Getting patient feedback in real-time. New Zealand Artificial Limb Services journey to providing a patient-centered healthservice

The New Zealand Artificial Limb Service (NZALS) provides a critical health service to enable people with artificial limbs to live independent and productive lives. They care for over 4,400 people through five city-based Limb Centres and 14 regional clinics throughout New Zealand.

Their vision is to offer a whole-of-life, world-class service. Crucial to achieving this vision is the recognition that every patient is different. People don’t walk in and take a new limb off the shelf; each new limb is made for each person individually. What’s more, enabling a person to live a good life with an artificial limb is about much more than the limb itself. The different physical and emotional needs of each patient must become part of the service, and this requires the very best, systematic approach to patient-centred practices, including how patient feedback is gathered.

Before approaching Cemplicity, NZALS would survey patients annually, who were asked to rate their overall satisfaction with NZALS. The results were always extremely positive, but the approach had its limitations.

“We were using old school market research approaches, but it wasn’t a well- integrated option and it didn’t have real time reporting,” says CEO of NZALS, Sean Gray. “For instance, we might hear about a patient experience months after the event — we didn’t have an opportunity to escalate those issues that needed to be addressed at the time.

Using the Cemplicity platform we’re able to respond immediately. It allows us to collect quantitative data, but also gather patient stories which allow us to improve our service in a very timely way.

Charts below show very good overall satisfaction and trust and confidence in the NZALS


Repairers went out of their way to make me feel comfortable and confident to walk again

– NZALS patient feedback

There were several reasons NZALS approached Cemplicity to develop a patient driven continuous improvement programme. It was, for instance, important that the surveys would be conducted independently.  “We contract Cemplicity to contact our patients on our behalf and Cemplicity then presents NZALS with anonymous survey results. That protects the individual’s privacy and independence,” says Sean. “And of course, it also means the integrity of the results is maintained.”

However, if patients are not happy, or have an issue that needs addressing, they have the option to ask staff to get in touch through the survey. “So we can respond, by phone or email, and we’re generally able to address the patients’ concerns.” For example, a patient asked, “How can I get help in my region?” leaving us with their mobile number enabling a follow-up phone call and referral to a clinic nearby.

It was also important that the Cemplicity platform met the IT requirements that govern data collection for publicly funded health services in New Zealand. Cemplicity’s platform has been used by the Health Quality and Safety Commission in their national programme, the organisation responsible for leading and coordinating improvements in safety and quality in health care in New Zealand. “So we didn’t have to go through that very time-consuming risk assessment process.”

A final reason for choosing Cemplicity was its willingness to tailor the service to the NZALS budget. It was clear from the outset of discussions that Cemplicity was committed to contributing to great patient outcomes and prepared to work with clients to ensure the Cemplicity platform was accessible, no matter what the size of the organisation was.

Below is an example of a Contact Register

Patient surveys are now conducted within a month of any interaction a patient has with NZALS, which might be after a patient has been fitted for a new limb, for the repair of an existing one, or for a variety of reasons. The survey typically takes patients 15 minutes, and patients are asked a number of questions developed by NZALS. This includes asking patients to rate overall satisfaction with their device —  such as whether they’re satisfied with the functionality, look and fit of the artificial limb. There are also questions about the service — such as whether they received a rehabilitation plan and if they were involved in the development of that plan. Patients are invited to highlight any particular concerns, or make suggestions about how any aspect of the service could be improved.

These details are important to NZALS explains Sean; “We have a moral responsibility to regularly benchmark our services, to identify what is going well, and where the opportunities for improvement are. We also have contractual requirements to collect data about how our patients rate their satisfaction with our service.

It offers much more than a box-ticking exercise. This programme is informing tactical decision making every day, enabling incremental improvements that are leading to collective improvement across the service.”

Importantly, the feedback captured by Cemplicity delivers insights that can be usefully shared with a range of audiences. This includes funding agencies, such as District Health Boards and the Accident Compensation Corporation. “We’re able to show our funders that we’re doing a great job, and the funders can use our information in their own KPIs.  So, we’re providing them with data that has been independently collected, that demonstrates our value to funders, that allows them to demonstrate their value to their management.”

The feedback is also valuable to NZALS staff, which includes orthopedic surgeons, vascular surgeons, rehabilitation physicians, prosthetists and orthotists, and physio- and occupational therapists. “Staff love it,” says Sean. “They’ve welcomed the chance to get feedback on their own work. It’s nice to be told you’re doing a good job. It’s important to talk about what needs improving, but we can forget to celebrate our successes.  Being praised when they’re doing a great job is very motivating for our teams.”

Every stage was handled in a professional but personal manner. I cannot speak highly enough about all of the staff.

– NZALS patient feedback