Objectives and Background Emergency departments (ED) are notorious for its high complaint rate by patients because EDs are usually congested with a large number of patients and the waiting time is long. Consultation time for each patient would be very limited. Short consultation and limited availability of diagnostic investigations contribute to diagnostic challenges and errors.

Methods This is a retrospective quantitative review of complaints against EDs lodged by patients through the Public Relations Office in 2009 & 2010. The demographics of these patients and their attendances were recorded. The issues were categorised into the following: Communication, Access, Treatment, Rights, Administration, Environment and Cost. The data was compared with our previous publication on complaint in 1990–1994.

Results There were 114 complaints lodged in 2009–2010 (72 in 1990–1994). Apparently the age, residential district and billing patterns of these complaint patients were comparable with our overall distribution. Complaint rate would be higher during overnight shift. For urgent cases, compliant validity is 86%; (65% in 1990–1994); for non-urgent cases, validity is 78% (58% in 1990–1994). In our data, 45% were diagnosis and treatment related (it was 29% in 1990–1994). 50% were related to missing diagnosis and improper management. Around 30% is related to inadequacy of care. Proper referral and more detailed explanation is likely a solution to lower the complaint rate. In terms of specialty distribution, orthopaedics (29%) was the group with the highest risk.

Conclusions The number of complaint cases studied was still small. We would recommend establishing a database for prospective analysis so that we can detect unforeseeable problems soon after they happened and we may act accordingly to minimise further occurrence. These cases may be reported on a half-yearly basis to all department staff, in a sharing attitude, to help colleagues to learn and beware of these problems. This should be a good start of “patient-centred care.”