""" Complaints models - Complaint management with SLA tracking This module implements the complaint management system that: - Tracks complaints with SLA deadlines - Manages complaint workflow (open → in progress → resolved → closed) - Triggers resolution satisfaction surveys - Creates PX actions for negative resolution satisfaction - Maintains complaint timeline and attachments """ from datetime import timedelta from django.conf import settings from django.db import models from django.utils import timezone from apps.core.models import PriorityChoices, SeverityChoices, TenantModel, TimeStampedModel, UUIDModel class ComplaintStatus(models.TextChoices): """Complaint status choices""" OPEN = 'open', 'Open' IN_PROGRESS = 'in_progress', 'In Progress' RESOLVED = 'resolved', 'Resolved' CLOSED = 'closed', 'Closed' CANCELLED = 'cancelled', 'Cancelled' class ComplaintSource(models.TextChoices): """Complaint source choices""" PATIENT = 'patient', 'Patient' FAMILY = 'family', 'Family Member' STAFF = 'staff', 'Staff' SURVEY = 'survey', 'Survey' SOCIAL_MEDIA = 'social_media', 'Social Media' CALL_CENTER = 'call_center', 'Call Center' MOH = 'moh', 'Ministry of Health' CHI = 'chi', 'Council of Health Insurance' OTHER = 'other', 'Other' class ComplaintCategory(UUIDModel, TimeStampedModel): """ Custom complaint categories per hospital. Replaces hardcoded category choices with flexible, hospital-specific categories. Uses ManyToMany to allow categories to be shared across multiple hospitals. """ hospitals = models.ManyToManyField( 'organizations.Hospital', blank=True, related_name='complaint_categories', help_text="Empty list = system-wide category. Add hospitals to share category." ) code = models.CharField( max_length=50, help_text="Unique code for this category" ) name_en = models.CharField(max_length=200) name_ar = models.CharField(max_length=200, blank=True) description_en = models.TextField(blank=True) description_ar = models.TextField(blank=True) parent = models.ForeignKey( 'self', on_delete=models.CASCADE, null=True, blank=True, related_name='subcategories', help_text="Parent category for hierarchical structure" ) order = models.IntegerField( default=0, help_text="Display order" ) is_active = models.BooleanField(default=True) class Meta: ordering = ['order', 'name_en'] verbose_name_plural = 'Complaint Categories' indexes = [ models.Index(fields=['code']), ] def __str__(self): hospital_count = self.hospitals.count() if hospital_count == 0: return f"System-wide - {self.name_en}" elif hospital_count == 1: return f"{self.hospitals.first().name} - {self.name_en}" else: return f"Multiple hospitals - {self.name_en}" class Complaint(UUIDModel, TimeStampedModel): """ Complaint model with SLA tracking. Workflow: 1. OPEN - Complaint received 2. IN_PROGRESS - Being investigated 3. RESOLVED - Solution provided 4. CLOSED - Confirmed closed (triggers resolution satisfaction survey) SLA: - Calculated based on severity and hospital configuration - Reminders sent before due date - Escalation triggered when overdue """ # Patient and encounter information patient = models.ForeignKey( 'organizations.Patient', on_delete=models.SET_NULL, null=True, blank=True, related_name='complaints' ) # Contact information for anonymous/unregistered submissions contact_name = models.CharField(max_length=200, blank=True) contact_phone = models.CharField(max_length=20, blank=True) contact_email = models.EmailField(blank=True) # Reference number for tracking reference_number = models.CharField( max_length=50, unique=True, db_index=True, null=True, blank=True, help_text="Unique reference number for patient tracking" ) encounter_id = models.CharField( max_length=100, blank=True, db_index=True, help_text="Related encounter ID if applicable" ) # Organization hospital = models.ForeignKey( 'organizations.Hospital', on_delete=models.CASCADE, related_name='complaints' ) department = models.ForeignKey( 'organizations.Department', on_delete=models.SET_NULL, null=True, blank=True, related_name='complaints' ) staff = models.ForeignKey( 