HH/apps/complaints/models.py

1588 lines
52 KiB
Python

"""
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"
PARTIALLY_RESOLVED = "partially_resolved", "Partially Resolved"
RESOLVED = "resolved", "Resolved"
CLOSED = "closed", "Closed"
CANCELLED = "cancelled", "Cancelled"
class ResolutionCategory(models.TextChoices):
"""Resolution category choices"""
FULL_ACTION_TAKEN = "full_action_taken", "Full Action Taken"
PARTIAL_ACTION_TAKEN = "partial_action_taken", "Partial Action Taken"
NO_ACTION_NEEDED = "no_action_needed", "No Action Needed"
CANNOT_RESOLVE = "cannot_resolve", "Cannot Resolve"
PATIENT_WITHDRAWN = "patient_withdrawn", "Patient Withdrawn"
class ComplaintType(models.TextChoices):
"""Complaint type choices - distinguish between complaints and appreciations"""
COMPLAINT = "complaint", "Complaint"
APPRECIATION = "appreciation", "Appreciation"
class ComplaintSourceType(models.TextChoices):
"""Complaint source type choices - Internal vs External"""
INTERNAL = "internal", "Internal"
EXTERNAL = "external", "External"
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 with 4-level SHCT taxonomy.
Supports hierarchical structure:
- Level 1: Domain (CLINICAL, MANAGEMENT, RELATIONSHIPS)
- Level 2: Category (Quality, Safety, Communication, etc.)
- Level 3: Subcategory (Examination, Patient Journey, etc.)
- Level 4: Classification (Examination not performed, etc.)
Uses ManyToMany to allow categories to be shared across multiple hospitals.
"""
class LevelChoices(models.IntegerChoices):
DOMAIN = 1, "Domain"
CATEGORY = 2, "Category"
SUBCATEGORY = 3, "Subcategory"
CLASSIFICATION = 4, "Classification"
class DomainTypeChoices(models.TextChoices):
CLINICAL = "CLINICAL", "Clinical"
MANAGEMENT = "MANAGEMENT", "Management"
RELATIONSHIPS = "RELATIONSHIPS", "Relationships"
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",
)
level = models.IntegerField(
choices=LevelChoices.choices,
help_text="Hierarchy level (1=Domain, 2=Category, 3=Subcategory, 4=Classification)"
)
domain_type = models.CharField(
max_length=20,
choices=DomainTypeChoices.choices,
blank=True,
help_text="Domain type for top-level categories"
)
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):
level_display = self.get_level_display()
hospital_count = self.hospitals.count()
if hospital_count == 0:
hospital_info = "System-wide"
elif hospital_count == 1:
hospital_info = self.hospitals.first().name
else:
hospital_info = f"{hospital_count} hospitals"
if self.level == self.LevelChoices.CLASSIFICATION and self.parent:
parent_path = " > ".join([self.parent.name_en])
return f"{level_display}: {parent_path} > {self.name_en}"
else:
return f"{level_display}: {self.name_en} ({hospital_info})"
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)
# Public complaint form fields
relation_to_patient = models.CharField(
max_length=20,
choices=[
('patient', 'Patient'),
('relative', 'Relative'),
],
blank=True,
verbose_name="Relation to Patient",
help_text="Complainant's relationship to the patient"
)
patient_name = models.CharField(
max_length=200,
blank=True,
verbose_name="Patient Name",
help_text="Name of the patient involved"
)
national_id = models.CharField(
max_length=20,
blank=True,
verbose_name="National ID/Iqama No.",
help_text="Saudi National ID or Iqama number"
)
incident_date = models.DateField(
null=True,
blank=True,
verbose_name="Incident Date",
help_text="Date when the incident occurred"
)
staff_name = models.CharField(
max_length=200,
blank=True,
verbose_name="Staff Involved",
help_text="Name of staff member involved (if known)"
)
expected_result = models.TextField(
blank=True,
verbose_name="Expected Complaint Result",
help_text="What the complainant expects as a resolution"
)
# 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 - 4-level SHCT taxonomy
domain = models.ForeignKey(
ComplaintCategory, on_delete=models.PROTECT, related_name="complaints_domain",
null=True, blank=True, help_text="Level 1: Domain"
)
category = models.ForeignKey(
ComplaintCategory, on_delete=models.PROTECT, related_name="complaints",
null=True, blank=True, help_text="Level 2: Category"
)
