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Understanding and responding to patients’ experiences: the national context Richard Gleave. Patient Feedback. Feedback is from patients’ experience following care and treatment as near real-time as possible.

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Understanding and responding to patients experiences the national context richard gleave l.jpg

Understanding and respondingto patients’ experiences:the national contextRichard Gleave


Patient feedback l.jpg
Patient Feedback

Feedback is

  • from patients’ experience

  • following care and treatment

  • as near real-time as possible

We could not have asked for a better service – she was seen quickly by very competent and kind staff who were sensitive to her needs, made sure she was given adequate pain relief and quickly fixed her arm. She came out smiling and happy!

  • Dr Jones

  • Trust

  • Listen

  • Recommend

  •       This doctor is highly rated

90%

65%

100%



There is growing interest in using real time feedback to understand patients experiences l.jpg

is the systematic collection, analysis and reporting of feedback from patients immediately or soon after care or treatment, and the use of this insight to drive up quality

enables organisations to collect and act on information quickly, to focus on local priorities at a ward, clinic or departmental level and to get rapid feedback on improvements made in response

complements the information available from the National Patient Survey programme, conducted to a set timescale with nationally agreed questions

Real-time patient feedback

Real-time patient feedback

Real-time patient feedback

There is growing interest in using real-time feedback to understand patients’ experiences


Why put patient experience centre stage local reasons l.jpg
Why put patient experience centre stage – local reasons

  • Quality of service

  • “Repeat business” model


Why put patient experience centre stage national drivers l.jpg

Delivery Drivers

National Policy Drivers

Operating Framework sets out the case for commissioners and providers to work together to improve experience

Local CQUIN Schemes must include some measures of patient experience

Quality Accounts must include progress on measures in CQUIN schemes

Regulatory Regime– the Act setting up CQC says it must look at people’s needs and experiences of care

National Contractsrefer to the monitoring of quality

High Quality Care for All confirms quality is the organising principle behind everything that we do

NHS Constitution sets out rights and pledges relating to the quality of care. Commitment to the quality of care is one of six NHS values

The Operating Framework sets out the 2009-10 requirement

These combine to accelerate implementation of quality improvement programmes

Why put patient experience centre stage – national drivers


Patient experience is a critical dimension of quality l.jpg

Patient

Experience

Quality as the organising principle

Clinical Effective-ness

Safety

Patient experience is a critical dimension of quality

Successful quality improvement programmes require a sound understanding of patients’ experiences of care

Getting feedback directly from patients enables NHS organisations to identify what needs to change to make their services more responsive to the people who use them

Providers and commissioners need to have strong links between patient experience and the wider range of information that can be collected to improve services


The quality framework l.jpg
The Quality Framework

Bring clarity to quality – standards

Measure quality

Publish quality performance

Recognise and reward quality

Clinical leadership

Safeguard quality

Stay ahead

  • Expanded role for NICE

  • NHS Evidence

  • Metrics – local, national, international

  • Clinical dashboards

  • Quality accounts

  • NHS Choices

  • International measures

  • CQUIN

  • SHAs – Medical Directors; clinical advisory boards

  • National Quality Board

  • Care Quality Commission

  • SHA duty to innovate

  • Innovation funds and prizes

  • Academic Health Science Centres

  • Health Innovation and Education Clusters


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Principles for Quality Improvement

National

Co-production at all levels of the system

Regional

Local

Subsidiarity

Team

Local clinical ownership of indicators

Sources of evidence-based indicators include Royal Colleges, specialist societies, NHS Information Centre, universities, commercial sector


The operating framework l.jpg
The Operating Framework

“Commissioners and providers will want to work in partnership to implement systems that respond to the views and experiences of patients and improve the patient experience of services. The opportunity to have near real-time feedback of patients’ experience gives providers and commissioners an unprecedented opportunity to respond to changes and improve the patient experience.”



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There is widespread enthusiasm in the NHS for real-time patient feedback but implementation is variable and unsystematic

  • Appetite for feedback has increased significantly – nationally and locally

  • Some providers are ahead of the game and are already collecting and using real-time patient feedback and a range of technologies

  • Others need support to get started

  • Commissioners are starting their journey also, linking into World Class Commissioning competency 3


The secretary of state s commitment l.jpg
The Secretary of State’s commitment patient feedback but implementation is variable and unsystematic

“we need to ensure that the patient is placed even closer to the centre of the NHS. That is why I’m going to be asking every hospital Trust over the next year to collect immediate feedback from patients on their experience of care. Each hospital will know within two weeks how patients feel about their care. Only then can we start to link patient experience with the clinical outcome”.


Going further l.jpg
Going Further patient feedback but implementation is variable and unsystematic

  • Not just for hospitals – GP and community services

    2. Not just collect – use to transform services and lever up quality

    3. To empower patients and support choice


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The NHS needs to use patient feedback more effectively and report what it has done as a result of that feedback

From: To:

  • Collecting data by itself has no value – surveys need to result in actionable data

  • if you ask the wrong question, the answer will never be right (or you won’t know what needs to be changed to improve experience)

  • Close the feedback loop to demonstrate to patients and the public that change has resulted from their feedback

  • Reporting timescales will differ

    • Variant of quality triangle, time continuum or frequency curve to show different between operational and strategic uses of patient feedback

  • Reporting vehicles will differ

    • ward, clinic, department level reports – ward boards and posters

    • NHS Choices

    • Quality Accounts, CQUIN schemes, annual reports,


Using data to bring about change l.jpg
Using data to bring about change report what it has done as a result of that feedback

  • Create a culture that values deeper understanding of customers

  • Invest in the skills and resources to deliver the change

  • Invest time in defining the purpose of data collection and collecting he right data

  • Integrate customer data into performance management systems

  • Segment customers

  • Develop a ‘single customer view’(360 picture bringing all customer data together)

    National Social Marketing Centre


Real time patient feedback serves a multiplicity of purposes l.jpg

Provider report what it has done as a result of that feedback

Serviceimprovement

Serviceplanning

Real-time Right-time

Informing

Commissioning

Contract

Management

Local

Accountability

Strategic

planning

Commissioner

Real-time patient feedback serves a multiplicity of purposes

  • For providers, it offers a unique opportunity to make measurable improvements in service quality in a variety of settings, in order that services become more responsive

  • PCTs need real-time patient feedback to support commissioning and accountability


The nhs is getting better at gathering patient feedback in a variety of ways and at different times l.jpg
The NHS is getting better at gathering patient feedback in a variety of ways and at different times

  • National patient surveys

  • Local patient surveys

  • Hand-held technology

  • On-line surveys

  • Patient stories

  • Feedback websites

  • Kiosks

  • Comment cards

  • Bedside terminals

  • Compliments and complaints

  • Focus groups

  • Membership groups

  • Telephone interviews

  • On-line communities

  • PALS data

  • Walking the floor


To deliver the nhs needs to build capacity and capability l.jpg
To deliver, the NHS needs to build capacity and capability variety of ways and at different times

  • Local (co-production and subsidiarity)

    • PCTs and providers to work together to avoid over-burdening patients and to use the system

    • Clear Leadership

    • Build into engagement strategies

  • National - what DH will do

    • Guidance, building on work to date and sharing good practice

    • Learning network to draw on experience of early adopters to accelerate progress

    • Engaging with suppliers


What really matters to patients l.jpg
What really matters to patients variety of ways and at different times

  • Get the basics right

  • Fit in with my life

  • Treat me as a person

  • Work with me as a partner


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