Download National Patient Experience Survey Programme

Overview of the National Patient
Experience Survey Programme
June Boulger
Acute Hospital Services
Contents of this presentation
1) Background to the development of the
NPE Survey in Ireland.
2) Focusing upon
Quality improvement plans in
Response to the NPE Survey
findings.
Who benefits from the NPE Survey?
Patients
Patients can make a difference to the quality of their care.
Service providers
The survey results help identify areas for improvement in
patient care.
Regulators
The survey results inform quality and safety of care.
Policy-makers
The survey results inform national policy and planning.
Why Measure?
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To track public attitudes to the health system
To identify and monitor problems in care delivery
To facilitate performance assessment and benchmarking
To help professionals reflect on their practice
To inform service redesign and monitor impact of changes
To promote informed choice of provider
To enable public accountability and transparency
Purpose
Phase
Key actions
Key players
Timeframe
Getting started
Engaging with key stakeholders in the design and
development of the survey methodology
HSE, HIQA, DoH, Patient Focus, Patient
representatives,
2015-2017
Engaging key stakeholders ‐to create buy-in and support AHD, HGs, Communications, Office of the
Secure resources and manpower etc.
CIO, QAVD.
Measurement
Scoping an implementation plan
Conducting the field work
HSE, HIQA, DoH, Patient Focus, Patient
representatives,
April 2017December 2017
Conducting the data analysis
Solutions
Publishing the findings www.patientexperience.ie.
AHD, HGs, Communications, Office of the
CIO, QAVD.
Identifying evidence based solutions
HSE cross divisional teams
Working in partnership with key stakeholders
HR, Communications, QPS,
Co-design work to develop implementation plans
HGs, AHD, others
June 2017-Januray
2018
Publishing the solutions www.patientexperience.ie.
Implementation Board to ward level strategy
Network of enablers involved in delivering solutions
HSE cross divisional teams
September 2017Ongoing
HR, Communications, QPS, HGs, AHD
and others
Evaluation
Process, impact and outcome evaluation plans developed HIQA, DoH
HSE cross divisional teams
HR, Communications, QPS, HGs, AHD
July 2017-Ongoing
NPE Survey: in Ireland
1.
Establish Governance Structure.
2.
Develop Survey Tool.
3.
Administration of the Survey.
4.
Overview of NPE Process.
5.
Testing of NPE Processes.
6.
Timelines.
Scope for NPE Survey
 have been discharged from a public acute hospital during the survey
period
 be age 18 and over
 hold a postal address in the Republic of Ireland
 have stayed a minimum of one overnight in a public acute hospital,
prior to discharge, in the survey month.
Target Population
41 Public Acute Hospitals across 6 hospital groups
Estimated sample of 27,000 eligible participants
Aiming for 40% response rate to achieve statistical significance
across all hospitals
The NPE Survey questionnaire
 The NPE Survey questionnaire consists of a total of 60
questions:
 57 structured questions
 closed tick-box responses
 3 free flow questions/written responses
 e.g. positive experiences, areas for improvement
What are the planned outputs?
By December 31, 2017
 National Report : Published
 Hospital Group Report : Published
 Hospital Report x 41
In 2018
 Quality Improvement Plan for each hospital and hospital
group.
Traditionalists/Veterans
1925-1945
Baby Boomers
1945-1964
Generation X
1965-1980
Generation Y/Millenials
“Nexters” 1980-2002
“Keepers of the Grail”
it’s Monday”
Invented “Thank God,
don’t live to work”
“Work to live,
“Upcoming optimists”
Logic and Discipline
Participation / Equity
and work
Balance between life
Diversity / Morals
Stable environment
Personal challenges
Feedback
Structure
Respectful of authority
Nonauthoritarian
Dislikes close supervision
Respectful of Tradionalists
Characteristics
Conformers
Optimistic
highly Motivated
Can-do attitude
Work Priorities
No1 Priority - work
To be a star
Fun and flexible
Money
Don’t rush things
Skill practice
Visual stimulation
Mentor programs
Technology
Unsure and resistant
Willing to learn
Technology savy
Technology superior
Career Goal
Build a legacy
Build a stellar career
Build a portable career
Build parallel careers
Slogans
Values
Provide
Authority
Train
Involvement in decision making
Were you involved as much as you wanted to be in decisions about your
% responding ‘Yes, definitely’
care and treatment?
%
Source: National Inpatient Surveys Care Quality Commission June
2016, n=83,000+
Searching for Health Information
Inflexible and Rule-Bound
• Assumes everyone
wants/needs the
same type of care
• No room for
personal goals
• Rigid, controlled by
professionals/syste
m
managers/regulators
Complex and Fragmented
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Not integrated
Uncoordinated
Confusing
Burdensome for
patients and carers
Using patient feedback for quality
improvement (2)
 The NPE Survey results
allow external
benchmarking: How do we
fare in comparison to our
overall Hospital Group or
nationally?
Source: Picker Institute Europe (2009)
Co-Production = promoting productive partnerships
to tackle difficult problems together
• ‘with’, not ‘to’ or ‘for’
• ‘what matters to you?’, instead of
‘what’s the matter with you?’
What Matters to You (individual)?
I want to
continue living in
my own home I want help to
manage my pain
for as long as
so I can sleep
possible
better and be
more active
I need advice on
how to eat a
healthy diet to
control my
diabetes
What Matters to You (group)?
We want fast
We wish more
access to
could be done to
stop people getting
good, safe,
ill in the first place
joined-up
local services
We think you should
provide better help
for older, frailer
people so they can
stay in their own
homes
What Patients Need to Know
• What are my options?
• What are the benefits and possible
harms?
• How likely are these benefits and
harms?
• How can you help me make a decision
that’s right for me?
Shared Decision Making
• Clinicians and patients working
together to select tests,
treatments, management or
support packages, based on
clinical evidence and the
patient’s informed preferences.
Coulter and Collins. Making Shared Decision
Making a Reality. King’s Fund 2011
Sharing Expertise
Clinician
Patient
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Diagnosis
Disease aetiology
Prognosis
Treatment options
Outcome probabilities
Experience of illness
Social circumstances
Attitude to risk
Values
Preferences
Changing Models of Care
Changing Roles
Personalised care planning
• Conversation between a
patient and a clinician to
jointly agree goals and
actions for managing the
patient’s health problems.
• Aim: to help people live well,
focusing on their goals and
concerns and supporting
their capacity for self-care.
Measurement is Not Enough
Hearts and Minds Matter More
Some common objections
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“We do it already”
“We don’t have the right tools”
“Patients don’t want it”
“We have too many other demands and priorities”
The Karesk Model of a Healthy Workplace
“A highly
engaged
employee cares
more for the
success of the
organisation.”
“A highly engaged employee cares
“ works harder for patients
Leading to improved
experience and better
outcomes for patients
Better Financial performance and greater productivity
Essential Elements of a Change Strategy
Strong, committed senior leadership
Dedicated champions
Active engagement of patients and families
Clear goals
Focus on the workforce
Building staff capacity
Adequate resourcing
Performance measurement and feedback
Coulter A et al BMJ 2014, 308: 225
“We don't see things as they are, we
see them as we are.”
Anaïs Nin
Contact and further info
 Web: www.patientexperience.ie
- HSE Lead, National Patient Experience Survey Programme
- June Boulger
- [email protected]
- 086 8069829
Tracy O’ Carroll, HIQA
[email protected]