300 likes | 306 Views
Standard 2: Partnering with consumers. Nicola Dunbar, Accrediting Agencies Surveyor Workshop, 10 July 2012. Why have a Standard about partnering with consumers?.
E N D
Standard 2:Partnering with consumers Nicola Dunbar, Accrediting Agencies Surveyor Workshop, 10 July 2012
Why have a Standard about partnering with consumers? • Declaration of Alma Ata (1978)“The people have the right and duty to participate individually and collectively in the planning and implementation of their health care” • Benefits of partnerships associated with: • experience of care • business and operations of delivery health services • work environment • clinical quality and outcomes: • decreased mortality • lower readmission rates • fewer healthcare associated infections • reduced length of stay • improved adherence to treatment • improved functional status
The Standard • Leaders of a health service organisation implement systems to support partnering with patients, carers and others consumers to improve the safety and quality of care. • Patients, carers, consumers, clinicians and other members of the workforce use the systems for partnering with consumers.
Three criteria • Consumer partnership in service planning • Governance structures are in place to form partnerships with consumers and/or carers • Consumer partnership in designing care • Consumers and/or carers are supported by the health service organisation to actively participate in the improvement of the patient experience and patients health outcomes • Consumer partnership in service measurement and evaluation • Consumers and/or carers receive information on the health service organisation’s performance and contribute to the ongoing monitoring, measurement and evaluation of performance for continuous quality
1. Consumer partnership in service planning 2.1: Establishing governance structures to facilitate partnership with consumers and/or carers • Why? • Consumers have a unique perspective that can help identify opportunities for improvement that might not otherwise be apparent • What? • Develop / adapt a framework that includes requirements for involving consumers in clinical and organisational governance (2.1.1) • Develop and implement a policy for identifying and involving diverse groups who access your services (2.1.2)
1. Consumer partnership in service planning 2.2: Implementing policies, procedures and/or protocols for partnering with patients, carers and consumers in: • strategic and operational/services planning • decision making about safety and quality initiatives • quality improvement activities • Why? • Need to take a systematic approach to partnering with consumers • What? • Develop / adapt and implement systematic processes for involving consumers in: • strategic and/or operational planning (2.2.1) • decision-making about safety and quality (2.2.2)
1. Consumer partnership in service planning 2.3: Facilitating access to relevant orientation and training for consumers and/or carers partnering with the organisation • Why? • Ensuring that individuals have the necessary skills and capacity to engage with healthcare providers is essential for effective partnerships • What? • Develop / adapt / provide access to orientation training and resources for consumers who participate in governance processes (2.3.1)
1. Consumer partnership in service planning 2.4: Consulting consumers on patient information distributed by the organisation • Why? • 60% of the population have a low level of health literacy • Need to present information in a way that can be understood by target audience • What? • Develop and implement a systematic process for sourcing consumer feedback on publications (2.4.1) • Use consumer feedback to inform development and refinement of patient information publications (2.4.2)
2. Consumer partnership in designing care 2.5: Partnering with consumers and/or carers to design the way care is delivered to better meet patient needs and preferences • Why? • Benefits of involving consumers in design and redesign projects: • improved communication and teamwork • better consumer experiences • better patient flow • What? • Develop / adapt and implement a systematic process for involving consumers in design and redesign projects (2.5)
2. Consumer partnership in designing care 2.6: Implementing training for clinical leaders, senior management and the workforce on the value of and ways to facilitate consumer engagement and how to create and sustain partnerships • Why? • One of the most effective change mechanisms for improving the experience of patients is education and training for healthcare providers • What? • Develop / adapt / provide access to training and resources on partnering with consumers (2.6.1) • Involve consumers in providing training (2.6.2)
3. Consumer partnership in service measurement and evaluation 2.7: Informing consumers and/or carers about the organisation’s safety and quality performance in a format that can be understood and interpreted independently • Why? • Increases transparency about performance and potential for engagement with the community • What? • Develop / adapt and implement a policy on providing safety and quality performance information to the community, consumers and carers (2.7.1)
3. Consumer partnership in service measurement and evaluation 2.8: Consumers and/or carers participating in the analysis of safety and quality performance information and data, and the development and implementation of action plans • Why? • Ensures that consumer perspective is considered in interpretation of, and response to safety and quality performance information • What? • Develop / adapt and implement a process for involving consumers in: • analysis of organisational safety and quality performance data (2.8.1) • planning and implementation of quality improvements (2.8.2)
3. Consumer partnership in service measurement and evaluation 2.9: Consumers and/or carers participating in the evaluation of patient feedback data and development of action plans • Why? • Ensures that consumer perspective is considered in interpretation of, and response to patient feedback information • What? • Develop / adapt and implement a process for involving consumers in: • the evaluation of patient feedback information (2.9.1) • planning and implementation of quality improvements identified through patient feedback information (2.9.2)
General issues – 1 • What is a consumer? • Patients, family members, carers etc who are currently or have recently used the service • Patients, family members, carers etc who have used the service in the past • Representatives from consumer groups, disease-based groups etc, members of local community All items and all standards
General issues – 2 • Different terms – same concepts: • Consumer partnerships • Consumer / patient / community / citizen engagement • Consumer participation • Consumer-centred care / patient-centred care / patient and family-centred care • Key principle: • Improving the health service by… • … using the knowledge, skills and experience of … • … people who are using, have used or may use the health service All items and all standards
General issues – 3 • Some jurisdictions have programs / requirements / legislation in this area – will determine nature of processes for partnering with consumers • eg legislated consumer advisory committees in Victoria • eg consumer engagement framework in Queensland All items
General issues – 3 • Methods for partnering with consumers can vary depending on the nature of the organisation and context: • Size of the health service • Nature of services provided • Staff and resources available to support partnerships • Availability of local consumer groups / individuals • Nature of community served – demographics, geographic spread etc • Development of partnership processes to date – recognising that these are new concepts and some items are core, but most are developmental All items
