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How hospitals can used PatientReported experience questionnaire (PREM)? (EN)

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Mr Quentin Schoonvaere, Data & Improvement Officer - PAQS

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How hospitals can used PatientReported experience questionnaire (PREM)? (EN)

  1. 1. How hospitals can used Patient- Reported experience questionnaire (PREM)? 15 Octobre 2019 – Quentin Schoonvaere – PAQS ASBL
  2. 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. 3. PAQS ASBL ?
  4. 4. PAQS means Plateforme PlatformP Amélioration continue Continuous improvementA Qualité des soins Quality of careQ Sécurité des patients Patient SafetyS
  5. 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. 6. Working together Q/S Healthcare institutions Physicians Nurses Pharmacists … Health insurance fund Regional authorities Universities Patients
  7. 7. Our activities Programs Pilots Collaboratives Experiences sharing Training In person E-learning Workshops Resources Existing From our programs R&D Communication
  8. 8. Examples of resources Tools Publications Sharing AE
  9. 9. Why PAQS works on patient experience ?
  10. 10. Regional Strategy Education AE Management Measures & Indicators Safety Standards Patients & Families Involvement
  11. 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. 12. Messages about safety in our daily lives
  13. 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. 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. 15. Using PREM in a hospital
  16. 16. Examples of methods used to collect patient experience Source: The Health Foundation (2013) Evidence scan: Measuring patient experience 16
  17. 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. 18. PREM
  19. 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. 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. 21. Quantitative results for the identification of « problems »
  22. 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. 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. 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. 25. Interactive TV Brochure Appointment card Reminder
  26. 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. 27. Conclusion
  28. 28. Importance of listening to patients 28 Let’s avoid these kind of situation
  29. 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. 30. www.paqs.be - contact@paqs.be - @PAQSASBL

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