Innovative learning from simulated patient complaints

Repeated inquiries have highlighted issues with patient safety, communication and the exploration of complaints, emphasising the interplay between each in securing the optimum patients’ journey through health and social care provision (Francis 2013, Keogh 2013). The Care Quality Commission (2014) highlighted that every concern or complaint is an opportunity to improve. A complaint may signal a problem, with the potential to help save lives, and well-handled concerns can help to improve the quality of patient care. Despite these potential benefits there is a wide variation in how complaints are handled or the fostering of an open culture where all complaints are welcomed and learnt from. The University of Derby in delivering pre-registration nursing education utilises simulation to explore patient complaints in order to facilitate recognition of the value they offer, providing transferability to enhance nursing practice and improve patient safety. The simulated experience consists of examining the reasons for complaints; impacts upon service users; lessons for nurses and other health professionals; means of address and preventing repetition of similar incidents;enhancements for practice and lessons for organisations. As part of this process the inclusion and effects of Human Factors are explored from the inception of the simulation experience. Students’ simulate three phases: root cause analysis; the development of a response letter; and a proposal for practice enhancement. These are all subsequently explored via a simulated Boardroom experience. This consists of a panel of allocated ‘experts’ to which the students’ present their findings and recommendations to enhance potential future patient experience and safety. Robust exploration of students’ thought processes and actions are incorporated within this experience via questioning, observation and reflections of the panel. Resulting from this simulation, students develop key transferrable skills: critical thinking; team working; leadership; knowledge of systems and processes; communication skills; customer care; quality assurance, governance and promoting patient safety that are mapped against the competencies outlined in the Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. This experience and feedback is recorded within each students practice document. This is used for subsequent review by their practice mentor, and can be used as part of their practice assessment at the applicable progression point. Learning from service user complaints is high on the agendas of commissioners and healthcare providers. This simulated experience has the potential to be transferred in to not only nursing practice but also any other healthcare professional pre-registration education and continued professional development. References Care Quality Commission (2014) Complaints Matter. Newcastle Upon Tyne: CQC. Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationery Office. Keogh, B. (2013) Review into the Quality of Care and Treatment Provided by 14 Hospital Trusts in England: An overview report. London: The Stationary Office. Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. London: NMC. Key words: • simulation • complaints • patient safety • enhancing practice. Bullet points that indicate how your work contributes to knowledge development: • innovative approaches to teaching and learning through the application of simulated complaints • enhancement of patient safety and the quality of care • development of transferable competence for nursing practice.

Repeated inquiries have highlighted issues with patient safety, communication and the exploration of complaints,
emphasising the interplay between each in securing the optimum patients’ journey through health and social care
provision (Francis 2013, Keogh 2013). The Care Quality Commission (2014) highlighted that every concern or
complaint is an opportunity to improve. A complaint may signal a problem, with the potential to help save lives, and
well-handled concerns can help to improve the quality of patient care. Despite these potential benefits there is a
wide variation in how complaints are handled or the fostering of an open culture where all complaints are welcomed
and learnt from.
The University of Derby in delivering pre-registration nursing education utilises simulation to explore patient
complaints in order to facilitate recognition of the value they offer, providing transferability to enhance nursing
practice and improve patient safety.
The simulated experience consists of examining the reasons for complaints; impacts upon service users; lessons
for nurses and other health professionals; means of address and preventing repetition of similar incidents;enhancements for practice and lessons for organisations. As part of this process the inclusion and effects of Human
Factors are explored from the inception of the simulation experience.
Students’ simulate three phases: root cause analysis; the development of a response letter; and a proposal for
practice enhancement. These are all subsequently explored via a simulated Boardroom experience. This consists
of a panel of allocated ‘experts’ to which the students’ present their findings and recommendations to enhance
potential future patient experience and safety. Robust exploration of students’ thought processes and actions are
incorporated within this experience via questioning, observation and reflections of the panel.
Resulting from this simulation, students develop key transferrable skills: critical thinking; team working; leadership;
knowledge of systems and processes; communication skills; customer care; quality assurance, governance and
promoting patient safety that are mapped against the competencies outlined in the Nursing and Midwifery Council
(2010) Standards for Pre-registration Nursing Education. This experience and feedback is recorded within each
students practice document. This is used for subsequent review by their practice mentor, and can be used as part
of their practice assessment at the applicable progression point.
Learning from service user complaints is high on the agendas of commissioners and healthcare providers. This
simulated experience has the potential to be transferred in to not only nursing practice but also any other healthcare
professional pre-registration education and continued professional development.
References
Care Quality Commission (2014) Complaints Matter. Newcastle Upon Tyne: CQC.
Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationery
Office.
Keogh, B. (2013) Review into the Quality of Care and Treatment Provided by 14 Hospital Trusts in England: An
overview report. London: The Stationary Office.
Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. London: NMC.
Key words:
• simulation
• complaints
• patient safety
• enhancing practice.
Bullet points that indicate how your work contributes to knowledge development:
• innovative approaches to teaching and learning through the application of simulated complaints
• enhancement of patient safety and the quality of care
• development of transferable competence for nursing practice.