The User’s Perspective of Quality
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The User’s Perspective of Quality. David Stockwell Clinical Biochemistry Service Manager ABMU NHS Trust Tim von Pokorny Pathology Quality Manager Gwent Healthcare NHS Trust. Quality Management System Overview. Policies User requirement Standards

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The User’s Perspective of Quality

David Stockwell

Clinical Biochemistry Service Manager

ABMU NHS Trust

Tim von Pokorny

Pathology Quality Manager

Gwent Healthcare NHS Trust


Quality Management System Overview

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework


National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework


National Strategy

Local/Corporate Strategy

Strategic

alignment

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework

Service Delivery Model

Technology/Workforce


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework

Service Delivery Model

Technology/Workforce

Procedures


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework

Service Delivery Model

Technology/Workforce

Training

&

Competency

Assessment

Procedures


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework

Service Delivery Model

Technology/Workforce

Training

&

Competency

Assessment

Procedures

Output


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework

Service Delivery Model

Technology/Workforce

Training

&

Competency

Assessment

Procedures

Output

Audit

Meet SMART objectives?

Accuracy Timeliness Relevance?

Meet user requirement?


Why measure user satisfaction
Why Measure User Satisfaction

“Ongoing evaluation and improvement processes are essential to ensure that the service provided by the laboratory meets the needs and requirements of users”

CPA standards V2.00 September 2007


User Requirement

Legislation

National Strategy

Local/Corporate Strategy

Policies

User requirement Standards

SMART objectives -Accuracy Timeliness Relevance

Cost Benefit Framework

A

B

Service Delivery Model

Technology/Workforce

C D

Training

&

Competency

Assessment

E F

Procedures

G

Output

Audit

Meet SMART objectives?

Accuracy Timeliness Relevance?

Meet user requirement?

H


An approach to measuring user satisfaction

An approach to measuring User Satisfaction


User satisfaction
User Satisfaction

…Measure of how your organisation’s total product performs in relation to a set of customer requirements.

“How to Measure Customer Satisfaction”. 2nd edition.


Capturing information on user satisfaction
Capturing information on user satisfaction

  • Compliments

  • Complaints

  • Meeting forums

  • One to one conversation

  • Correspondence (email, letter)

  • Questionnaires


Questionnaire structure
Questionnaire Structure

  • Importance

  • Satisfaction

  • Comments


Q1. How important is the availability of access to advice / information from the Pathology Department?

Clinical Biochemistry NA 1 2 3 4 5 6 7 8 9 10

Cytology (Gynae.) NA 1 2 3 4 5 6 7 8 9 10

Cytology (non Gynae.) NA 1 2 3 4 5 6 7 8 9 10

Haematology NA 1 2 3 4 5 6 7 8 9 10

Histology NA 1 2 3 4 5 6 7 8 9 10

Microbiology NA 1 2 3 4 5 6 7 8 9 10

How satisfied are you with the availability of access to advice / information from the Pathology Department?

Clinical Biochemistry NA 1 2 3 4 5 6 7 8 9 10

Cytology (Gynae.) NA 1 2 3 4 5 6 7 8 9 10

Cytology (non Gynae.) NA 1 2 3 4 5 6 7 8 9 10

Haematology NA 1 2 3 4 5 6 7 8 9 10

Histology NA 1 2 3 4 5 6 7 8 9 10

Microbiology NA 1 2 3 4 5 6 7 8 9 10

Comments:




Graph showing combined mean importance score vs combined mean satisfaction score for each question
Graph showing combined mean importance score vs combined mean satisfaction score for each question


Priorities mean satisfaction score for each question

For

Improvement

(PFI)



Quick win pfis
Quick Win PFIs for our Primary Care Users


User for our Primary Care Users

Comments


Satisfaction index
Satisfaction Index for our Primary Care Users


Mirror survey
Mirror Survey for our Primary Care Users

  • Survey Employees

  • Highlights Underestimation of Importance

  • Facilitates Internal Feedback


WEQAS on-line survey Project for our Primary Care Users

Aims - Seek to demonstrate the potential of structured assessment of user requirement and satisfaction as a reliable, valid, robust indicator of service quality and its continued improvement.

  • Potential benefits:

  • Demonstrate the potential of user satisfaction as a reliable indicator of service quality.

  • Promote and roll out good practice – do once and share.

  • Reduce duplication of effort. – CPA requires regular surveys to be carried out

  • Giving all services access to “good” survey question design.

  • The results of structured all Wales surveys following a schedule of topics, will inform

  • future service planning and improvement.

