TAKING PATIENT EXPERIENCE TO THE NEXT LEVEL

“I am constantly looking for new ways to use the information coming through, keeping staff engaged is key to the success of the programme. “

Averil Boon, Programme Manager of Patient Experience at Bay of Plenty District Health Board (BOPDHB), is passionate about driving improvement in patient experiences. The Bay of Plenty region itself is located on the north-east coast of New Zealand’s North Island, incorporating a major port and some of the most beautiful beaches in the country, serving a population of 226,530 people[2].

In 2014, BOPDHB saw an opportunity. The Health Quality and Safety Commission (The Commission) had embarked on a journey to deliver a national patient experience programme across New Zealand. The Commission launched The National Patient Experience Survey (NPES) with Cemplicity to experience and evaluate the quality of inpatient care across every public hospital in New Zealand.

The programme is unique in that it offers each individual hospital district the ability to gather feedback more frequently and to ask more questions specific to their location, beyond the specific needs of The Commission. The idea being that individual districts could use this ‘best practice’ framework to drive genuine improvement ahead of the NPES, which would continuously benchmark progress across the whole country.

BOPDHB quickly took up the option for higher frequency surveying, seeing this as an opportunity to create a real-time patient feedback loop.

“Getting the data in real-time is vitally important as I can act instantly “

– Averil Boon, Programme Manager of Patient Experience at BOPDHB

Medication Side Effects
The survey itself covers 4 domains of care including communication, partnership, coordination and physical and emotional needs . Across these domains, Medication Side Effects and Condition Management have consistently scored the lowest across all district health boards, BOP included.

“The main benefit for being part of a National Programme is I think it’s good to realise everyone is struggling with the same aspects of care. It’s nice to know you aren’t an outlier “

The Commission engaged an independent consultant to determine[1]. Why patients were reacting negatively to Medication Side Effects and Condition Management in the NPES and 2. Design a cost-effective interventions programme DHBs could roll out to improve them. Ultimately, the report hoped to drive improvement in patient outcomes, reduce re-admission rates and in turn, reduce costs associated with re-admissions. You can read the full piece on the study here. (https://www.hqsc.govt.nz/assets/ Consumer-Engagement/Publications/Raising_ the_bar_on_the_National_Patient_Experience_ Survey_-_May_2017.pdf)

In response to this report 2016 BOP DHB trialled pharmacy students in the ‘transit lounge’ (the final place patients visit before being discharged)

to be on hand to explain further, information around the medication side effects. Resource available at discharge is becoming increasingly important as care at home becomes more common. By using Cemplicity’s reporting portal to track feedback around experiences at discharge during the time the students were present, Averil was able to see noticeable improvements in real-time, illustrating one of the key benefits of a continuous, real-time programme.

Patient Stories
But it’s not just specific projects that drive positive patient experiences at BOPDHB, the Cemplicity programme delivers a constant stream of KPI’s and patient stories for Averil and her team.

“The real value for me is in the comments, it’s an endless bucket of information”

The comments provided can open up how one area of care has influenced a patient’s overall experience. For example, a patient may use the wording ‘apart from one nurse’ identifying the area of care where improvement could be made. They also provide insight on a project that may be happening at a hospital and key word searches can provide insight into what patients are picking up on in relation to the project.

With the word cloud users can quickly identify themes as they develop, enabling users to see associated themes and where areas may be overlapping. These word clouds often bring through information regarding aspects of care that aren’t directly asked about in the survey but have been important to patients through their experience and shared by several others.

Part of Averil’s daily routine involves checking the comments and the Contact Register, Cemplicity’s alerts algorithm, gives users the tools to act immediately when things have gone awry. If a patient provides their contact details Averil has the ability to follow them up that day, assign someone to the case and take immediate action. Following up on this feedback as soon as it comes in prevents future patients from experiencing the same issue.

Engaging Staff
Showing staff and patients that the feedback patients have taken the time to give is being listened to has proven key to the success of the programme at BOPDHB. Inspiration from a trip to the Cleveland Clinic led to comments from patients being incorporated into the hospital entrance. Hospitals are usually a place that can seem impersonal and through displaying positive patient stories to those arriving it creates a sense of welcome to those walking the corridor, reassured by positive experiences of others. Having the comments on display not only in the main corridor but also on ward noticeboards keeps patients, visitors and staff engaged with the programme.

The Cemplicity system is integrated in several levels of the DHB from a ward level through to the board. On wards feedback from the patients are visible on noticeboards alongside data on incidents on the ward, upcoming events and other logistical topics. Ward managers are able to use the information to build into staff reviews and at a higher-level board reports, where trends in patient experience over time are shared along with standout patient stories.

Final Thoughts
Building on their participation in the National Programme has enabled BOPDHB to drive change within their district. Improving patient experience and building partnerships are part of the annual plan in Bay of Plenty which they are constantly working towards using feedback from the Cemplicity portal and wider clinical data to achieve.

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[1] See our case study here on the national programme.

[2] https://www.health.govt.nz/new-zealand-health-system/my-dhb/bay-plenty-dhb/population-bay-plenty-dhb

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