S187 - Day 1 - 1200 - Gaining insight and acting on patient feedback
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Health and Care Innovation Expo 2014, Pop-up University ...

Health and Care Innovation Expo 2014, Pop-up University

S187 - Day 1 - 1200 - Gaining insight and acting on patient feedback

Dan Wellings
Neil Churchill

#Expo14NHS

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S187 - Day 1 - 1200 - Gaining insight and acting on patient feedback Presentation Transcript

  • 1. Building choice of high quality support for commissioners Insight and feedback – why it matters and what we are doing about it Dan Wellings Head of Insight and Feedback
  • 2. Insight and feedback – what do we do?
  • 3. What does insight mean? • Using qualitative and quantitative data to inform what we do • It is not based on one data source • It is about using whatever sources we have – Not just surveys; whole range of market and social research techniques • Term widely accepted in private sector – Question mark over public sector • Always asking the question, what don’t we know? • As much an art as science • Answering the question “So what?”
  • 4. Why is it important? “The confidence that individuals have in their beliefs depends mostly on the quality of the story they can tell about what they see, even if they see little. We often fail to allow for the possibility that evidence that should be critical to our judgement is missing – what we see is all there is” Daniel Kahneman Thinking, Fast and Slow
  • 5. Why it matters... “Doesn’t bother me, it’s rubbish here.” Blackburn resident
  • 6. What does a “very good” experience mean? Source: GP Patient Survey 2012-2013 Very good Fairly good Neither Poor All respondents who answered the question (948,758) Q Overall, how would you describe your experience of your GP surgery? 5% 5% 4% 3% 2% 13% 12% 10% 9% 7% 5% 4% 4% 49% 49% 46% 44% 41% 33% 29% 29% 31% 32% 39% 43% 49% 60% 66% 65% 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 to 84 85 +
  • 7. 8 12 17 17 20 27 26 25 25 34 45 37 46 57 55 62 57 70 74 88 81 74 72 71 68 63 62 60 55 47 40 39 34 31 29 29 26 19 17 1480 11110 Doctors Teachers Professors Judges Scientists Clergyman/Priests The Police Television News Readers Social workers The ordinary man/woman in Civil Servants Managers in the NHS Pollsters Trade Union officials Local councillors Business Leaders Bankers Managers in local Journalists Government Ministers Politicians generally % Not trust % Trust How do we take our love of doctors into account? Q. “For each, would you tell me whether you generally trust them to tell the truth or not?” Base: 1,026 United Kingdom adults aged 15+, 10-16 June 2011 Source: Ipsos MORI/BMA
  • 8. To what extent do we need to tackle “gratitude bias”? -40% -20% 0% 20% 40% 60% 80% 1983 1984 1986 1987 1989 1990 1991 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Pre War (born before 1945) Baby Boomers (born 1945-1965) Generation X (born 1966-1979) Generation Y (born 1980 onwards) Data: BSA 1983-2010. Each data point represents >100 respondents Net satisfaction with the running of the NHS
  • 9. So what impact will the changing demographic have on satisfaction? 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 83 84 85 86 87 89 90 91 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 % sample universe from pre war generation % Generation Y % Generation x % Baby boomers1983: All adults Proportion of UK population from each generational grouping Source: Eurostat 2010: All adults aged over 66 1983: All adults aged under 39 2010: All adults aged between 45 and 65 2010: All adults aged between 44 and 31 2010: All adults aged under 31
  • 10. How was your experience? (1) Adult Inpatient Survey 2012 1% 1% 1% 2% 2% 5% 6% 12% 24% 20% 25% 0% 5% 10% 15% 20% 25% 30% 0 1 2 3 4 5 6 7 8 9 10 Overall… I had a very good experience Base: 61399 (all respondents). Fieldwork: Sept 2012 – Jan 2013 Source: CQC/Picker Institute 18% rated their overall experience lower than 7/10 I had a very poor experience
  • 11. How was your experience? (2) Adult Inpatient Survey 2012 Base: 61399 (all respondents). Fieldwork: Sept 2012 – Jan 2013 Source: CQC/Picker Institute BUT 62% reported at least one aspect of poor care 18% 62%Poor overall experience Experienced some form of poor care Overall experience measures good for tracking satisfaction but not for rooting out problems?
  • 12. © Ipsos MORI Paste co- brand logo here Sometimes an overall measure can mask poor experience • On third day she asked for a bedpan • Nurse told her it wasn’t worth running back and forth, told her to do it in the bed • Nurse complained to her in the morning that she was soaking wet “… in [the hospital] they treated me well” “Oh yes I found it satisfactory” Female, white, 65+, in hospital for several months Her report… Her experience…
  • 13. UNCLASSIFIED Means nothing if nothing is done
  • 14. Friends and Family Test
  • 15. Friends and Family Test Overview Simple test based on Net Promoter Score methodology ‘How likely are you to recommend our <ward / A&E department> to friends and family if they needed similar care or treatment?’ 1 Extremely Likely 2 Likely 3 Neither Likely nor Unlikely 4 Unlikely 5 Extremely Unlikely 6 Don’t know
  • 16. A measure and an intervention?
  • 17. UNCLASSIFIED Methodology – pros and cons RobustnessUsability
  • 18. Are we trying to shoehorn FFT into model it can‟t fit into?