# Keep CharField for backward compatibility (stores the code)
subcategory = models.CharField(max_length=100, blank=True, help_text="Level 3: Subcategory code (legacy)")
classification = models.CharField(max_length=100, blank=True, help_text="Level 4: Classification code (legacy)")
# New FK fields for proper relationships
subcategory_obj = models.ForeignKey(
ComplaintCategory, on_delete=models.PROTECT, related_name="complaints_subcategory",
null=True, blank=True, help_text="Level 3: Subcategory"
)
classification_obj = models.ForeignKey(
ComplaintCategory, on_delete=models.PROTECT, related_name="complaints_classification",
null=True, blank=True, help_text="Level 4: Classification"
)
# Location hierarchy - required fields
location = models.ForeignKey(
'organizations.Location',
on_delete=models.PROTECT,
related_name='complaints',
null=True,
blank=True,
help_text="Location (e.g., Riyadh, Jeddah)"
)
main_section = models.ForeignKey(
'organizations.MainSection',
on_delete=models.PROTECT,
related_name='complaints',
null=True,
blank=True,
help_text="Section/Department"
)
subsection = models.ForeignKey(
'organizations.SubSection',
on_delete=models.PROTECT,
related_name='complaints',
null=True,
blank=True,
help_text="Subsection within the section"
)
# Type (complaint vs appreciation)
complaint_type = models.CharField(
max_length=20,
choices=ComplaintType.choices,
default=ComplaintType.COMPLAINT,
db_index=True,
help_text="Type of feedback (complaint vs appreciation)"
)
# Source type (Internal vs External)
complaint_source_type = models.CharField(
max_length=20,
choices=ComplaintSourceType.choices,
default=ComplaintSourceType.EXTERNAL,
db_index=True,
help_text="Source type (Internal = staff-generated, External = patient/public-generated)"
)
# 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.ForeignKey(
"px_sources.PXSource",
on_delete=models.PROTECT,
related_name="complaints",
null=True,
blank=True,
help_text="Source of complaint",
)
# Creator tracking
created_by = models.ForeignKey(
'accounts.User',
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name='created_complaints',
help_text="User who created this complaint (SourceUser or Patient)"
)
# 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, help_text="First SLA reminder timestamp")
second_reminder_sent_at = models.DateTimeField(null=True, blank=True, help_text="Second SLA reminder timestamp")
escalated_at = models.DateTimeField(null=True, blank=True)
# Resolution
resolution = models.TextField(blank=True)
resolution_category = models.CharField(
max_length=50,
choices=ResolutionCategory.choices,
blank=True,
db_index=True,
help_text="Category of resolution"
)
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, generate reference number, and sync complaint_type from metadata"""
# Track status change for signals
if self.pk:
try:
old_instance = Complaint.objects.get(pk=self.pk)
self._status_was = old_instance.status
except Complaint.DoesNotExist:
self._status_was = None
# Generate reference number if not set (for all creation methods: form, API, admin)
if not self.reference_number:
from datetime import datetime
import uuid
today = datetime.now().strftime("%Y%m%d")
random_suffix = str(uuid.uuid4().int)[:6]
self.reference_number = f"CMP-{today}-{random_suffix}"
if not self.due_at:
self.due_at = self.calculate_sla_due_date()
# Sync complaint_type from AI metadata if not already set
# This ensures that model field stays in sync with AI classification
if self.metadata and 'ai_analysis' in self.metadata:
ai_complaint_type = self.metadata['ai_analysis'].get('complaint_type', 'complaint')
# Only sync if model field is still default 'complaint'
# This preserves any manual changes while fixing AI-synced complaints
if self.complaint_type == 'complaint' and ai_complaint_type != 'complaint':
self.complaint_type = ai_complaint_type
super().save(*args, **kwargs)
def calculate_sla_due_date(self):
"""
Calculate SLA due date based on source, severity, and hospital configuration.
Priority order:
1. Source-based config (MOH, CHI, Internal)
2. Severity/priority-based config
3. Settings defaults
Source-based configs take precedence over severity/priority-based configs.
