Mr Quentin Schoonvaere, Data & Improvement Officer - PAQS

1. How hospitals can used Patient-
Reported experience questionnaire
(PREM)?
15 Octobre 2019 – Quentin Schoonvaere – PAQS ASBL

2. Who am I ?
Data & Improvement Officer à la PAQS
• Demographer
• Projects related to indicators:
✓ Indicators reported by patients (PROM – PREM
– PRIM)
✓ Other quality indicators
• Data analysis

3. PAQS ASBL ?

4. PAQS means
Plateforme
PlatformP
Amélioration continue
Continuous improvementA
Qualité des soins
Quality of careQ
Sécurité des patients
Patient SafetyS

5. Mission
PAQS aims
to promote, support and organize
the development and implementation
of initiatives of continuous quality of care and patient
safety improvement
in Brussels and Walloon healthcare institutions

6. Working together
Q/S
Healthcare
institutions
Physicians
Nurses
Pharmacists
…
Health
insurance
fund
Regional
authorities
Universities
Patients

7. Our activities
Programs
Pilots
Collaboratives
Experiences sharing
Training
In person
E-learning
Workshops
Resources
Existing
From our programs
R&D
Communication

8. Examples of resources
Tools Publications
Sharing AE

9. Why PAQS works on patient
experience ?

10. Regional Strategy
Education
AE Management
Measures & Indicators
Safety Standards
Patients & Families Involvement

11. What “patient experience” means ?
Patient SafetyExperience
Patient experience: « The sum of all interactions, shaped by an
organization’s culture, that influence patient perceptions across the
continuum of care » (Beryl Institute)

12. Messages about safety in our daily lives

13. A link between patient experience & patient safety ?
Patient experience: « The sum of all interactions, shaped by an
organization’s culture, that influence patient perceptions across the
continuum of care » (Beryl Institute)
Experience Patient Safety

14. What literature says about the association between
patient experience and patient safety
Patient safetyExperience
A systematic literature review highlights that it is more
common to find a positive association between patient
experience and safety issues. The lack of association can be
explained by different factors (1)
Some examples of relations:
• PSI/AI & patient experience (2,3)
• Safety culture & patient experience(4-6)
• Complications & patient experience(7,8)

15. Using PREM in a hospital

16. Examples of methods used to collect patient
experience
Source: The Health Foundation (2013) Evidence scan: Measuring patient experience 16

17. Experience and patient safety are closely linked
Patient safetyExperience PREM
PRIM
Patient experience: « The sum of all interactions, shaped by an
organization’s culture, that influence patient perceptions across the
continuum of care » (Beryl Institute)

18. PREM

19. Picker Patient Experience questionnaire:
15 questions to evaluate7 dimensions of patient experience
Respect for
patient
preferences
Emotional
support
Continuity and
transition of
care
Physical
comfort
Information and
education
Involvement of
family and
friends
Coordination of
care

20. Allocation of the questions within those themes
• Did a doctors talk in front of you as if you weren’t there?
Yes, often/ Yes, sometimes/No
• Did you want to be more involved in decisions made about your care and
treatment ?
Yes, definitely/ Yes, to some extent/No
• Overall, did you feel you were treated with respect and dignity while you were in
hospital ?
Yes, always/ Yes, sometimes/No
Continuity and
transition
• Did a member of staff explain the purpose of the medicines you were to take at
home in a way you could understand ?
Yes, completely/ Yes, to some extent/No/ I had no medicines
• Did a member of staff tell you about medication side effects to watch when you
went home?
Yes, completely/ Yes, to some extent/No/ I didn’t need an explanation
• Did someone tell you about danger signals regarding your illness or treatment to
watch for after you went home?
Yes, completely/ Yes, to some extent/No
Respect for
patient
preferences

21. Quantitative results for the identification of
« problems »

22. Comparison of care units in a same hospital
2 units with significant differences
-> necessity to improve the
continuity of care and particularly
the communication of information
about the medicines to take at
home
Unit to monitor
Problems with medication side effects to watch when patient went home (1st semester 2019)
%ofnegativeexperience

