As the Australian healthcare system continues to evolve, policies such as GP co-payments have raised controversy amongst patient groups. Indeed, when any complex system is looking to improve itself, a critical stakeholder from which feedback should be assessed is the end-user. However, when creating new policies we approach expert academics, industry bodies, doctors, nurses, practitioners, politicians and consultants, yet how often do we broadly consult healthcare’s end-user?
Thankfully, state health departments have more recently emphasised quality metrics linked to patient experience. Many of our public hospitals are now required to demonstrate that they are collecting and improving patient experience. However the system’s evolution in Australia is lagging behind the UK, where the National Health Service faced a more urgent crisis with the Mid-Staffordshire NHS Trust between 2009-10. At the time, overall care was found to be concerning and in several instances negligent. An £11million investigation of care in the Trust between 2005 – 09 led by Robert Francis, QC demonstrated major gaps between senior management and front line staff and patients.
According to Francis’ report “The Trust failed to listen to patients’ concerns, the board did not review the substance of complaints and incident reports were not given the necessary attention. The Trust’s board was found to be disconnected from what was actually happening in the hospital and chose to rely on apparently favourable performance reports by outside bodies such as the Healthcare Commission, rather than effective internal assessment and feedback from staff and patients.”
Following the outcomes of the investigation and the development of more patient-centred measures, the Prime Minister David Cameron said in 2012 – “I am determined to give patients a far greater voice within the NHS as a way of highlighting the best and worst of care within our hospitals. I want the NHS to put patient satisfaction at the heart of what they do and expect action to be taken at hospitals where patients and staff say standards are not good enough.”
Whilst we have yet to experience a similar crisis in Australia, CEO’s of health services and hospitals are still scratching their heads in determining the best strategies to collect, analyse and improve patient experience. In addition, the complexity of the data provides additional fodder to management meetings where budgets and priorities have to be allocated. Whilst patient experience data seems like an additional complication, it really should be seen as an important opportunity.
Patient feedback, when analysed well and actioned appropriately, provides important insights on how to deliver better outcomes and cost savings to a hospital through better targeting of projects and solutions. As demonstrated in the UK, alleviation of patient concerns in an early stage acts as an ‘early warning system’ that can reduce systemic errors and multi-million dollar lawsuits. There are also often many positive stories that can be effectively shared in the organisation to lift morale and staff engagement.
The ‘Future Solutions in Australian Healthcare White Paper’ noted that empowering consumers and listening to their feedback is one of the drivers of innovation in the healthcare system. The more ‘end-users’ are collectively involved in shifting the system forward, the greater the impetus for change – the same is true for any complex system.
Healthcare managers should consider a 4-step approach to improving patient experience. The first is to have a systematic strategy and data-gathering process – how you collect experiences and ask the questions is critical. The second is to analyse the data effectively to translate them into actionable insights – there are now ‘big data’ technologies available that can do faster and more effectively than analysts. The third is to action and implement changes through a cross-functional prioritisation process. Visibly demonstrate the results of feedback and management actions to drive culture change, motivation and results. Finally, monitor experience with performance to ensure that solutions are continuously aligned with patient needs.