"""
# Try source-based SLA config first
if self.source:
try:
sla_config = ComplaintSLAConfig.objects.get(
hospital=self.hospital,
source=self.source,
is_active=True
)
sla_hours = sla_config.sla_hours
return timezone.now() + timedelta(hours=sla_hours)
except ComplaintSLAConfig.DoesNotExist:
pass # Fall through to next option
# Try severity/priority-based config
try:
sla_config = ComplaintSLAConfig.objects.get(
hospital=self.hospital,
source__isnull=True, # Explicitly check for null source
severity=self.severity,
priority=self.priority,
is_active=True
)
sla_hours = sla_config.sla_hours
return timezone.now() + timedelta(hours=sla_hours)
except ComplaintSLAConfig.DoesNotExist:
pass # Fall through to next option
# Try severity/priority-based config without source filter (backward compatibility)
try:
sla_config = ComplaintSLAConfig.objects.get(
hospital=self.hospital,
severity=self.severity,
priority=self.priority,
is_active=True
)
sla_hours = sla_config.sla_hours
return timezone.now() + timedelta(hours=sla_hours)
except ComplaintSLAConfig.DoesNotExist:
pass # Fall back to settings
# Fall back to settings defaults
sla_hours = settings.SLA_DEFAULTS["complaint"].get(
self.severity, settings.SLA_DEFAULTS["complaint"]["medium"]
)
return timezone.now() + timedelta(hours=sla_hours)
def get_sla_config(self):
"""
Get the SLA config for this complaint.
Returns the source-based or severity/priority-based config that applies to this complaint.
Returns None if no config is found (will use defaults).
"""
# Try source-based SLA config first
if self.source:
try:
return ComplaintSLAConfig.objects.get(
hospital=self.hospital,
source=self.source,
is_active=True
)
except ComplaintSLAConfig.DoesNotExist:
pass # Fall through to next option
# Try severity/priority-based config
try:
return ComplaintSLAConfig.objects.get(
hospital=self.hospital,
source__isnull=True,
severity=self.severity,
priority=self.priority,
is_active=True
)
except ComplaintSLAConfig.DoesNotExist:
pass # Fall through to next option
# Try severity/priority-based config without source filter (backward compatibility)
try:
return ComplaintSLAConfig.objects.get(
hospital=self.hospital,
severity=self.severity,
priority=self.priority,
is_active=True
)
except ComplaintSLAConfig.DoesNotExist:
pass # No config found
return None
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")
def get_tracking_url(self):
"""
Get the public tracking URL for this complaint.
Returns the full URL that complainants can use to track their complaint status.
"""
from django.contrib.sites.shortcuts import get_current_site
from django.urls import reverse
# Build absolute URL
try:
site = get_current_site(None)
domain = site.domain
except:
domain = 'localhost:8000'
return f"https://{domain}{reverse('complaints:public_complaint_track')}?reference={self.reference_number}"
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, source, severity, and priority.
Allows flexible SLA configuration instead of hardcoded values.
Supports both source-based (MOH, CHI, Internal) and severity/priority-based configurations.
"""
hospital = models.ForeignKey(
"organizations.Hospital", on_delete=models.CASCADE, related_name="complaint_sla_configs"
)
source = models.ForeignKey(
"px_sources.PXSource",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="complaint_sla_configs",
help_text="Complaint source (MOH, CHI, Patient, etc.). Empty = severity/priority-based config"
)
severity = models.CharField(
max_length=20,
choices=SeverityChoices.choices,
null=True,
blank=True,
help_text="Severity level for this SLA (optional if source is specified)"
)
priority = models.CharField(
max_length=20,
choices=PriorityChoices.choices,
null=True,
blank=True,
help_text="Priority level for this SLA (optional if source is specified)"
)
sla_hours = models.IntegerField(help_text="Number of hours until SLA deadline")
# Source-based reminder timing (from complaint creation)
first_reminder_hours_after = models.IntegerField(
default=0,
help_text="Send 1st reminder X hours after complaint creation (0 = use reminder_hours_before)"
)
second_reminder_hours_after = models.IntegerField(
default=0,
help_text="Send 2nd reminder X hours after complaint creation (0 = use second_reminder_hours_before)"
)
escalation_hours_after = models.IntegerField(
default=0,
help_text="Escalate complaint X hours after creation if unresolved (0 = use overdue logic)"
)
# Legacy reminder timing (before deadline - kept for backward compatibility)
reminder_hours_before = models.IntegerField(default=24, help_text="Send first reminder X hours before deadline")
# Second reminder configuration
second_reminder_enabled = models.BooleanField(default=False, help_text="Enable sending a second reminder")
second_reminder_hours_before = models.IntegerField(default=6, help_text="Send second reminder X hours before deadline")
# Thank you email configuration
thank_you_email_enabled = models.BooleanField(default=False, help_text="Send thank you email when complaint is closed")
is_active = models.BooleanField(default=True)
class Meta:
ordering = ["hospital", "source", "severity", "priority"]
unique_together = [["hospital", "source", "severity", "priority"]]
indexes = [
models.Index(fields=["hospital", "is_active"]),
models.Index(fields=["hospital", "source", "is_active"]),
]
def __str__(self):
source_display = self.source.name if self.source else "Any Source"
sev_display = self.severity if self.severity else "Any Severity"
pri_display = self.priority if self.priority else "Any Priority"
return f"{self.hospital.name} - {source_display} - {sev_display}/{pri_display} - {self.sla_hours}h"
def get_first_reminder_hours_after(self, complaint_created_at=None):
"""
Calculate first reminder timing based on config.