'organizations.Staff', on_delete=models.SET_NULL, null=True, blank=True, related_name='complaints' ) # Complaint details title = models.CharField(max_length=500) description = models.TextField() # Classification category = models.ForeignKey( ComplaintCategory, on_delete=models.PROTECT, related_name='complaints', null=True, blank=True ) subcategory = models.CharField(max_length=100, blank=True) # Priority and severity priority = models.CharField( max_length=20, choices=PriorityChoices.choices, default=PriorityChoices.MEDIUM, db_index=True ) severity = models.CharField( max_length=20, choices=SeverityChoices.choices, default=SeverityChoices.MEDIUM, db_index=True ) # Source source = models.CharField( max_length=50, choices=ComplaintSource.choices, default=ComplaintSource.PATIENT, db_index=True ) # Status and workflow status = models.CharField( max_length=20, choices=ComplaintStatus.choices, default=ComplaintStatus.OPEN, db_index=True ) # Assignment assigned_to = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, blank=True, related_name='assigned_complaints' ) assigned_at = models.DateTimeField(null=True, blank=True) # SLA tracking due_at = models.DateTimeField( db_index=True, help_text="SLA deadline" ) is_overdue = models.BooleanField(default=False, db_index=True) reminder_sent_at = models.DateTimeField(null=True, blank=True) escalated_at = models.DateTimeField(null=True, blank=True) # Resolution resolution = models.TextField(blank=True) resolved_at = models.DateTimeField(null=True, blank=True) resolved_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, blank=True, related_name='resolved_complaints' ) # Closure closed_at = models.DateTimeField(null=True, blank=True) closed_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, blank=True, related_name='closed_complaints' ) # Resolution satisfaction survey resolution_survey = models.ForeignKey( 'surveys.SurveyInstance', on_delete=models.SET_NULL, null=True, blank=True, related_name='complaint_resolution' ) resolution_survey_sent_at = models.DateTimeField(null=True, blank=True) # Metadata metadata = models.JSONField(default=dict, blank=True) class Meta: ordering = ['-created_at'] indexes = [ models.Index(fields=['status', '-created_at']), models.Index(fields=['hospital', 'status', '-created_at']), models.Index(fields=['is_overdue', 'status']), models.Index(fields=['due_at', 'status']), ] def __str__(self): return f"{self.title} - ({self.status})" def save(self, *args, **kwargs): """Calculate SLA due date on creation""" if not self.due_at: self.due_at = self.calculate_sla_due_date() super().save(*args, **kwargs) def calculate_sla_due_date(self): """ Calculate SLA due date based on severity and hospital configuration. First tries to use ComplaintSLAConfig from database. Falls back to settings.SLA_DEFAULTS if no config exists. """ # Try to get SLA config from database try: sla_config = ComplaintSLAConfig.objects.get( hospital=self.hospital, severity=self.severity, priority=self.priority, is_active=True ) sla_hours = sla_config.sla_hours except ComplaintSLAConfig.DoesNotExist: # Fall back to settings sla_hours = settings.SLA_DEFAULTS['complaint'].get( self.severity, settings.SLA_DEFAULTS['complaint']['medium'] ) return timezone.now() + timedelta(hours=sla_hours) def check_overdue(self): """Check if complaint is overdue and update status""" if self.status in [ComplaintStatus.CLOSED, ComplaintStatus.CANCELLED]: return False if timezone.now() > self.due_at: if not self.is_overdue: self.is_overdue = True self.save(update_fields=['is_overdue']) return True return False @property def short_description_en(self): """Get AI-generated short description (English) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('short_description_en', '') return '' @property def short_description_ar(self): """Get AI-generated short description (Arabic) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('short_description_ar', '') return '' @property def short_description(self): """Get AI-generated short description from metadata (deprecated, use short_description_en)""" return self.short_description_en @property def suggested_action_en(self): """Get