  • Compare within and between lab performance of meeting user requirement by use of

  • the overall “satisfaction index”.

  • Contributing to developing key performance indicators that capture the value of

  • Pathology services.


Method: for our Primary Care Users

A proof of concept on-line survey using Survey Monkey has been conducted

Pilot to All Wales distributed to Quality Managers

April 2009: On line survey for national use distributed comprising 10 questions from the Gwent Healthcare NHS Trust user survey

Pilot to local users in ABMU (Swansea/Bridgend area)

April 2009: On line survey for local use distributed using the survey principles of the Gwent Healthcare NHS Trust user survey


http://www.surveymonkey.com for our Primary Care Users


How does it work? for our Primary Care Users

Step 1 – Design the survey


Users receive an email with a link to the survey: for our Primary Care Users

To complete the survey- please follow the attached link:

http://www.surveymonkey.com/s.aspx?sm=ZpY5MHue4oUTAPLMI6Ui4Q_3d_3d



Step 2 – User completes survey for our Primary Care Users


Step 3 – Collect the results for our Primary Care Users


Results for all user types… for our Primary Care Users


or filtered by user category… for our Primary Care Users(in this case Consultant medical Staff)




Satisfaction Index Calculation score….

Performance assessment - the satisfaction index (parametric example)

Mean and standard deviation of the “importance” and “satisfaction” responses will be calculated for each question. A weighting factor will be calculated from the (mean importance / ∑ importance). The “mean satisfaction” value will be multiplied by a weighting factor to calculate a weighted score based on importance. Satisfaction index (%) = ∑ weighted score *10

A satisfaction index is calculated for each Laboratory (and a sub-score for each discipline). Performance is assessed within and between Laboratories using the Satisfaction Index.


Further reading: score….

“How to Measure Customer Satisfaction”

2nd Edition, Nigel Hill, John Brierley and

Rob Mac Dougall. Gower Publishing Limited.

ISBN 0-566-08595-X

“Handbook of customer satisfaction

and loyalty measurement” 2nd Edition.

Nigel Hill and Jim Alexander. Gower Publishing Limited.

ISBN 0-566-08194-6

www.leadershipfactor.co.uk



A e sample questions
A&E – sample questions score….

  • Is there an agreement between A&E Consultant staff regarding requesting certain tests e.g. Thyroid function?

  • Does your Pathology deliver a service compatible with achieving A&E targets?

  • Is there a difference between the Pathology service:

    • Out-of-hours and within working hours

    • Between-Pathology disciplines

  • Form filling:

    • How dissatisfied are you with manual filling in of request forms?

    • How important is electronic test requesting?

  • Add-on tests:

    • How important is the ability to retrospectively add on tests?

    • How easy do you find this?


  • On-call mortician score….

    • How important is your on-call mortician service?

    • How satisfied are you with your on-call mortician service?

  • Toxicology:

    • Are you satisfied with the local toxicology service that is provided?

  • POCT pregnancy:

    • Do you use POCT pregnancy testing?

    • Are you satisfied with local provision?

  • POCT glucose:

    • How satisfied are you with the training and assessment of competency of users of POCT glucose devices?


  • POCT blood gases: score….

    • How compliant are medical staff with POCT blood gas analysis procedures? (e.g. individual password use, disinfection etc)

  • Results:

    • How important is the paper report?

    • How important is it to see on the computer whether the sample has been received yet by the laboratory (even if not yet analysed)?

  • Incidents:

    • How responsive is your Pathology Service to investigating relevant incidents which arise in A&E?

  • Emergency Planning:

    • Does your Trust have one system for assigning emergency specimen numbers for a major incident?

    • Does your A&E department have a stock of in-date tubes for sample collection for chemical incidents?


Who to contact
Who to contact? score….

  • To whom should questionnaire be sent?

  • Suggest:

    • All lead Consultants

    • Named Lead Nurse

    • Service Manager


Results
Results score….

  • Report for All-Wales

  • Sub-report for each individual Trust

  • ABMU to provide support for collation of results


In summary score….

  • The assessment of user requirement and satisfaction is a CPA requirement.

  • It informs your policies

  • It is important to have a structured approach to measuring this.

  • The degree of user satisfaction is as legitimate and important a measure of quality

  • as the more traditional assessments of accuracy/precision and timeliness.

  • Electronic survey methods enable Laboratories to compare their satisfaction scores

  • (when distributing identical surveys) and set bench marking standards.

  • It is a driver for continuous service improvement

Thank you


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