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March 2010, Volume 40 Number 3 , p 14 - 15



While hospitalized for a surgical procedure, I had several troubling experiences. For example, no one responded to my call bell on two occasions. In aaddition, my pain medication, which should have been administered around the clock, was given far behind schedule several times, allowing my pain to escalate. My pain wasn't routinely assessed on every shift.As a nurse, I know I received substandard care, and I'm concerned about other patients who may have a similar experience in this hospital. After discharge, what's the best way to communicate my dissatisfaction to nursing management—not to stir up trouble, but to improve patient care?—M.T.,VA.Under guidelines from the Centers for Medicare and Medicaid Services (CMS), "patients should have reasonable expectations of care and services and the facility should address those expectations in a timely, reasonable, and consistent manner" (CMS Interpretive Guidelines, Sec. 482.13 [a][2}). If care is substandard, patients may lodge a grievance, defined as a written or verbal complaint about unsatisfactory care, abuse, or neglect.The facility should have a process in place to deal with most complaints on the spot. Under CMS guidelines, the facility must inform patients of the internal grievance process and whom to contact with grievances.Our legal consultant says the guidelines are a bit unclear about provisions for dissatisfied patients after discharge, but she believes the same guidelines apply. She advises you to use the hospital's grievance process to submit a written complaint about your experience. The hospital is required to review, investigate, and resolve grievances within a reasonable time. (In most cases, 7 days is considered reasonable.) It should also give you a written notice of the hospital's determination regarding the investigation.You don't say if you work in the facility where you were hospitalized, but if so, contacting someone from the employee relations or human resources

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