AI-generated suggested action (English) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('suggested_action_en', '') return '' @property def suggested_action_ar(self): """Get AI-generated suggested action (Arabic) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('suggested_action_ar', '') return '' @property def suggested_action(self): """Get AI-generated suggested action from metadata (deprecated, use suggested_action_en)""" return self.suggested_action_en @property def title_en(self): """Get AI-generated title (English) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('title_en', '') return '' @property def title_ar(self): """Get AI-generated title (Arabic) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('title_ar', '') return '' @property def reasoning_en(self): """Get AI-generated reasoning (English) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('reasoning_en', '') return '' @property def reasoning_ar(self): """Get AI-generated reasoning (Arabic) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('reasoning_ar', '') return '' @property def emotion(self): """Get AI-detected primary emotion from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('emotion', 'neutral') return 'neutral' @property def emotion_intensity(self): """Get AI-detected emotion intensity (0.0 to 1.0) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('emotion_intensity', 0.0) return 0.0 @property def emotion_confidence(self): """Get AI confidence in emotion detection (0.0 to 1.0) from metadata""" if self.metadata and 'ai_analysis' in self.metadata: return self.metadata['ai_analysis'].get('emotion_confidence', 0.0) return 0.0 @property def get_emotion_display(self): """Get human-readable emotion display""" emotion_map = { 'anger': 'Anger', 'sadness': 'Sadness', 'confusion': 'Confusion', 'fear': 'Fear', 'neutral': 'Neutral' } return emotion_map.get(self.emotion, 'Neutral') @property def get_emotion_badge_class(self): """Get Bootstrap badge class for emotion""" badge_map = { 'anger': 'danger', 'sadness': 'primary', 'confusion': 'warning', 'fear': 'info', 'neutral': 'secondary' } return badge_map.get(self.emotion, 'secondary') class ComplaintAttachment(UUIDModel, TimeStampedModel): """Complaint attachment (images, documents, etc.)""" complaint = models.ForeignKey( Complaint, on_delete=models.CASCADE, related_name='attachments' ) file = models.FileField(upload_to='complaints/%Y/%m/%d/') filename = models.CharField(max_length=500) file_type = models.CharField(max_length=100, blank=True) file_size = models.IntegerField(help_text="File size in bytes") uploaded_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, related_name='complaint_attachments' ) description = models.TextField(blank=True) class Meta: ordering = ['-created_at'] def __str__(self): return f"{self.complaint} - {self.filename}" class ComplaintUpdate(UUIDModel, TimeStampedModel): """ Complaint update/timeline entry. Tracks all updates, status changes, and communications. """ complaint = models.ForeignKey( Complaint, on_delete=models.CASCADE, related_name='updates' ) # Update details update_type = models.CharField( max_length=50, choices=[ ('status_change', 'Status Change'), ('assignment', 'Assignment'), ('note', 'Note'), ('resolution', 'Resolution'), ('escalation', 'Escalation'), ('communication', 'Communication'), ], db_index=True ) message = models.TextField() # User who made the update created_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, related_name='complaint_updates' ) # Status change tracking old_status = models.CharField(max_length=20, blank=True) new_status = models.CharField(max_length=20, blank=True) # Metadata metadata = models.JSONField(default=dict, blank=True) class Meta: ordering = ['-created_at'] indexes = [ models.Index(fields=['complaint', '-created_at']), ] def __str__(self): return f"{self.complaint} - {self.update_type} - {self.created_at.strftime('%Y-%m-%d %H:%M')}" class ComplaintSLAConfig(UUIDModel, TimeStampedModel): """ SLA configuration for complaints per hospital, severity, and priority. Allows flexible SLA