23. Implementation of PREM project at CHU de
Charleroi
1st Phase
Questionnaire in
qualitative mode
•At least 30 questionnaires in 6 pilot Units
•194 questionnaires collected
•Then temporary STOP
2nd Phase
Development of
actions
(improvements?)
• 119 improvement opportunities proposed by patients
• Testing some of these opportunities during 3 to 6
months
3rd Phase
Repeating the
questionnaire in q
qualitative mode
Evaluation of opportunities tested
with at least 30 questionnaires per
pilot unit
C.H.U. de Charleroi
C.H.U de Charleroi is a public
hospital managed by
« l’Intercommunale de Santé
Publique du Pays de Charleroi
(ISSPPC) ». It consists of different
integrated institutions: Hôpital
André Vésale in Motigny-le-Tilleul,
Hôpital Civil Marie Curie in
Lodelinsart, Hôpital Vicent Van
Gogh in Marcienne-au-Pont
(psychiatric department) and
Hôpital Léonard de Vinci in
Montigny-le-Tilleul dedicated to
rehabilitation
www.chu-Charleroi.be

24. Results 4A -
internal medicine
Improvement opportunities
• Broadcast on interactive TV specific information about the
stay in the unit (channel 4A) + brochure to share these
information :
✓ Team presentation + how to contact its different members
✓ Presentation of the unit’s infrastructures
✓ Presentation of the unit’s operation
• Pictures + Information about the different medical
examinations
• Video about colonoscopy
• Creation of a communication sheet patients/physicians
✓ Patients write questions to remember of them during the
medical doctor’s visit
• Reminding the different colors on the call button
• New informative pictograms (fasting, false swallowing,...)
• Time slots for medical consult

25. Interactive TV
Brochure
Appointment card
Reminder

26. First feedbacks about this project
• Quantifying objectively the encountered
problems
• Some new issues not discussed in satisfaction
surveys
• Patients appreciates the tool – they feel listened
-> provide for other way of expression (free text
space – interviews – focus groups )
• Feedback are important for caregivers
-> gives sense to their profession
• Institutional support is essential for developing
necessary resources
• Cannot be applied everywhere - identifying the
units/ teams motivated by these kinds of tools
• It could be difficult to ensure the sustainability of
the tool due to a Higher workload
-> incorporate questions in existing tools (in satisfaction
survey)
• Little interest by physicians (cultural change)
• Understanding of questions for certain patients
Benefits Limits

27. Conclusion

28. Importance of listening to patients
28
Let’s avoid
these kind of
situation

29. Bibliography
1. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and
effectiveness. BMJ Open 2013;3:pii: e001570 10.1136/bmjopen-2012-001570
2. Kemp KA, Santana MJ, Southern DA, McCormack B, Quan H. Association of inpatient hospital experience with patient
safety indicators: a cross-sectional, Canadian study. BMJ open. 2016;6(7):e011242-e
3. Black N, Varaganum M, Hutchings A. Relationship between patient experience (PREMs) and patient reported outcomes
(PROMs) in elective surgery. BMJ Qual Saf 2014;23:534–42. 10.1136/bmjqs-2013-002707
4. Lyu H, Wick EC, Housman M et al. Patient satisfaction as a possible indicator of quality surgical care. JAMA Surg
2013;148:362–7. 10.1001/2013.jamasurg.270
5. Sorra J, Khanna K, Dyer N et al. Exploring relationships between patient safety culture and patients’ assessment of
hospital care. J Patient Saf 2012;8:131–9. 10.1097/PTS.0b013e318258ca46
6. Anhang Price R, Elliott MN, Zaslavsky AM et al. Examining the role of patient experience surveys in measuring health care
quality. Med Care Res Rev 2014;71:522–54. 10.1177/1077558714541480
7. Stein SM, Day M, Karia R et al. Patients’ perceptions of care are associated with quality of hospital care: a survey of 4605
hospitals. Am J Med Qual 2015;30:382–8. 10.1177/1062860614530773
8. Weissman JS, Lopez L, Schneider EC et al. The association of hospital quality ratings and adverse events. Int J Qual Health
Care 2014;24:129–35. 10.1093/intqhc/mzt092

30. www.paqs.be - contact@paqs.be - @PAQSASBL