UNIVERSITI TUNKU ABDUL RAHMAN

FACULTY OF MEDICINE & HEALTH SCIENCES (FMHS)

TITLE OF MPU33142 PROFESSIONAL
ASSIGNMENT 1 DEVELOPMENT AND PRACTICE I
ASSIGNMENT
INDIVIDUAL ASSIGNMENT COVERPAGE
STUDENT’S NAME NG JIA YUET

STUDENT’S ID 20UMB04128

YEAR & DEGREE OF PHYSIOTHERAPY YEAR 1 TRIMESTER 1

TRIMESTER OF
STUDY

COURSE MPU33142 PROFESSIONAL DEVELOPMENT AND PRACTICE I

LECTURER’S NAME PUAN NADIA SAFIRAH BINTI RUSLI

DATE OF 4th NOVEMBER 2021

SUBMISSION
ACTUAL WORD 1972 words
COUNT

0
ASSIGNMENT 1 (25%)

A 76-year-old Mrs. X suffered from a haemorrhagic Cerebral Vascular Accident two

weeks ago and has been discharged from the hospital. Today is her first appointment for
outpatient rehabilitation in the hospital. She has arrived 10 minutes early at the rehabilitation
department with her son. Upon handing over her appointment card at the counter, they have
been told by the receptionist to wait at the chair without any other instruction. Fifteen minutes
has gone by, yet they have not been attended by anyone. Mrs. X started to feel anxious and
informed her son to check with the receptionist. The son asked the receptionist about why his
mother has not been attended by anyone because it has been past 5 to 10 minutes of their
appointment time. It turns out that the receptionist has forgotten to give them the waiting
number and the therapist was not informed of their arrival as well.

A small argument happened but it ended up by the receptionist explaining that she did not
know that this is Mrs. X first time. Not long after, Mrs. X name was called by a therapist for
an assessment. Their anxious mood slowly lowers down when their time with the therapist
has come. Mrs. X and her son cooperates well with the therapist, and they agree to the
explanation and management designed by the therapist regarding Mrs. X condition. The
therapist decided to use a hot pack to apply at Mrs. X lower extremity and give some
exercises to her. The whole treatment lasted for 1 hour and a half and they are very happy
with it.

At home, Mrs. X was trying to do exercises as prescribed by the therapist. However, she
could not remember any of it. She told her son that exercise could not be done as she has
forgotten everything. Feeling concerned, her son asked if there are any notes given to her
regarding the exercise. Mrs. X shake her head denoting nothing was given to her. Feeling
upset, her son called the rehabilitation clinic and expressed his complaint to the receptionist.
The receptionist told him that the therapist is not available at the moment and told him they
will notify the therapist.

A week went by, the son asked Mrs. X if there is any call from the rehabilitation clinic.
Mrs. X once again shakes her head and complaint of her condition has been regressed as she
has no strength to get up from bed and walk to the toilet. He asked Mrs. X when the next
appointment of her rehabilitation will be, and it turns out there is no appointment card was
given to Mrs. X nor the son. This has raised another concern from her son. Furious, her son
decided to call the rehabilitation clinic again and raised his concern to the head of department.

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Questions:

1) Explain THREE (3) events that may lead to medical negligence.

a) Include the person involved and description of the event. (10 marks)

Medical negligence can be generally defined as the situation where a health

care provider provides a poor medical care or services which further causes damage to
the patient’s health. According to the situation given above, there are 3 events that
may lead to medical negligence.

Firstly, the receptionist forgotten to give Mrs. X the waiting number and did
not inform the therapist of their arrival as well and gave explanation that he/she did
not know that this was Mrs. X first time to rehabilitation clinic. In this event, the
receptionist was unresponsible as he/she did not ensure the quality of his/her services
to the patient and chose to give an inappropriate explanation instead of apologizing to
the patient. This will cause patients to lose confidence in the services and
professionalism of this rehabilitation clinic. Besides, according to the human right to
health care, everyone should receive an accessible, available, acceptable, and good
quality services from hospitals, clinics, medicines, and doctors on an equitable basis,
where and when needed. In this event, the receptionist provided an unacceptable and
bad quality of services to the patient which may leads to medical negligence.

Secondly, the therapists did not give any note or documents regarding the
exercise prescribed to Mrs. X. In this event, the therapist made a very serious mistake
as it is compulsory to provide a detail documentation on the exercise that is prescribed
for the patient to ensure that the patient can follow the instructions on it and done the
exercise prescribed at home. Furthermore, Mrs. X is an old-age patient, therapists
should be aware that she is likely to forget the steps of the exercise prescribed.
Therefore, the therapists should also teach the prescribed exercise steps to Mrs. X’s
son and give him a copy of the detailed documentation. This mistake made by the
therapists will causes Mrs. X’s condition to worsen and suffering from pain and may
lead to medical negligence.