configuration instead of hardcoded values. """ hospital = models.ForeignKey( 'organizations.Hospital', on_delete=models.CASCADE, related_name='complaint_sla_configs' ) severity = models.CharField( max_length=20, choices=SeverityChoices.choices, help_text="Severity level for this SLA" ) priority = models.CharField( max_length=20, choices=PriorityChoices.choices, help_text="Priority level for this SLA" ) sla_hours = models.IntegerField( help_text="Number of hours until SLA deadline" ) reminder_hours_before = models.IntegerField( default=24, help_text="Send reminder X hours before deadline" ) is_active = models.BooleanField(default=True) class Meta: ordering = ['hospital', 'severity', 'priority'] unique_together = [['hospital', 'severity', 'priority']] indexes = [ models.Index(fields=['hospital', 'is_active']), ] def __str__(self): return f"{self.hospital.name} - {self.severity}/{self.priority} - {self.sla_hours}h" class EscalationRule(UUIDModel, TimeStampedModel): """ Configurable escalation rules for complaints. Defines who receives escalated complaints based on conditions. """ hospital = models.ForeignKey( 'organizations.Hospital', on_delete=models.CASCADE, related_name='escalation_rules' ) name = models.CharField(max_length=200) description = models.TextField(blank=True) # Trigger conditions trigger_on_overdue = models.BooleanField( default=True, help_text="Trigger when complaint is overdue" ) trigger_hours_overdue = models.IntegerField( default=0, help_text="Trigger X hours after overdue (0 = immediately)" ) # Escalation target escalate_to_role = models.CharField( max_length=50, choices=[ ('department_manager', 'Department Manager'), ('hospital_admin', 'Hospital Admin'), ('px_admin', 'PX Admin'), ('specific_user', 'Specific User'), ], help_text="Role to escalate to" ) escalate_to_user = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, blank=True, related_name='escalation_target_rules', help_text="Specific user if escalate_to_role is 'specific_user'" ) # Conditions severity_filter = models.CharField( max_length=20, choices=SeverityChoices.choices, blank=True, help_text="Only escalate complaints with this severity (blank = all)" ) priority_filter = models.CharField( max_length=20, choices=PriorityChoices.choices, blank=True, help_text="Only escalate complaints with this priority (blank = all)" ) order = models.IntegerField( default=0, help_text="Escalation order (lower = first)" ) is_active = models.BooleanField(default=True) class Meta: ordering = ['hospital', 'order'] indexes = [ models.Index(fields=['hospital', 'is_active']), ] def __str__(self): return f"{self.hospital.name} - {self.name}" class ComplaintThreshold(UUIDModel, TimeStampedModel): """ Configurable thresholds for complaint-related triggers. Defines when to trigger actions based on metrics (e.g., survey scores). """ hospital = models.ForeignKey( 'organizations.Hospital', on_delete=models.CASCADE, related_name='complaint_thresholds' ) threshold_type = models.CharField( max_length=50, choices=[ ('resolution_survey_score', 'Resolution Survey Score'), ('response_time', 'Response Time'), ('resolution_time', 'Resolution Time'), ], help_text="Type of threshold" ) threshold_value = models.FloatField( help_text="Threshold value (e.g., 50 for 50% score)" ) comparison_operator = models.CharField( max_length=10, choices=[ ('lt', 'Less Than'), ('lte', 'Less Than or Equal'), ('gt', 'Greater Than'), ('gte', 'Greater Than or Equal'), ('eq', 'Equal'), ], default='lt', help_text="How to compare against threshold" ) action_type = models.CharField( max_length=50, choices=[ ('create_px_action', 'Create PX Action'), ('send_notification', 'Send Notification'), ('escalate', 'Escalate'), ], help_text="Action to take when threshold is breached" ) is_active = models.BooleanField(default=True) class Meta: ordering = ['hospital', 'threshold_type'] indexes = [ models.Index(fields=['hospital', 'is_active']), models.Index(fields=['threshold_type', 'is_active']), ] def __str__(self): return f"{self.hospital.name} - {self.threshold_type} {self.comparison_operator} {self.threshold_value}" def