoughts about the idea.

• Chief operating officer: "We are pressed more than ever on productivity and cost control. If ombudsmen are able to remove barriers, sign one up."
• Nursing officer: "With patient census high, tension levels produce more conflict. We need to solve problems in-house, not online or in the media."
• Medical staff director: "My physicians often need advice on managing patient and staff conflicts, particularly with dissatisfied patients."
• Board member: "My job is to ensure that traditional hospital values, including fair treatment of patients and employees, are supported and protected. Ombudsmen are one tool for doing so."
• Legal advisor: "Any way to avoid litigation and reduce the risk of escalating conflict works for me."

Some leaders have created an ombudsman position exclusively for patients to ensure high levels of satisfaction. This is a customer-friendly approach. Others use ombudsmen to provide services to employees as well as patients.

A Message of Receptivity

The ombudsman's overriding purpose is to remove barriers that impede effective patient care, foster problem solving, and prevent problems from escalating to the point that the workplace environment becomes corrosive. At an implicit level, the ombudsman in the workplace can help the organization model its expectations to the entire professional and support team. A problem-solving, complaint-handling program sends a public message that senior managers are responsive to workplace and customer complaints.

The presence of an ombudsman inspires confidence that the organization can provide safe, reliable and secure patient care in productive, team-oriented processes.

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