Smith-Merry, JenniferWalton, MerrilynHealy, JudithHobbs, Coletta2021-09-130156-5788http://hdl.handle.net/1885/247797Objective. This paper explores how hospital complaints managers react to recommendations for systemic quality reforms by health complaints commissions in response to complaints by patients in Queensland and New South Wales. Methods. Semi-structured qualitative interviews were conducted with complaints managers in 17 hospitals. Interview transcripts were then thematically analysed and data on responses to health complaint commissions was organised in relation to Valerie Braithwaite’s typology of motivational postures. Results. Respondents supported involvement by an independent authority where patients had serious complaints about the services they received in hospital, but wanted more negotiation with commissions on service improvement recommendations. Conclusions. Hospital complaints managers mostly responded as virtuous or rational actors to the symbolic power of complaints commissions. This maybe context dependent because Australian health commissions operate within a pro-reform context as a result of recent publicity around health system failures.This study was supported, in part, by a Discovery Grant (DP1093048) from the Australian Research Council.application/pdfen-AU© AHHA 2016health ombudsmanpatient grievancesquality regulation201710.1071/AH161382020-11-23