Returns hours after creation if configured, else hours before deadline.
"""
if self.first_reminder_hours_after > 0:
return self.first_reminder_hours_after
else:
return max(0, self.sla_hours - self.reminder_hours_before)
def get_second_reminder_hours_after(self, complaint_created_at=None):
"""
Calculate second reminder timing based on config.
Returns hours after creation if configured, else hours before deadline.
"""
if self.second_reminder_hours_after > 0:
return self.second_reminder_hours_after
elif self.second_reminder_enabled:
return max(0, self.sla_hours - self.second_reminder_hours_before)
else:
return 0 # No second reminder
def get_escalation_hours_after(self, complaint_created_at=None):
"""
Calculate escalation timing based on config.
Returns hours after creation if configured, else use overdue logic (after SLA).
"""
if self.escalation_hours_after > 0:
return self.escalation_hours_after
else:
return None # Use standard overdue logic
class EscalationRule(UUIDModel, TimeStampedModel):
"""
Configurable escalation rules for complaints.
Defines who receives escalated complaints based on conditions.
Supports multi-level escalation with configurable hierarchy.
"""
hospital = models.ForeignKey("organizations.Hospital", on_delete=models.CASCADE, related_name="escalation_rules")
name = models.CharField(max_length=200)
description = models.TextField(blank=True)
# Escalation level (supports multi-level escalation)
escalation_level = models.IntegerField(
default=1,
help_text="Escalation level (1 = first level, 2 = second, etc.)"
)
max_escalation_level = models.IntegerField(
default=3,
help_text="Maximum escalation level before stopping (default: 3)"
)
# 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)")
# Reminder-based escalation
reminder_escalation_enabled = models.BooleanField(
default=False,
help_text="Enable escalation after reminder if no action taken"
)
reminder_escalation_hours = models.IntegerField(
default=24,
help_text="Escalate X hours after reminder if no action"
)
# Escalation target
escalate_to_role = models.CharField(
max_length=50,
choices=[
("department_manager", "Department Manager"),
("hospital_admin", "Hospital Admin"),
("medical_director", "Medical Director"),
("admin_director", "Administrative Director"),
("px_admin", "PX Admin"),
("ceo", "CEO"),
("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 ExplanationSLAConfig(UUIDModel, TimeStampedModel):
"""
SLA configuration for staff explanation requests.
Defines time limits and escalation rules for staff to submit explanations
when a complaint is filed against them.