General issues – 4 • Methods for involving consumers could include: • Representative on board • Representatives on relevant committees • Consumer advisory committee or similar • “Critical friends” or other less formal groups – more ad hoc groups that may be suitable for smaller organisations, or specialist areas • Holding planning days, forums or workshops with consumer participants – also joint consumer/staff workshops • Consultation process to seek feedback – could be a large formal processes, or small targeted consultations on discrete issues Methods for involving consumers particularly relevant for 2.1, 2.2, 2.4, 2.5, 2.8, 2.9
General issues – 5 • Methods for involving consumers could include (cont): • Focus groups / waiting room discussions / informal meetings • Meetings with community and consumer organisations • Can also gain information about the views of consumers from: • Patient experience and other consumer surveys • Real time feedback forms • Review of complaints • Providing information publicly and inviting comment Methods for involving consumers particularly relevant for 2.1, 2.2, 2.4, 2.5, 2.8, 2.9
General issues – 6 • Policy frameworks: • Can have one overall policy framework that sets out requirement for involvement of consumers and has a set of associated policies / protocols / plans that cover specific ways in which consumers will be involved • Can have policy framework reflected in terms of reference and documents for relevant governance structures (eg consumer advisory committee or board) • Can have separate consumer partnership / engagement etc policies for the whole organisation • Can have consumer partnership policies for specific clinical areas (eg maternity, paediatrics) • Can have consumer partnerships include in policies for other organisational activities and functions (eg safety and quality, review of patient experience information) All items
General issues – 7 • Need documentation of systems and processes to partner with consumers: • Documentation from formal structures such as committees, policies, consultation processes, training etc • Documentation needed even for less formal methods such as critical friends groups, waiting room discussions: • could be in the form of project plans, reports of feedback obtained, file notes of discussions etc • Where the involvement is based only on processes to seek feedback from consumers: • need indication of how this information feeds into organisational governance processes All items
Specific issues – 1 • Consideration of hard to reach groups (2.1.2): • Formal assessment of community profile (or similar process) not necessary • Should be some recognition / understanding of nature of population served documented as part of the policy framework for involving consumers • Strategies for involving consumers in hard to reach groups relevant to local population should be included in policy framework • Processes for involving consumers from hard to reach groups may not be across the whole health service – may initially be focussed in areas where there are particular issues (eg drug and alcohol services, mental health)
Specific issues – 2 • Training and support for consumers and/or carers (2.3.1): • Could include: • written information • training and education • ongoing support • Does not need to be developed or delivered internally – there are external organisations that can provide such training, or have material that can be adapted • Demonstration of training could include: • policies regarding need / support for training • training calendar • attendance records • training materials
Specific issues – 3 • Consulting consumers on patient information (2.4.1 and 2.4.2): • Not all health services will develop their own patient information publications: • they may be obliged to use certain documents and have no control over the content (eg from state health departments) • they may choose patient information publications from consumer / disease groups / professional associations – if possible they should try and choose resources that have been developed in consultation with consumers • if using external publications – need to consider whether they need to be tested locally (eg if there are differences in local population) • Need to demonstrate not only that feedback has been obtained from consumers, but that it has been considered when publications are finalised Core items
Specific issues - 4 • Partnering with consumers to design care (2.5.1): • There are a range of methodologies for designing care (eg service redesign, user-centred design, experience-based design etc) • The focus of this item is not on the specific methodology used • The focus is about the need to involve consumers: • both as part of the design / re-design process (eg collecting feedback about experiences, including consumers in processes to generate solutions) • and also as part of the governance process (eg on steering committees)
Specific issues – 5 • Training for workforce (2.6.1): • Training can be part of orientation, continuing professional development, online education etc • Focus of training is on partnering with consumers when care is provided – rather than partnerships at an organisational or governance level • Does not need to be developed or delivered internally – there are external organisations that can provide such training, or have material that can be adapted • Demonstration of training could include: • policies regarding need / support for training • training calendar • attendance records • training materials Core item
Specific issues – 6 • Involving consumers in training (2.6.2): • Can involve consumers both in design and delivery of training • Different methods for involving consumers in delivery can be used, such as: • inviting consumers to speak about their experiences • using video or audio recordings of consumers’ experiences • undertaking exercises where workforce “live in the patient’s shoes” • Documentation can include: • records of meetings, focus groups etc where consumers provide feedback on training • training materials involving consumers • feedback from consumers involved in training • records of training provided by consumers
Specific issues – 7 • Provide consumers with information about safety and quality (2.7.1): • Focus is on providing information about safety and quality performance in a way that can be can be easily understood by consumers • Can include making information available to the general public (eg through the media, web site), as well as providing information to consumers who use the health service (eg posters / displays) • Documentation can be based on information made available to consumers Core item
Resources • Safety and Quality Improvement Guide for Standard 2 • Additional material about Standard 2 to follow from the Commission • Jurisdictional programs • National and state-based consumer groups • Other Australian organisations and resources • International organisations: • Picker Institute / Picker Europe • Institute for Family and Patient Centered Care
Summary • Purpose of the Standard is to support effective partnerships between consumers, patients, carers, healthcare providers and health service organisations at all levels of healthcare provision, planning and evaluation • There is no one way of achieving this purpose – strategies that are needed to establish and maintain partnerships will depend on context • Health services need to demonstrate that they engage consumers, and use the information they provide to improve services • www.safetyandquality.gov.au • nicola.dunbar@safetyandquality.gov.au