Dr Rachel Flynn HIQA - IPPOSI Patient Reported Outcome Measures conference Oct 2018
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The National Patient Experience Survey Programme in Ireland aims to put the patient voice at the center of acute healthcare by conducting annual inpatient experience surveys. The 2017 survey found areas of good experience including respect, clear communication from doctors and nurses, and confidence in hospital staff. Areas needing improvement included communication around care and treatment, involvement in decision-making, and information provided at discharge. In response, initiatives have been implemented like communications skills training and improved discharge planning. The goal is to continuously listen to patients' experiences and drive sustainable improvement across health and social care.
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Dr Rachel Flynn HIQA - IPPOSI Patient Reported Outcome Measures conference Oct 2018
- 1. THE NATIONAL PATIENT EXPERIENCE SURVEY PROGRAMME Hearing, understanding and responding Rachel Flynn Director of Health Information and Standards, HIQA
- 2. BACKGROUND Ireland’s first inpatient experience survey Carried out in 2017, repeated in 2018 Move towards patient-centred care, policy and regulation Using patient feedback to improve quality and safety of care. Partnership between provider (HSE), regulator (HIQA) and policy maker (Department of Health) Cross-system buy-in to overcome barriers
- 3. PUTTING THE VOICE OF THE PATIENT AT THE CENTRE OF ACUTE HEALTHCARE Patient experience is a good indicator of healthcare quality and performance (1-3) The NPE Survey equally values and seeks to represent every patient voice among those who take part. 61 internationally validated items, tailored to Irish context PREMs organised by ‘stages of care’ along the patient journey
- 4. AREAS OF GOOD EXPERIENCE IN ACUTE HEALTHCARE (2017) Respect, dignity and privacy Communication: clear answers from doctors and nurses Confidence and trust in hospital staff “The household staff who gave me my meals treated me with dignity, and talked to me and expressed interest and concern about how I was feeling.”
- 5. AREAS OF GOOD EXPERIENCE IN ACUTE HEALTHCARE (2017) Respect, dignity and privacy Communication: clear answers from doctors and nurses Confidence and trust in hospital staff “The nursing staff were very attentive, helpful and caring – answered questions – never gave the impression that they were in a hurry despite being on a busy ward.”
- 6. AREAS OF GOOD EXPERIENCE IN ACUTE HEALTHCARE (2017) Respect, dignity and privacy Communication: clear answers from doctors and nurses Confidence and trust in hospital staff “I felt the surgeon communicated with me on a personal level, which gave me trust and built my confidence in facing surgery.”
- 7. AREAS NEEDING IMPROVEMENT IN ACUTE HEALTHCARE (2017) Communication: opportunity and time for patient and family to discuss care and treatment with a doctor Involvement in decision-making about care and treatment Lack of information provided at discharge “Keep patient and family more informed about what’s going on. My children felt that they were told nothing and constantly had to ask.”
- 8. AREAS NEEDING IMPROVEMENT IN ACUTE HEALTHCARE (2017) Communication: opportunity and time for patient and family to discuss care and treatment with a doctor Involvement in decision-making about care and treatment Lack of information provided at discharge “When a decision was made to keep me in I wasn’t informed or included in the decision.”
- 9. AREAS NEEDING IMPROVEMENT IN ACUTE HEALTHCARE (2017) Communication: opportunity and time for patient and family to discuss care and treatment with a doctor Involvement in decision-making about care and treatment Lack of information provided at discharge “I had major surgery and was naïve about the level of care and the effects that the medication would have when I went home. I live alone and I felt this could have been explained better.”
- 10. NATIONAL-LEVEL RESPONSE Communications Skills Training National HR and RCSI Leadership School in partnership with European Association for Communications in Healthcare
- 11. RESPONSE BY HOSPITAL GROUP DISCHARGE PLANNING :THE SAOLTA HOSPITAL GROUP Hospital staff together with Health Literacy Committee, including representation from Patient Council piloted in two wards following positive feedback by patients, families and carers, launched at GUH in April 2018 3000 copies in English and 500 copies in Irish available on the Saolta website
- 12. RESPONSE FROM HOSPITALS Tallaght University Hospital Mercy University Hospital Kerry University Hospital
- 13. WHAT’S NEXT? Hearing, understanding and responding to the experience of people using Ireland’s health and social care services to drive sustainable improvement. Listen, Understand & Improve Maximise engagement across health and social care Become a centre of Excellence Provide Reliable Information
- 14. References: 1. Coulter A, Cleary PD. Patients’ Experiences With Hospital Care In Five Countries. Health Affairs. 2001;20(3):244-52. 2. Luxford K, Sutton S. How does patient experience fit into the overall healthcare picture? Patient Experience Journal. 2014;1(Inaugural issue). 3. Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the Role of Patient Experience Surveys in Measuring Health Care Quality. Medical care research and review : MCRR. 2014;71(5):522-54.
Editor's Notes
- The Sláintecare Report sets out a 10 year plan for our health and social care services and references the use of standardised national patient surveys and other communication channels to engage with the people that use health and social care services and use their responses to inform improvements and where appropriate shape policy.
- Information gathered provides a clear picture of the quality of acute healthcare, as reported by patients themselves. As the survey is repeated over the coming years, it will be possible to measure how patients’ experiences change over time.
- National Healthcare Communications Programme Purpose – to make conversations easier – as communication in healthcare requires a special set of skills Skills training programme for Clinical and non clinical staff There are 4 modules: Non clinical staff: Skills and building rapport with patients and active listening For clinicians Challenging Communication(Open disclosure, breaking bad news, complaints) Communicating with colleagues (Clinical h/over) 6 pilot sites: Beaumont, Kilkenny, Waterford, Galway, Limerick, Mercy. Each has a nominated facilitator(Snr Medical Professional). Each Facilitator will roll out in their sites in Oct and Nov National Team will evaluate the findings Roll out across the country in 2019
- 1. Tallaght University Hospital - Catering staff in Tallaght University Hospital now use tablets to take patients’ orders. This will allow the catering team to keep track of patients’ dietary requirements and tastes, and will ensure that patients get the food they order 2. Mercy University Hospital - Patients are asked four questions early in the their hospital journey to obtain information necessary to get them on the correct path to discharge. Patients and staff were invited to give their feedback on the initiative. The image on the left shows the form used to get patient and staff feedback on the questions asked. 3. Kerry University Hospital - University Hospital Kerry (UHK), in conjunction with the Antimicrobials Stewardship Committee, has prepared a leaflet for patients who are discharged on antibiotics. The Antibiotics Patient Information Leaflet (PIL) will now be attached to patients’ prescriptions upon discharge.