  • 19. Friend and Family Test - outcomes • Soft closing bins have been purchased for inpatient areas as a response to patients feeding back that noisy bins kept them awake at night • Comments regarding disturbed nights led to Introducing the ‘Quiet Protocol’ to help patients sleep well at night Environmental issues Mid Staffs NHS Foundation Trust Sandwell and West Birmingham Hospitals NHS Trust
  • 20. • The A&E department’s self-check in service had no disinfectant hand gel. This has now been provided • Feedback from a patient with a stoma bag that it would be useful to have a shelf in the patient toilets in the surgical ward has led to the Trust fitting shelves in the toilets so people have somewhere to place their belongings Hygiene related issues Hull & East Yorkshire Hospitals NHS Trust East and North Herts NHS Trust – Lister Hospital Friend and Family Test - outcomes
  • 21. • After negative feedback, the Trust has introduced medication cards for patients who are off the ward during drug rounds to alert them that their medication is waiting to be dispensed • "Was in pain on previous admission, felt ignored by staff" – comment led to self-medication programme - patients manage their own analgesic medication when they are in pain Medication issues The Royal Wolverhampton NHS Trust The Royal Wolverhampton NHS Trust Friend and Family Test - outcomes
  • 22. What is most effective model for data usage?
  • 23. Why is insight important? “The most important single change in the NHS in response to this report would be for it to become, more than ever before, a system devoted to continual learning and improvement of patient care, top to bottom and end to end” A promise to learn – a commitment to act The Berwick Report
  • 24. @danwellings dan.wellings@nhs.net We look forward to working with you
  • 25. Neil Churchill Director of Patient Experience - (Domain 4 Lead)
  • 26. „If you‟d asked me the most important quality of a doctor, I would have said competence. When I became a patient I soon realised how important compassionate attributes in the people looking after me were‟ Kate Granger
  • 27. www.institute.nhs.uk/theguide http://www.kingsfund.org.uk /projects/ebcd/experience- based-co-design-description
  • 28. The priorities for patients with breast and lung cancer were different Lung cancer Breast cancer Communication of diagnosis Functioning of day surgery unit Information about treatment Appointments system and conduct of OP clinics Continuity and coordination of care Communication Information about symptoms
  • 29. State of Caring survey 2013 84% of carers surveyed said that caring has a negative impact on health. Up from 74% in 2011/12
  • 30. State of Caring “Good care empowers and enables both the carer and the cared-for. Poor care leads to ill-health and stress for both carer and cared- for.”
  • 31. Carers Trust‟s Triangle of Care – a therapeutic alliance between, carer, patient and professional Six Key Standards to ensure carers are included and supported: 1. Carers and the essential role they play are identified at first contact or as soon as possible thereafter. 2. Staff are „carer aware‟ and trained in carer engagement strategies. 3. Policy and practice protocols regarding confidentiality and information sharing are in place. 4. Defined post(s) responsible for carers are in place. 5. A carer introduction to the service and staff is available, with a relevant range of information across the care pathway. 6. A range of carer support services is available.
  • 32. © Ipsos MORI Paste co- brand logo here To what extent do we need to tackle “gratitude bias”? -40% -20% 0% 20% 40% 60% 80% Pre War (born before 1945) Baby Boomers (born 1945-1965) Generation X (born 1966-1979) Generation Y (born 1980 onwards) Data: BSA 1983-2010. Each data point represents >100 respondents Net satisfaction with the running of the NHS
  • 33. CASE STUDY “I went to the dentist, reported to the receptionist and the receptionist forgot about me. I‟m not used to my sight loss and lost my orientation and couldn't bring herself to ask anyone for help and just felt too nervous to shout out or anything. I ended up sitting there for hours and it was an extremely frightening experience.”
  • 34. a) Welcoming b) Safe c) Caring and involving d) Well organised and calm The 15 Steps Challenge – what to look out for…
  • 35. Point of Care 2014 Staff Satisfaction = Improved Patient Satisfaction and Care
  • 36. Patient experience is closely linked to patient involvement and engagement Experience Involvement Being involved is part of having a good experience Involving patients is one means to understanding and improving experiences Individual Individual and collective
  • 37. 17 April 2013 Derbyshire Healthcare NHS Foundation Trust Opening Ceremony @GrangerKate
  • 38. Everyone Counts: Planning for Patients 2014/15 to 2018/19 – Plans are expected to demonstrate measurable improvement in patient experience as well as continued investment in generating feedback. Improvement will be supported through: tools to help establish who is receiving poor care and where poor care is to be found; – proven methods to enhance feedback and insight from vulnerable patient groups; – tools to measure and improve the experience of carers; – independent evaluation of improvement methodologies and easier access to proven techniques and support for their implementation, including train the trainer and master classes; – recommended methodologies to strengthen forms of staff engagement which can support improvements in patient experience through better staff experience; – support for the collaborative sharing of learning and good practice; and – a strategy to learn from complaints and improve the experience of making a complaint.