1. National Patient Experience Survey
Programme
Partnership Approach
Tracy O’Carroll and June Boulger
tocarroll@hiqa.ie /june.boulger2@hse.ie
December 8th 2016
3. a near fatal car accident changed everything…
while I may have been the patient lying in the hospital bed, I was not the only one in
that Room who was suffering. The observations that I made truly inspired me and
helped me understand how important the role of communication is among the
patient, family, and health care provider. When I was able to learn how to talk again,
I soon discovered that the power of the voice is amplified when the message is of
gratitude, that a simple smile cannot be underestimated, and that body
language and tone of voice are critical components within the Hospital
room.
The Patient Experience: The Importance of Care, Communication, and Compassion in the
Hospital Room: Brian Boyle
4. Patient Satisfaction vs.
Patient Experience
Patient experience is more than satisfaction alone.
Embedded within patient experience is;
a focus on individualised care
tailoring of services to meet patient needs and
engage them as partners in their care.
5. Why Bother?
Research has consistently demonstrated that patient experience correlates with …better
health outcomes. For example, patients hospitalized for acute myocardial infarction (AMI)
who reported more problems with care had poorer outcomes both one month and twelve
months after discharge..
Patient experience is also positively correlated with:
key financial indicators
patient loyalty and retention
reduced medical malpractice risk
and increased employee Satisfaction.
doi: 10.1377/hlthaff.2010.0238 HEALTH AFFAIRS 29, NO. 5 (2010): 921–925
6. Benefits
Holistic way of hearing patients voice
Internationally: Best practice
Excellent proxy for quality and safety
8. Benefit – Service Provider
Identify areas for improvement of patient care in individual
units
Provides assurance
Benchmark care provided
9. Benefit – Regulator
Informs quality and safety of care
Informs risk analysis
Drive Accountability
10. Benefit – Policy Developer
National Policy and planning
National Healthcare Quality Reporting System Service
Plan
currently there are no standardised comparable patient experience
surveys applied across the health sector; ..if you don't measure it,
you cannot improve it.
11. Ireland
Currently there is no standardized national comparable
patient experience survey applied across the health sector.
This is recognised as a significant gap.
12. International Findings
Model Partnership model adopted
Governance Strong Governance arrangements
Scope: Scope of the Survey must be clear
Survey Tool: Internationally recognised questions
Data Protection: Not an issue internationally
Communication: Robust
Commitment: Capital and Operations, Financial, HR
https://www.hiqa.ie/publications/international-review-patient-experience-survey
13. Project Outline
1. Establish Governance Structure
2. Develop Survey Tool
3. Communication Tools / Guidance / Information Governance
documentation
4. Stakeholder Engagement
5. Managed Service
6. Outputs
14. Partnership Model
National Patient Experience Programme
Department of
Health
Health Information
and Quality
Authority
(LP)
Health Service
Executive
Patient
Representative
18. Scope of NPE Survey
Adult Acute Care
18+
Minimum stay = 1 night
19. Survey Tool Development
1. International Questions Set currently purchased from Picker
Institute Europe
2. Tested library of questions with 8 NPE Focus Groups
6 with patients in: Galway, Limerick, Tralee, Mater, St.
James and Connolly
2 with Data Users: Dublin and Cork
3. Delphi Study: 48 Participants
4. Consultation with International Experts: Picker Institute
Europe
20. Examples of Questions
Did the staff treating and examining you introduce themselves?
□ Yes, all of the staff introduced themselves
□ Some of the staff introduced themselves
□ Very few or none of the staff introduced themselves
□ Don’t know / can’t remember
Did you feel you were involved in decisions about your discharge from
hospital?
Yes, definitely
Yes, to some extent
No
I did not want to be involved
24. Managed Service
Software: Business Processes, RFT, Define Requirements
Website: Devoted to NPE: Section for Patients and Section for Service
Providers
26. MCG’s Neuroscience Center of
Excellence adult inpatient unit
Length of stay in the neurosurgical unit decreased by 50%.
Discharges (volume) increased 15.5%.
