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Measuring Patient Experience in Ireland
Measuring Patient Experience
in Ireland
Presentation by:
Greg Price, Director of Advocacy
Quality and Patient Safety Directorate
Health Service Executive, Ireland
Irish Health Care System Current situation
• Irish Healthcare Services under constant flux of change and reform
Utilisation of Irish Health Care Services 2007
• 4.5 million people residing in the Republic of Ireland
• On average 64% of our population consult a general practitioner each year, 30% have a hospital experience, 21% have an experience of community services and 27% are reported non-users of any service.
Measuring patient experience
what has happened? • To date a strong focus on complaints and complaints analysis
• Four National Patient Experience Surveys since 2004 – 2004 National survey of patients experience of hospital services
www.isqsh.ie
– 2006 National survey of patients experience of emergency departments www.hse.ie
– 2007 National Survey of patients experience of both primary care and acute hospital services www.hse.ie
– 2010 National survey of patients experience of hospital services www.isqsh.ie
– Annual survey of mental health services –second opinion www.irishadvocacynetwork.ie
Insight 07’ INSIGHT 07’
Research commissioned by the HSE
Conducted by Prof. Cecily Kelliher, UCD
Eight dimensions of patient experience (Picker UK) were explored:
• Fast access to reliable services,
• Effective treatment delivered by a trusted professional,
• Involvement in decisions and respect for preferences,
• Clear, comprehensive information and support for self care,
• Attention to physical and environmental needs,
• Emotional support, empathy and respect,
• Involvement and support for family carer's,
• Continuity of care with smooth transitions.
Survey of inpatients, community and GP services
3,517 respondents across Ireland
Full report available on the HSE web page- www.hse.ie
Overall rating of care
Inpatient ratings for cleanliness
Inpatient –involvement in decision making
Information about your condition
Being able to confide in your doctor
Most recent findings ISQSH survey of 5,092 inpatients in 2010 Key findings
ISQSH
2010
Being treated with dignity and respect a major predictor of
satisfaction
•96.5% trusted staff in charge of their care
•88% were involved in the decision making about their care
•90% rated information received as good or very good
•92.3% stated that overall they were satisfied with their
experience
•92% said that they would recommend the hospital to
someone else
www.isqsh.ie
At local service level At local level a wide range of surveys are carried out by
individual service providers
However, as there is no universal approach, it is not possible to collate the findings from them to provide a national picture or to benchmark service user experience across service providers
……due to variations in sample size, timing, services covered and questionnaires used.
Led to a need to standardise approaches to measuring patient experience across out whole healthcare system
Current work underway to standardise
our approach • National patient experience programme currently
being developed in partnership with key stakeholders – Focus on the development of patient experience
surveys combined with analysis of feedback from other methods including complaints
– Acknowledge support of our neighbours • Dr. Ian Seccombe
• Team of Researchers at Health Improvement Scotland
• Surveys will measure OECD indicators
How does it all fit?
The National Healthcare Charter
• The Department of Health together with the HSE in 2008 committed to the development of a National Healthcare Charter www.hse.ie
• Developed in partnership with key stakeholders
– Public consultation
– Consultation with community and hospital services nationally
– Review of international evidence and health care charters in other jurisdictions
– Review of complaints received and patient feedback about their experience
– Support from professional and regulatory bodies
– Support from trade unions and Health Services Partnership Forum
A consistent and recognisable message
It’s Safer to Ask promoting shared decision making in health, promoting
safety
• Questions to ask your healthcare
provider
• Suitable for all healthcare settings
hospitals, surgeries, community
services, out-patient clinics
• Consulted with you (clinical leads)
about this leaflet
Patient feedback –promoting balance • Patient feedback in Ireland is deemed as an under utilised resource
• Due to strong focus on complaints there has been a lack of balanced
feedback in relation to capturing patient experience
• Policy developments have led to a real impetus for change and a drive to do
this work well
– Examples of best practice,
• Mercy University Hospital Cork
• “Emergency Departments, taking patient feedback seriously” an
analysis of qualitative feedback received by the HSE corporate feedback
system.
• Revised patient feedback leaflet seeking balance
1. What worked well
2. What could we improve on
3. What should always happen every-time you or others use this
service “always events”
You said We did
demonstrating that we are listening,
making changes and
letting people know about it
YOU SAID WE DID YOU SAID
Long waiting for emergency “After 3 hours, we were brought in for bloods to be taken, which I later discovered were necessary to determine if she had clots. We were told it would be a further hour and a half before they would have the results. WHY IN HELL WERE THESE NOT CARRIED OUT AS SOON AS SHE ARRIVED?”
WE DID
Fast-tracking of blood tests is being implemented along with new recommendations for the most appropriate blood tests to be done.
These protocols will be in place in all Emergency Departments in 2013.
YOU SAID WE DID
YOU SAID
Support of family or carer’s, “The suffering of patients is greatly exacerbated by preventing family members from accompanying them, ….Patients have no way of alerting staff if they need assistance”.
WE DID
Visiting policy is being developed
A national ED visiting policy is being developed by a team of ED nurses and patient representatives to ensure the needs of patients and their families and carer’s are addressed, while allowing ED staff to manage the number of people in the ED at any time.
Examples of how we are involving patients collectively –in the co-production of health
• Patient feedback, complaints, surveys, patient stories
• Patients being recruited to design health care audits and to carry audits in our services
• Patient partnership forums in 50 hospitals in Ireland (need to be evaluated)
• Patient partnership forum established for the clinical programmes and the Quality and Patient Safety Directorate
Forum involved in the design and evaluation of programmes and Identifying priorities for the programmes
• Patient safety champions network
• 300 Volunteer advocates in residential care settings for older people
• National service user executive mental health
Transforming the dynamic – how the Advocacy Unit helps services
• Advocacy Unit, supports services to implement the National Health Care charter,
• Help services to measure patient experience and develop guidance for doing so
• Help build capacity, training for staff and service users to work in partnership
• Develop advocacy services
• Train staff in open communication skills following an adverse event
• Develop patient empowerment resources and literature
Next Steps
• Delighted to share all of our work with you
• Grateful to our neighbours for their
generosity and kindness in sharing
resources and time
• Look forward to working together to improve
patient experience and patient outcomes
Contact: Greg Price
Director of Advocacy,
The National Advocacy Unit,
Quality and Patient Safety Directorate
Health Service Executive
Oak House
Millennium Park
Naas
Co. Kildare
00353-45-880400