"""
hospital = models.ForeignKey(
"organizations.Hospital",
on_delete=models.CASCADE,
related_name="explanation_sla_configs"
)
# Time limits
response_hours = models.IntegerField(
default=48,
help_text="Hours staff has to submit explanation"
)
reminder_hours_before = models.IntegerField(
default=12,
help_text="Send reminder X hours before deadline"
)
# Escalation settings
auto_escalate_enabled = models.BooleanField(
default=True,
help_text="Automatically escalate to manager if no response"
)
escalation_hours_overdue = models.IntegerField(
default=0,
help_text="Escalate X hours after overdue (0 = immediately)"
)
max_escalation_levels = models.IntegerField(
default=3,
help_text="Maximum levels to escalate up staff hierarchy"
)
is_active = models.BooleanField(default=True)
class Meta:
ordering = ["hospital"]
verbose_name = "Explanation SLA Config"
verbose_name_plural = "Explanation SLA Configs"
indexes = [
models.Index(fields=["hospital", "is_active"]),
]
def __str__(self):
return f"{self.hospital.name} - {self.response_hours}h to respond"
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"),
],
)
# Source
source = models.ForeignKey(
"px_sources.PXSource",
on_delete=models.PROTECT,
related_name="inquiries",
null=True,
blank=True,
help_text="Source of inquiry",
)
# Status
status = models.CharField(
max_length=20,
choices=[
("open", "Open"),
("in_progress", "In Progress"),
("resolved", "Resolved"),
("closed", "Closed"),
],
default="open",
db_index=True,
)
# Creator tracking
created_by = models.ForeignKey(
'accounts.User',
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name='created_inquiries',
help_text="User who created this inquiry (SourceUser or Patient)"
)
# Assignment
assigned_to = models.ForeignKey(
"accounts.User", on_delete=models.SET_NULL, null=True, blank=True, related_name="assigned_inquiries"
)
assigned_at = models.DateTimeField(null=True, blank=True)
# 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"
)
# Workflow classification
is_straightforward = models.BooleanField(
default=True,
verbose_name="Is Straightforward",
help_text="Direct resolution (no department coordination needed)"
)
is_outgoing = models.BooleanField(
default=False,
verbose_name="Is Outgoing",
help_text="Inquiry sent to external department for response"
)
outgoing_department = models.ForeignKey(
"organizations.Department",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="outgoing_inquiries",
help_text="Department that was contacted for this inquiry"
)
# Follow-up tracking
requires_follow_up = models.BooleanField(
default=False,
db_index=True,
help_text="This inquiry requires follow-up call"
)
follow_up_due_at = models.DateTimeField(
null=True,
blank=True,
db_index=True,
help_text="Due date for follow-up call to inquirer"
)
follow_up_completed_at = models.DateTimeField(
null=True,
blank=True,
help_text="When follow-up call was completed"
)
follow_up_completed_by = models.ForeignKey(
"accounts.User",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="completed_inquiry_followups",
help_text="User who completed the follow-up call"
)
follow_up_notes = models.TextField(
blank=True,
help_text="Notes from follow-up call"
)
follow_up_reminder_sent_at = models.DateTimeField(
null=True,
blank=True,
help_text="When reminder was sent for follow-up"
)
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}"
class ComplaintExplanation(UUIDModel, TimeStampedModel):
"""
Staff/recipient explanation about a complaint.
Allows staff members to submit their perspective via token-based link.
Each staff member can submit one explanation per complaint.
Includes SLA tracking for explanation submission deadlines.
"""
complaint = models.ForeignKey(Complaint, on_delete=models.CASCADE, related_name="explanations")
staff = models.ForeignKey(
"organizations.Staff",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="complaint_explanations",
help_text="Staff member who submitted the explanation",
)
explanation = models.TextField(help_text="Staff's explanation about the complaint")
token = models.CharField(
max_length=64, unique=True, db_index=True, help_text="Unique access token for explanation submission"
)
is_used = models.BooleanField(
default=False, db_index=True, help_text="Token expiry tracking - becomes True after submission"
)
submitted_via = models.CharField(
max_length=20,
choices=[
("email_link", "Email Link"),
("direct", "Direct Entry"),
],
default="email_link",
help_text="How the explanation was submitted",
)
email_sent_at = models.DateTimeField(null=True, blank=True, help_text="When the explanation request email was sent")
responded_at = models.DateTimeField(null=True, blank=True, help_text="When the explanation was submitted")
# Request details
requested_by = models.ForeignKey(
"accounts.User",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="requested_complaint_explanations",
help_text="User who requested the explanation",
)
request_message = models.TextField(blank=True, help_text="Optional message sent with the explanation request")
