Defining an integrative multidimensional framework for patient complaint management systems

Patient complaints represent a significant yet sometimes underutilized source of organisational learning in hospitals. While they are sometimes processed as administrative tasks aimed at resolution, emerging research demonstrates their value as indicators of system vulnerability and early warning signals for patient safety. This mini-review contributes to the literature by offering a new integrative framework that synthesizes eight previously fragmented domains of complaint management: System Consistency in Learning from Complaints, standard classification of complaints, leadership commitment for organisational learning, effective individual and interpersonal behaviour for organisational learning, organisational change driven by organisational learning, data analytics for organisational learning, proactive risk detection, ethical and legal considerations. Using an integrative, framework-informed methodology, the paper combines inductive identification of conceptual patterns with deductive synthesis across theoretical and policy literatures. The review's key contribution lies in reconceptualizing patient complaints as a system embedded within hospital operations, rather than an administrative function. By mapping connections across the eight domains, the framework reveals how complaints serve as multidimensional organisational assets that can expose systemic weaknesses, cultural blind spots, and latent safety risks. The review also identifies significant theoretical and measurement gaps, including the lack of validated multidimensional instruments to assess complaint management holistically. It further proposes a new research direction by outlining how performance-based contracting could align incentives among patients, clinicians, and managers to strengthen responsiveness and learning, with implications for health system governance and public health oversight.