Capturing patient experience data

Lord Darzi’s 2008 report, High Quality Care for All,1 states that “the patient experience can only be improved by analysing and understanding patient satisfaction with their own experiences.” And that, “we will make payments to hospitals conditional on the quality of care given as well as the volume.” This has placed greater accountability on NHS Trusts to accurately measure patient feedback. Not only is there a requirement to analyse Patient Reported Outcome Measures (PROM) results, but Trusts must also research the patient experience in order to identify measures which could develop and improve patient care. The Government Whitepaper Working Together: Public Services On Your Side highlighted significant changes that NHS Trusts and other service providers would have to make to ensure that minimum standards of service are met. A greater emphasis on empowering patients to have their say was made and has, since the introduction of the Performance Framework for NHS Providers (2009) become fundamental as a core measurement of standards. The Government later released its Whitepaper An Information Revolution in Public Services, which identified a requirement for NHS Trusts to find new methods to improve the patient experience. This highlighted the need for accurate information collection, with the view that the effective analysis of this data could help to identify problems and redesign services to deliver excellence and satisfaction in patient care.

An unclear definition

However, within the NHS today, the definition of “patient experience” is still not clear. Some Trusts relate patient experience to ‘customer care’ issues, while others confuse patient experience measures with PROMs. Some clinicians believe that patient experience data is only useful as a measure of specific clinical outcomes. There is, therefore, still a requirement to identify “key areas” of patient experience that all agree are the fundamentals to quality measurement. The present Government has ambitions to achieve healthcare outcomes that are: “Among the best in the world, which can only be realised by involving patients fully in their own care, with decisions made in partnership with clinicians, rather than clinicians alone.”2 The Government states that international evidence demonstrates that involving patients in their care improves their health outcomes, boosts satisfaction with the services received and increases knowledge in their personal health and chosen treatment. Following the recent Information Revolution consultation, data will have to be made freely available in order to provide the public with more information and a wider choice of care. To do so, many Trusts will have to change the way information is accessed, collected and analysed. A developer of data capture solutions, Formic believes, that it is best to capture the patient view at the point of delivery which, it says, provides fast, accurate results that will give insight for management to make measurable improvements. In his 2010 White Paper for the NHS the Secretary of State for Health, Andrew Lansley, said: “At present, PROMs, other outcome measures, patient experience surveys and National Clinical Audit are not used widely enough.” He goes on to say that more widespread use of patient experience surveys and real-time feedback will be encouraged, and that patients will be able to rate services and clinical departments according to the quality of care they have received. Hospitals will have to be more open and accountable about mistakes and staff feedback will play an important role in making improvements to the quality of patient care. Patient outcomes monitoring is closely related to clinical audit, and the two could be integrated, alongside other measurements of the patient experience as a whole. Programmes such as these seek to improve treatment outcome and the patients overall experience. Information, such as physiological, medical and personal information could be collected. Indeed, much of this information is already held by many NHS Trusts, albeit in multiple clinical databases. The programmes also measure survival rates and the physical improvement of the patient. Various results are often adjusted according to “case mix” so that reliable evidence can be made available for clinicians, managers, patients and the general public. The area of monitoring treatments, feedback and the setting and achieving of clinical audit and patient outcome and experience objectives will become of increasing focus. While most Trusts already have clinical audit teams that are experienced in clinical audit and statistical analysis, these have been predominantly focussed on gathering information from internal clinical sources. The switch in emphasis toward patient feedback will mean that they now have to put in place the methods and processes for obtaining this information in volume, while also ensuring its quality. Given the financial constraints that are likely to apply to these teams, it is likely that they will need to find new and innovative ways of achieving this. In the future NHS Trusts will have to act more like commercial organisations – not only ensuring they are financially stable, but above all customer focused. However, unlike other sectors, healthcare is in its infancy in putting the customer first. Patients today are customers who are used to making decisions and choices on products and services by reading reviews on the Internet. To date the NHS is not able to show patients comments from other people before they put their life, or their family’s life, in the hands of a clinician. It is hoped that the adoption of a patient-centric approach to systems will encourage patients to provide their feedback and take some responsibility for their care. Patients will then be able to make comparisons between NHS Trusts. However, it is important that they can make these comparisons based on information that has been carefully assessed and accurately presented. It also needs to be personalised and should reflect other patient opinion – with the option to make comment and provide ratings.