what do you like the best/least about the clinic? waterloo region nurse practitioner-led clinic
TRANSCRIPT
What do you like the best/least about the clinic?
Waterloo RegionNurse Practitioner-Led Clinic
Angie Kalra
June 2014
WRNPLC PatientSatisfaction
Survey
Background
As part of the clinic mandate and agreement with the
Ontario Ministry of Health, a Quality Improvement Plan
is being initiated.
Quality Improvement Focus
The clinic’s approach to Quality Improvement includes:
Timely access to primary care when patients need care
Primary care that is integrated with patient’s other health experiences, including hospital stay and home care.
Patient-centered care, based on developing a partnership with patients to achieve appropriate health outcomes
Method
2-pronged approach
Paper and Pencil Version
Survey Monkey Version
Convenience Sample (June 2014)
Anonymized data collection
Changes
Added Ministry Mandated questions
Removed few questions
Added provider location
Demographics- November 2013
Demographics- June 2014
Changes
Demographics remain roughly the same
Female population rose 3 percent while male population decreased
Analysis of data
N=96 responses, all paper
All data was transcribed into the Survey Monkey site
Numeric data was analyzed and data charts created.
Short answer data was summarized by noting recurring themes
N=96 responses
Location of Provider- June 2014
Response Percent
Response Count
77.2% 7126.1% 24
9203selected both
skipped question
Answer Options
CambridgePioneer Park
answered question
Results:
3 patients see their provider at both locations.
Limitation: Cambridge site treats more patients
Hear About Clinic- June 2014
MOH- 3 Health Care Connect- 4
Online- 5 Hospital- 8
CCAC-3 Friends & Family- 27
Recurring Themes
Response Count
87
87
5skipped question
How did you hear about our clinic?
Answer Options
answered question
Office Hours- November 2013
Office hours - June 2014
Differences:
Results are roughly the same from November 2013 to June 2014 with no notable differences
Transportation to Clinic–November 2013
Transportation to the clinic June 2014
Differences:
Results have improved this month with a higher percentage of patients selecting “always”
Common issue is public transit to the Pioneer Park location
Returning Calls- November 2013
Differences:
Results are roughly the same from November 2013 to June 2014 with no notable differences
Returning Calls - June 2014
Wait Times- November 2013
Differences:
Results appear to have improved this month with more patients selecting “always”
Wait Times- June 2014
Listens to You- November 2013
Listens to You - June 2014
Listens to you
Always Often
Sometimes Rarely
Never N/A
Differences:
Results are roughly the same from November 2013 to June 2014 with no notable differences
Answers Questions- November 2013
Differences:
Results have slightly improved from November 2013 to June 2014
Roughly 80% patients feel that the staff answers their questions
Answers Questions- June 2014
Clean Building- November 2013
Differences:
Results have improved from November 2013 to June 2014 with
Clean Building- June 2014
Feeling Safe- November 2013
Differences:
Results are roughly the same from November 2013 to June 2014 with roughly 88% of patients feeling safe within the clinic
Feeling Safe- June 2014
Referring Clinic- November 2013
Differences:
Results have improved from November 2013 to June 2014 with 85% of patients who would refer the clinic to their friends and family
Referring Clinic- June 2014
Privacy- November 2013
Differences:
Results are roughly the same from November 2013 to June 2014 with no notable differences
Privacy- June 2014
QIP QuestionsMinistry Mandated Questions
Time to See NP- June 2014
Response Percent
Response Count
21.7% 2019.6% 1835.9% 332.2% 220.7% 19
920
6.5
20 or more daysNot applicable (Don’t know/ refused)
answered questionskipped question
average days
2-19 days (See average days )
The last time you were sick or were concerned you had a health problem, how many days did it take from when you first tried to see your doctor or nurse practitioner to when you actually SAW him/her or someone else in their office?
Answer Options
Same dayNext day
Results:
Majority of patients waited 2-19 days to actually see their provider from when they first tried, with an average of 6.5 days.
Opportunity to Ask Questions- June 2014
Response Percent
Response Count
63.5% 6114.6% 144.2% 42.1% 20.0% 015.6% 15
960
Sometimes
skipped question
Answer Options
Never
Often
answered question
When you see your doctor or nurse practitioner, how often do they or someone else in the office give you an opportunity to ask questions about the recommended treatment?
Rarely
Always
Not applicable (Don’t know/ refused)
Differences:
Results are roughly the same from November 2013 to June 2014 with no notable differences
Involve Patients- June 2014
Response Percent
Response Count
64.6% 6214.6% 144.2% 42.1% 20.0% 014.6% 14
960
Sometimes
skipped question
Answer Options
Never
Often
answered question
When you see your doctor or nurse practitioner, how often do they or someone else in the office involve you as much as you want to be in decisions about your care and treatment?
Rarely
Always
Not applicable (Don’t know/ refused)
Differences:
Results are roughly the same from November 2013 to June 2014 with no notable differences
Spends Enough Time- November 2013
Response Percent
Response Count
70.8% 6815.6% 153.1% 30.0% 02.1% 28.3% 8
960
Sometimes
skipped question
Answer Options
Never
Often
answered question
When you see your doctor or nurse practitioner, how often do they or someone else in the office spend enough time with you?
Rarely
Always
Not applicable (Don’t know/ refused)
Question 19
Differences:
Fewer patients feel that their nurse practitioner spends enough time with them.
Short Answer Questions
“What do you like the best/least about our clinic?”
Recurring Themes (best):
Friendly Convenience Helpful Thorough
Care Knowledgeable Availability Listen
Excellent Private Fast Professional
Recurring Themes (least):
Location Confidentiality
Timings Few NPs
Examples of Answers
Best:
“Availability of same day appointments, enough time for thorough discussion at each visit, I feel that my nurse practitioner is taking a holistic approach in regards to my well being.”
“That you take time to be thorough and are open minded to my input regarding the care of my son and myself”
“Love the empathy and time a nurse practitioner has compared to a doctor,”
Examples of Answers
Least:
“Limited hours and few NPs to choose from”
“Location for me. There isn't always someone available in Kitchener.”
“…it is in a pretty inconvenient place.”
“Do you have any suggestions for improvement?”
Recurring Themes:
Parking More staff Infant knowledge
More hours Clerical Doctor availability
Examples of Answers
“More people available at Pioneer”
“More knowledge regarding infants and infant care needed”
“Promptly answering/returning messages and phone calls. Giving more time for meetings with patients.”
“Yes, it would be nice to see a doctor in the event that the nurse practitioner cannot help the patient.”
Summary of Results
Majority of clients heard about the clinic through friends and family
Compared to November 2013, 24.6% more patients find that wait times are acceptable
93% of patients would refer family or friends
91% of patients feel that their information is kept private
Roughly %99 of patients feel safe when at the clinic
All categories improved from November 2013 to June 2014 by an average of %11
Limitations of Survey Fewer patients at Pioneer Park
Convenience sample
Potential for response bias
Only English speaking clients were able
to participate
Patients felt rushed
Many incomplete surveys
How to Improve Next Time
Print surveys one sided
Mail out survey
Promote online version of survey
Next Steps
Repeat survey at specified intervals
Translate survey if possible
Consider offering individual interviews to collect data from those who require assistance
Perhaps encourage a nominal prize for participation in online survey
Set up laptop station for patients to fill out survey while waiting for treatment