Thirdly, there was no response back from the receptionist after one week Mrs.
X’s son complaint on the issues that isn’t any notes regarding the exercise prescribed
by the therapists given to her mother. Besides, when Mrs. X’ son asks her when the
next appointment of her rehabilitation will be, it turns out that no appointment card
was given to her nor her son after the first treatment. In this event, both receptionist
and therapist were responsible for negligence. After receiving the complaints, the
receptionist did not follow up and resolve the problem as promised. This is an
irresponsible act that disrespects the patient’s demands. This will make the patient to
feel abandoned, disappointed, frustrating, and furious on the disrespectful services by
the receptionist. Hence, this can be considered as the poor follow-up of the patient and
may lead to medical negligence. After the first treatment, the therapist did not arrange

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 and give the appointment card of the next rehabilitation session. For every patient, a
medical record is compulsory needed to promote optimum patient care by providing a
record of the baseline condition, treatments, and progress. It is also crucial to ensure
the continuity of care. In this event, the therapist’s negligence will cause patient
abandonment issues which leads to medical negligence.

2) How would you handle the care of Mrs. X as the receptionist and as the therapist to
avoid from getting complaints and legal charges from the patient/patient’s family?
a) Include citations. (10 marks)

The main duties of a clinical receptionist are greeting the patients and visitors,
scheduling appointments and ensure all appointments are on time, answering the calls
or any enquiries, and helping patients or patient’s guardian with completing necessary
forms and documentation [CITATION WES \l 2052 ]. In this incident, as the receptionist, I
will greet Mrs. X and her son politely upon their arrival. Then, I will confirm the
details of appointment based on the appointment card given. After checking, I will
assign them the waiting number and provide clear instructions to them such that please
them to wait patiently at the chairs for about 10 minutes and I will call the waiting
number and lead them to the specific room after the therapist is ready. Meanwhile, I
will also immediately inform the therapist of their arrival so that the therapist had
sufficient time to be prepared as soon as possible. The most important criteria of a
good medical receptionist are the effective communication with patients and
professionalism. Therefore, when encountering patients, I will make sure my speaking
manner are polite and appropriate, listens and comfort patient’s concern and anxiety,
and ensure professionalism of the service provided to build trust and leave a good
impression to the patients.

The main criteria of a good physiotherapist are effective communication skills,

great listening skills, loving and helpful, observant, reliable and professionalism
[ CITATION She17 \l 2052 ]. During the first encounter with them, I will first comfort
Mrs. X and tell her to relax and don’t be worries as I knew this was her first
rehabilitation session from her profile. After that, I will listen and communicate with
Mrs. X to confirm her problems that listed in her profile and gone through some
examinations to prevent misdiagnose and to understand her current condition clearly.
Then, I will provide the best treatment plan with some alternative plan and discuss
with Mrs. X. During the discussion, I will explain the treatment planning in detail such
as the treatment purpose, reasons of using the treatment and the treatment fees.
Meanwhile, I will use simpler wording so that she can understand better. The
treatment session will only proceed after Mrs. X has clearly understood and agreed
with the treatment plan provided. After the treatment, I will prescribe some exercise
that can be done by Mrs. X at home to improve her condition. As a good
physiotherapist, I should be observant to anticipate that Mrs. X is likely to forget the
steps of the exercise as she is an old-age patient. Therefore, I will educate Mrs. X’s
son about the steps of the exercise so that he could assist his mother when practicing

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 the exercise. Besides, I will also provide a detailed documentation regarding the
exercise to them so that they could follow the clear instructions on it and practise the
exercise at home. In the end of the session, I will arrange the subsequent appointments
and handle it together with the clinical record to the receptionist for the preparation of
appointment card and filing. Lastly, I will express my gratitude to Mrs. X and her son
for the cooperation and ask them to pay the bills and take their appointment card at the
reception counter.

3) If you are the head of the department, how would you respond to Mrs. X’s son
complaints?
a) Explain the steps in detail and relate it to the case. (20 marks)
b) Include citations.

A complaint in medical field refers to an expression of dissatisfaction of the

care, treatment and services provided by hospital, clinic, or a health care provider that
requires respond. The common reasons for patient complaints include treatment
failure, delayed treatment, post-surgery complications, poor services, or behaviour of
the health care providers[ CITATION Med21 \l 2052 ]. If I am the head of department, I
will response to Mrs. X’s son complaints in 10 steps.

First, I will take a proactive approach to identify Mrs. X’s son dissatisfaction.
For example, I will prominently display the complaints procedure and provide Mrs.
X’s son a feedback or comment card so that we could do the improvement work based
on these feedbacks in the future. Besides, I will also train all health care staffs to
identify the ‘body language’ associated with dissatisfaction so that they could handle
patient’s dissatisfaction better in their future working [ CITATION DrK21 \l 2052 ].

