Every complaint should be recorded minutely as it helps in many ways. A patient complaint form allows a person to file a complaint about a doctor or a medical facility to the higher authorities concerned. © 2004 Marc D. Goldstone, Esq. CONFIDENTIAL PATIENT COMPLAINT REPORT All patient complaints are confidential.
If a company really wants to excel in the field, a prompt notice needs to be taken … Service, equipment and billing complaints will be communicated to management and upper management. All complaints will be given serious attention. This report and any attachments are part of Klamath Tribal Health & Family Services Quality Improvement Program and therefore protected confidential documents under the law. Keeping care of the patients admitted in your organization is your responsibility, and listening to their problems and complaints is too. CREATING HEALTH CARE SOLUTIONS www.ccah-alliance.org (800) 700-3874 ext. If you need to record your patient’s grievances this log sample template can help you to do that as it offers blank space. Thus it should comprise of important segments that would urge the patient give out all the essential information. It can span from experiencing sleep deprivation due to testing in the early hours of the morning, lost personal belongings, messy rooms, lack of clear communication, and … SAMPLE HIPAA COMPLAINT TRACKING AND RESOLUTION LOG Complaint received from:_____ Date Complaint Received: / / Date Case Closed: / / 5504 1 Patient Complaint / Grievance Tracking Log Date Complaint Received Patients Name … These all complaints when are jotted down in a single file is known as a complaint log. The patient has the right to freely voice grievances and recommend changes in care or services without fear of reprisal or unreasonable interruption of services. Download Forms: Patient Complaint Log

Just by going through this log once, the management can know about the weaknesses and the work that has been done to rectify them and how much more work will be needed to reach the customer’s satisfaction level. Patient Complaint Log. Patient Complaint / Grievance Tracking Log CCAH-1030 MS GTL Date Complaint Received (MM/DD/YY Patients Name Grievance Description Forms Provided (Date/Initials) Date Plan Notified. So have a look at this frame before you design one.

A patient complaint is a statement from a patient regarding their dissatisfaction or concern with hospital services. This patient complaint form will be forwarded to the appropriate Department Manager, who … Thus a patient complaint form should comprise of segments like name and medical details of the person, his/her medical history, the problem for which he sought …