Patient Experience Now a Key Performance Measure for Acute Hospitals

The NHS Performance Framework now places great emphasis on measuring patient experience. The measure of patient experience sadly only applies to Acute Trusts and Mental Health Trusts. If one of these Trusts is failing on patient experience then it can only be ranked overall ‘performance under review’.

Performance on User Experience will be assessed by monitoring scores to a subset of survey questions in the national patient survey, which are categorised under 5 distinct “themes” that patients identify as important to them. The five broad headings that make up this domain are set out below:

I feel it is a shame that patient experience of primary and community services isn’t included. Poor experience and service in the community setting often means an admission and additional pressure on secondary care and a person deteriorating unnecessarily.

My Mum died sadly last June with primary bowel and secondary liver cancer. Her journey and experience over the 3 years since first symptoms appeared to the last months of her life were on a continuum of excellent (especially the blood transfusion service) to very poor (wouldn’t treat a dog that way).

Throughout Mum’s interactions with health professionals the one thing she wanted was to be seen as a person; with feelings and not an object (the patient) and her disease. Even more I and my brothers had to step in on occasions when it was assumed that because our Mum was older that it meant that her mental capacity was in question. A couple of times she spotted that she hadn’t been given some medication and when we brought it to a member of staff’s attention it was assumed Mum had forgotten – on both occasions it turned out to be Mum that was right. Mum kept her mental capacity to the last hour of her life and fortunately died as well as possible with her family with her and her grandchildren whom she adored and they her holding her to the end.

If building closer relationships means seeing the patient as a person and an equal partner in their care, then this is excellent. The patient and their family are a great source of control in the quality, safety and coordination of their care and treatment. Giving patients access to their medical records helps this even more. Please look at the excellent work of Dr Amir Hannan a paradigm pioneer in this area.

Maybe if we start talking about person-centred care (seeing the person the disease or condition has got) rather than as a patient (an object of care) then we may well make a step change in creating excellent service experience for people who use them and their families.

We need to consider how we help busy hospital clinicians raise the bar on patient experience especially building relationships and delivering safe, high quality patient care. Please see the work of Dr Gordon Caldwell on the Care by Design Better Care web pages.

I stayed at a great hotel last week where I was impressed that the group director’s mobile number and email was made available to all guests and there was a card to complete ranking overall experience and asking to name any member of staff who shone overall – wouldn’t it be interesting to do this in hospitals?

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Comments

  1. Good blog

    Most of us old fogeys like our Juniors to tell us something about who the person is, but the Juniors often fail to do this. I do not know why. I can only remember my patients if I know something about them.

    In San Diego, Dr Leda Felicio says to her Juniors

    “Give me the memory hook and the bullets”.

    I was watching one of her ward rounds, because I was interested in whether doctors and nurses spoke with each other on general wards in the States. I was at a Diabetes Conference.

    I can still recall a man on her round in his early 80s, dressed only in pajama bottoms, bald, having a blood transfusion for pancytopaenia caused by chemotherapy for his myeloma.

    I remember this because the memory hook was “He was one of the first pilots of a B52 bomber”.

    Last week we were looking after a man in his 70s with bad COPD – like many of our other patients. I said that the Juniors had not told me what his work had been.

    “I worked in cinema”

    “Do you mean as a projectionist or in making films?”

    “I was a camera man”

    “Oh, any films I might have seen”

    “I was on most of the Bond films and the Indiana Jones series”

    You can imagine how much more interested the Juniors suddenly became in him!

    We should be able to find something interesting about everyone, to help us to “connect” as Sam Shem, author of the black comedy “House of God” puts it.

    Doctors have to give human professional care and advice. Knowing who the patient is, binds us more strongly into the contract of clinical care.

    Once we care about the person, we will care for the person and care about handovers.

    — Dr Gordon Caldwell · Apr 12, 11:45 AM

  2. Your discussion on patient centred or person centred care resonates strongly with me on a personal level (I am a carer for my elderly mother who has dementia) and as a health care professional with a particular interest in service improvement through staff and patient engagement.
    Not sure if you have seen this video clip. I was moved to tears when I watched it. It illustrates vividly the importance of seeing the person in the patients we meet and care for in our daily work.
    http://www.wimp.com/reactionmusic/

    — Yolanda Fernandes · Apr 13, 01:50 PM

  3. I initially intended to leave a comment on your blog to mention how these days the hope of getting an appointment with my GP sooner rather than later is equivalent to trying to get concert tickets to the super famous. However also having read your blog post here, it struck a huge cord for me. The following quote ‘Maybe if we start talking about person-centred care (seeing the person the disease or condition has got) rather than as a patient (an object of care)’ bought me back to a time when my grandma was in hospital after a bad break to her hip, in the late stages of Alzheimer’s taking its hold, she was treated for her hip and her dementia not considered. Not eating her food was not a sign of non interest, she’d simply no longer had the skills to do so. She wasn’t seen as a whole person and her whole needs were denied. On returning to her care home after this stay in hospital, her health rapidly deteriorated and she passed away shortly after. I think person-centered care could have given her much more comfort.

    — Rebecca Butterworth · Apr 16, 10:34 PM

  4. I couldent agree more with the author on this one evem tho there are a few points I have diffrent outlooks on. dd1

    — Ezra · May 4, 05:37 PM

  5. I think it’s high time that people need to realize that patients are not only users of healthcare service, but valuable contributers to service redesign and co-creaters of healthcare.
    Not only that, relatives need to have a voice too. 2.5 million people over the age of 75 have informal care from relatives or friends, a quarter of them are age 65 years and over themselves.(The Information Centre 2010)
    I would direct you to the great work of the Health Foundation and NIHR CLAHRC for NWL in trying to engage and improve on patient and public interaction in the healthcare and scientific setting

    — John Soong · May 9, 06:42 PM

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