Second, I will acknowledge Mrs. X’s son complaints quickly and give him a
copy of the complaint procedures. This will help them to understand clearly on the
stages and process we adopted for his complaints and the estimated time they will
receive a formal response from us. Furthermore, I will also take some time to
empathize with Mrs. X’s son and see things from their perspective. By these, they will
know that their complaints have been heard and treated seriously so they are more
likely to react positively even though there may be some unavoidable slight delays for
the process [ CITATION Med211 \l 2052 ].

Third, I will identify all the parties involved and seek for their opinions in this
incident. After that, I will compound and co-ordinate the responses so that all the
parties are clear about their role in this complaint process. In this incident, the parties
involved are Mrs. X, Mrs. X’s son, the receptionist, and the therapist.

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 Fourth, a complete investigation is needed to gather all the facts in the incident
[ CITATION DrK21 \l 2052 ]. I will first have an interview with all the parties involved to
gather all the facts. In this incident, I found out that there’s 2 major cause that give rise
to the complaints. Firstly, the poor services provided by the receptionist. The
receptionist forgotten to give them the waiting number and did not inform the therapist
as well during their first visit to the rehabilitation clinic. However, the receptionist
provides an inappropriate explanation instead of apologizing to them. Besides, when
the receptionist first received the complaints from Mrs. X’s son on phone, the
receptionist did not notify the therapist as promised, nor resolve the problem and
respond back to them too. Secondly, the therapist’s negligence. The therapist did not
provide them any notes or documentation regarding the exercise prescribed under the
awareness that Mrs. X is an old-age patient. On top of that, the therapist also did not
inform them about the details of the following therapy session and did not give them
the appointment card of the next therapy session. This causes Mrs. X’s condition has
regressed and has no strength to get up from bed and walk to the toilet.

Fifth, I will ensure my emotions are stable and calm when dealing with Mrs.
X’s son dissatisfaction to prevent from becoming defensive. Besides, I will also try to
establish an approach to patient care which encourages feedback about the patient’s
perception of the service and the quality of care received [ CITATION Med211 \l 2052 ].

Sixth, complaints are best resolved at the lowest possible level. I will try to
resolve the complaints through face-to-face discussion, followed by an appropriate
letter sent to the patient which include an explanation, apology, reassurance and
acknowledging the satisfactory resolution. Besides, I will also seek for my medical
protection organization for assistance with the complaint response letter [ CITATION
DrK21 \l 2052 ].

Seventh, I will further contact Mrs. X or her son to follow up her current
condition and to ensure that the complaint is resolved satisfactorily. Following up is
the hardest part in handling complaints as it may make them feels uncomfortable.
However, it is a great opportunity to rebuild trust and confident from the patient and
display our professional concern [ CITATION Med211 \l 2052 ].

Eighth, everyone should learn from the problem to prevent from repeating the
same mistake in the future [ CITATION DrK21 \l 2052 ]. Hence, I will conduct a meeting
with all the workers and discuss about this incident and further conclude all the issues
that we should take note and make improvement. By this, all the employees including
myself, will learn lessons and earn experiences. Therefore, when something similar
happens in the future, all of them including myself are able to handle it calmer and
effectively.

Ninth, I will consider communication with Mrs. X’s son and make sure his
complaints will be handled efficiently, transparent, and maintain fairness to all parties

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involved. Hence, he is likely to accept the eventual outcome as he saw that we are
dealing with his complaints seriously and efficiently. Besides, I will also make sure
not to delay my responses to Mrs. X nor her son as anyone which is perceived lack of
interest or care might transform dissatisfaction into furious and seeking for vengeance
[ CITATION DrK21 \l 2052 ].

Tenth, if the in-house complaints procedure has failed or are felt to be

inappropriate to the patient’s need or to the situation, Mrs. X’s son should be informed
of any appropriate authorities to which they can take their complaints for further
investigation if appropriate.

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References
Grant, D. K. (2021, January 13). MIMS. Retrieved from Ten steps to handling complaints:
https://specialty.mims.com/topic/ten-steps-to-handling-complaints-
Jacobson, S. (2017, June 27). What Makes a Good Therapist? 10 Essential Qualities to Look
For. Retrieved from HARLEY THERAPY Counselling Blog:
https://www.harleytherapy.co.uk/counselling/what-makes-a-good-therapist.htm
Medical Protection. (2021, January 27). Ten steps to complaints handling. Retrieved from
Medical Protection: https://www.medicalprotection.org/malaysia/casebook-
resources/articles/articles/ten-steps-to-complaints-handling-mal
Medical Protection. (2021, April 21). Why do patients complain ? Retrieved from Medical
Protection: https://www.medicalprotection.org/uk/articles/why-do-patients-complain
WESLEY INSTITUTE OF TRAINING. (n.d.). WHAT DOES A MEDICAL RECEPTIONIST
DO? Retrieved from WESLEY INSTITUTE OF TRAINING:
https://wesleytraining.edu.au/what-does-a-medical-receptionist-do/