check_threshold(self, value): """Check if value breaches threshold""" if self.comparison_operator == 'lt': return value < self.threshold_value elif self.comparison_operator == 'lte': return value <= self.threshold_value elif self.comparison_operator == 'gt': return value > self.threshold_value elif self.comparison_operator == 'gte': return value >= self.threshold_value elif self.comparison_operator == 'eq': return value == self.threshold_value return False class Inquiry(UUIDModel, TimeStampedModel): """ Inquiry model for general questions/requests. Similar to complaints but for non-complaint inquiries. """ # Patient information patient = models.ForeignKey( 'organizations.Patient', on_delete=models.CASCADE, null=True, blank=True, related_name='inquiries' ) # Contact information (if patient not in system) contact_name = models.CharField(max_length=200, blank=True) contact_phone = models.CharField(max_length=20, blank=True) contact_email = models.EmailField(blank=True) # Organization hospital = models.ForeignKey( 'organizations.Hospital', on_delete=models.CASCADE, related_name='inquiries' ) department = models.ForeignKey( 'organizations.Department', on_delete=models.SET_NULL, null=True, blank=True, related_name='inquiries' ) # Inquiry details subject = models.CharField(max_length=500) message = models.TextField() # Category category = models.CharField( max_length=100, choices=[ ('appointment', 'Appointment'), ('billing', 'Billing'), ('medical_records', 'Medical Records'), ('general', 'General Information'), ('other', 'Other'), ] ) # Status status = models.CharField( max_length=20, choices=[ ('open', 'Open'), ('in_progress', 'In Progress'), ('resolved', 'Resolved'), ('closed', 'Closed'), ], default='open', db_index=True ) # Assignment assigned_to = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, blank=True, related_name='assigned_inquiries' ) # Response response = models.TextField(blank=True) responded_at = models.DateTimeField(null=True, blank=True) responded_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, blank=True, related_name='responded_inquiries' ) class Meta: ordering = ['-created_at'] verbose_name_plural = 'Inquiries' indexes = [ models.Index(fields=['status', '-created_at']), models.Index(fields=['hospital', 'status']), ] def __str__(self): return f"{self.subject} ({self.status})" class InquiryUpdate(UUIDModel, TimeStampedModel): """ Inquiry update/timeline entry. Tracks all updates, status changes, and communications for inquiries. """ inquiry = models.ForeignKey( Inquiry, on_delete=models.CASCADE, related_name='updates' ) # Update details update_type = models.CharField( max_length=50, choices=[ ('status_change', 'Status Change'), ('assignment', 'Assignment'), ('note', 'Note'), ('response', 'Response'), ('communication', 'Communication'), ], db_index=True ) message = models.TextField() # User who made the update created_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, related_name='inquiry_updates' ) # Status change tracking old_status = models.CharField(max_length=20, blank=True) new_status = models.CharField(max_length=20, blank=True) # Metadata metadata = models.JSONField(default=dict, blank=True) class Meta: ordering = ['-created_at'] indexes = [ models.Index(fields=['inquiry', '-created_at']), ] def __str__(self): return f"{self.inquiry} - {self.update_type} - {self.created_at.strftime('%Y-%m-%d %H:%M')}" class InquiryAttachment(UUIDModel, TimeStampedModel): """Inquiry attachment (images, documents, etc.)""" inquiry = models.ForeignKey( Inquiry, on_delete=models.CASCADE, related_name='attachments' ) file = models.FileField(upload_to='inquiries/%Y/%m/%d/') filename = models.CharField(max_length=500) file_type = models.CharField(max_length=100, blank=True) file_size = models.IntegerField(help_text="File size in bytes") uploaded_by = models.ForeignKey( 'accounts.User', on_delete=models.SET_NULL, null=True, related_name='inquiry_attachments' ) description = models.TextField(blank=True) class Meta: ordering = ['-created_at'] def __str__(self): return f"{self.inquiry} - {self.filename}"