# SLA tracking for explanation requests
sla_due_at = models.DateTimeField(
null=True,
blank=True,
db_index=True,
help_text="SLA deadline for staff to submit explanation"
)
is_overdue = models.BooleanField(
default=False,
db_index=True,
help_text="Explanation request is overdue"
)
reminder_sent_at = models.DateTimeField(
null=True,
blank=True,
help_text="Reminder sent to staff about overdue explanation"
)
escalated_to_manager = models.ForeignKey(
'self',
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name='escalated_from_staff',
help_text="Escalated to this explanation (manager's explanation request)"
)
escalated_at = models.DateTimeField(
null=True,
blank=True,
help_text="When explanation was escalated to manager"
)
class Meta:
ordering = ["-created_at"]
verbose_name = "Complaint Explanation"
verbose_name_plural = "Complaint Explanations"
indexes = [
models.Index(fields=["complaint", "-created_at"]),
models.Index(fields=["token", "is_used"]),
]
def __str__(self):
staff_name = str(self.staff) if self.staff else "Unknown"
return f"{self.complaint} - {staff_name} - {'Submitted' if self.is_used else 'Pending'}"
@property
def can_submit(self):
"""Check if explanation can still be submitted"""
return not self.is_used
@property
def attachment_count(self):
"""Count of explanation attachments"""
return self.attachments.count()
def get_token(self):
"""Return the access token"""
return self.token
class ExplanationAttachment(UUIDModel, TimeStampedModel):
"""Attachment for complaint explanation"""
explanation = models.ForeignKey(ComplaintExplanation, on_delete=models.CASCADE, related_name="attachments")
file = models.FileField(upload_to="explanation_attachments/%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")
description = models.TextField(blank=True)
class Meta:
ordering = ["-created_at"]
verbose_name = "Explanation Attachment"
verbose_name_plural = "Explanation Attachments"
def __str__(self):
return f"{self.explanation} - {self.filename}"
class ComplaintPRInteraction(UUIDModel, TimeStampedModel):
"""
PR (Patient Relations) contact with complainant.
Tracks when PR staff contact the complainant to take a formal statement
and explain the complaint procedure.
"""
complaint = models.ForeignKey(Complaint, on_delete=models.CASCADE, related_name="pr_interactions")
contact_date = models.DateTimeField(
help_text="Date and time of PR contact with complainant"
)
contact_method = models.CharField(
max_length=20,
choices=[
("phone", "Phone"),
("in_person", "In Person"),
("email", "Email"),
("other", "Other"),
],
default="in_person",
help_text="Method of contact"
)
pr_staff = models.ForeignKey(
"accounts.User",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="pr_interactions",
help_text="PR staff member who made the contact"
)
statement_text = models.TextField(
blank=True,
help_text="Formal statement taken from the complainant"
)
procedure_explained = models.BooleanField(
default=False,
help_text="Whether complaint procedure was explained to the complainant"
)
notes = models.TextField(
blank=True,
help_text="Additional notes from the PR interaction"
)
created_by = models.ForeignKey(
"accounts.User",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="created_pr_interactions",
help_text="User who created this PR interaction record"
)
class Meta:
ordering = ["-contact_date"]
verbose_name = "PR Interaction"
verbose_name_plural = "PR Interactions"
indexes = [
models.Index(fields=["complaint", "-contact_date"]),
]
def __str__(self):
method_display = self.get_contact_method_display()
return f"{self.complaint} - {method_display} - {self.contact_date.strftime('%Y-%m-%d')}"
class ComplaintMeeting(UUIDModel, TimeStampedModel):
"""
Meeting record for management intervention.
Simple record of meetings scheduled/agreed upon between management
and the complainant to resolve complaints.
"""
complaint = models.ForeignKey(Complaint, on_delete=models.CASCADE, related_name="meetings")
meeting_date = models.DateTimeField(
help_text="Date and time of the meeting"
)
meeting_type = models.CharField(
max_length=50,
choices=[
("management_intervention", "Management Intervention"),
("pr_follow_up", "PR Follow-up"),
("department_review", "Department Review"),
("other", "Other"),
],
default="management_intervention",
help_text="Type of meeting"
)
outcome = models.TextField(
blank=True,
help_text="Meeting outcome and agreed resolution"
)
notes = models.TextField(
blank=True,
help_text="Additional meeting notes"
)
created_by = models.ForeignKey(
"accounts.User",
on_delete=models.SET_NULL,
null=True,
blank=True,
related_name="created_meetings",
help_text="User who created this meeting record"
)
class Meta:
ordering = ["-meeting_date"]
verbose_name = "Complaint Meeting"
verbose_name_plural = "Complaint Meetings"
indexes = [
models.Index(fields=["complaint", "-meeting_date"]),
]
def __str__(self):
type_display = self.get_meeting_type_display()
return f"{self.complaint} - {type_display} - {self.meeting_date.strftime('%Y-%m-%d')}"