This study aims to explore factors that might hamper the use of patient complaints to improve quality. A teaching hospital in Taiwan was purposefully chosen for a case study based on data triangulation. The study included in-depth interviews with hospital senior managers, senior social workers, government officials and non-government organizations staff; as well as analysis of documents. In the Case Hospital, the organizational responses to complaints appear to be influenced by the interaction between managerial factors, operational factors and technical factors. Externally, there were no national guidelines to regulate how the hospital handled complaints. This was bound to have a major influence on the response of the hospital to complaints. Internally, the hospital itself did not place great importance on complaints. The mindset of the hospital was that patient complaints are not welcome. If the hospital attempts to use patient complaints to improve its quality of care, senior hospital management needs to recognize the values of complaints handling and respond to these in a more constructive manner. Moreover, the government has to set up the protocols of using complaints to improve quality at the policy level. This legal incentive would encourage the hospital to handling complaints effectively.