The nursing staff vacancy rate fell from 7.5% to 0%
Positive change in perceptions of the unit by faculty, staff
27. In Conclusion
“If patient engagement were a drug, it would be the blockbuster drug
of the century and malpractice not to use it.”
Leonard Kish on August 28, 2012
www.hl7standards.com/blog/2012/08/28/drug-of-the-century/
To be successful in the new era of health reform,
organizations will have to take engagement to a new
level and consider patients central to the care
Team.
2014
How does patient experience fit into the overall
healthcare picture? Patient Experience Journal
Karen Luxford BSc(Hons), PhD, FAIM, FAAQHC, Director, Patient Based Care, Clinical Excellence Commission, NSW, Australia
Sue Sutton RN, PhD, FHIMSS, President & CEO, Tower Strategies, ssutton@towerstrategies.com
Baseline data from a representative sample of patients across all acute services
Both reliable and valid and point us in the direction of shaping meaningful and focused improvement work / priorities across the system
We lag behind other countries internationally for not have a consistent systematic approach to measuring patient feedback in a scientific and robust way and therefore this project, this partnership with our colleagues from both HIQA and the DOH is especially welcome. The leadership and support from all stakeholders is of particular importance. It is the first step in ensuring that Patient Experience is high on agenda of the DG, CEO HIQA and Office of Patient Safety in DOH.
Constructive picture of what the key issues are. Imagine you are the patient and you are filling out the questionnaire. Overall score provides a generic rating, however the results of the specific areas are of particular interest. Dignity and respect. Involvement in decision making.
The analysis from this survey will provide us with Insight about what matters to patients, forming the agenda for PPI and QI priorities at local level.
MCGHealth (MCG Medical Center and MCG Children's Medical Center), Augusta, Georgia
Patient satisfaction increased from 10th to 95th percentile.
Neurosurgery length of stay decreased by 50%.
Reduction in medical error by 62%.
Number of patients discharged increased by 15.5%.
Positive change in perceptions of the unit by doctors, staff, and house staff.
The empowered and involved patient. Providing feedback. Involved in decision making, valued for the shared expertise –has better outcomes in healthcare.
Supports a cultural shift which we are embracing here today, the culture of patients as partners in their care, patients as partners in the design and delivery of healthcare services in ireland.
Shared decision making –shared expertise which exists between patients and healthcare providers
QI Priorities which supports Healthcare services to objectively identify what matters to patients in their areas and how best to address same.
Buy-in support and leadership of Group CEOs –
short, medium and long-term plans
Board to ward strategy for improvement which highlights the roles of all stakeholders to embed and support this work
Evaluate this work , Process, Impact, Outcomes, ultimately –follow-up patient surveys will demonstrate improvement
Opportunity to mould the work, priorities and agenda of patient forum groups across the country.
Benchmark against the standards
Provide assurance that services are listening, responding and improving based on what matters most to patients
Representative feedback-objective data
Challenges the media profiling of healthcare services, which is mostly negative and fails to capture the real picture / constructive and representative picture of what happens across the system and on an hourly/ daily basis
Regulator
Huge potential in identifying the key issues in an objective way which in turn may enhance or strengthen the work which is carried out in relation to assessments against the standards or highlighting areas of risk
Potential here in the analysis of qualitative data which participants are invited to provide as part of the questionnaire,
Benefits of analysing this data against a validated taxonomy which enables,
Assessment of risk
Themed analysis of the issues described
Driving accountability and a learning culture which supports and enables services to improve pat. Experience and overall outcomes of care
Direct correlation between mortality and severity of feedback
Review of literature by the Kingsfund highlighted that policy as a driver for change and as a way of improving pat. Experience cannot be underestimated. December 2015.
Insight and Influence-leadership
Great opportunity with the Launch of the Pat. Safety Office, to shape policy which will positively influence overall pat. Experience.
Ensuring that pat experience is strategically positioned on everyone’s agenda starts with our leaders.
Evidence and findings of the NPESP on the agenda of all team meeting, from Board to ward, supported by more qualitative examples of patient stories help to ensure that the meetings, discussions, agendas and decision making prioritises the real-issues, what really matters, every day, every where. Patients.