dr. katja stahl, picker institut deutschland, hamburg, germany 00 49 40 22 75 95 77
DESCRIPTION
Paris La Villette - Cité des Sciences et de l’Industrie Lundi 25 et mardi 26 novembre 2013. Plénière n°2. Les programmes d’expérience du patient. PATIENT EXPERIENCE Instruments, methodolgy, results. Dr. Katja Stahl, Picker Institut Deutschland, Hamburg, Germany 00 49 40 22 75 95 77 - PowerPoint PPT PresentationTRANSCRIPT
Dr. Katja Stahl, Picker Institut Deutschland, Hamburg, Germany00 49 40 22 75 95 77 [email protected]
Les programmes d’expérience du patient
Paris La Villette - Cité des Sciences et de l’Industrie
Lundi 25 et mardi 26 novembre 2013
Plénière n°2
PATIENT EXPERIENCEInstruments, methodolgy, results
Agenda
2
Patient experience - IntroductionPatient experience – Instruments & Methodology– Questionnaires– Survey procedure
Patient experience – The reality– Leading dimensions– Actual results
Patient experienceIntroduction
4
Patient experience
Communication and empathy influence health outcomeConsistent associations of patient experience with safety and effectiveness of carePrerequisite: Well-designed instruments & sound methodology
A valid measure?
Patient experienceInstruments & Methodology
6
The Picker Institutes"Understanding and respecting patients' values, preferences and expressed needs is the foundation of patient-centred care.“ Harvey Picker
7
Picker methodologyQuestionnaires & Procedure
8
Inpatient questionnaire contentEmergency Admission
Elective Admission
DoctorsNurses
Pain Surgery
Leaving the hospital
Facilities & Service
Overall impression
9
Picker methodologyQuestionnaires & Procedure
10
Report Questions
Minimizing ceiling effects
Minimizing confounding effects due to gratitude, expectations, demografic
characteristics
More realistic & actionable
answers
12
Picker methodologyQuestionnaires & Procedure
13
Postal survey after dischargeEvaluation of
the whole care
process
No worries
about
negative consequences
Emotiona
l distance to
the event
Anonymity
14
Picker methodologyQuestionnaires & Procedure
15
Picker clients(patient inpatient surveys, n≈400 hospitals)
> 800 beds
600-800 beds
300-600 beds
< 300 beds
Private, not for profit
Private, for profit
Public, not for profit
16
Transparency initiativesKlinikführer Berlin2007/08 (29 hosp.)
Klinikführer Rhein-Ruhr2004 (38 hosp.)
2005/06 (74 hosp.)2007/08 (75 hosp.)2010/11 (51 hosp.)
Klinikführer Bremen2010 (12 hosp.)2012 (12 hosp.)
Patient experienceThe reality
18
Picker Report 2013 Patient experience: leading dimensionsDimensions of patient experience and their influence on the overall experience
The interaction with health professionals are by far the most important dimensions for a positive overall experience
0,0%² 0,2%² 0,7%² 2,0%² 2,3%² 2,9%²
7,5%²
14,1%²
15,4%²
Doctor-patient-realtionship
29,9%²
Nurse-patient-relationship
30,9%²
²Influence (%) on overall experienceNurse-patient-interaction Rest & PrivacyDoctor-patient-interaction Information before dischargeFacilities & Service Involvement of family & friendsPerceived Outcome SurgeryCleanliness FoodAdmission
19
Picker Report 2013 Patient experience in German hospitals1
From the patients‘ perspective communication & information before discharge are the areas in most urgent need of improvement.
1Survey data from 111.835 patiens, 197 hospitals, 2009-12²percentage of answers indicating improvement areas
Cleanliness
Perceived Outcome
Nurse-patient-relationship
Surgery (information risks & benefits)
Facilities
Food
Admission
Rest & Privacy
Doctor-patient-relationship
Involvement of family & friends
Information before discharge
0% 10% 20% 30% 40% 50%
10%
15%
16%
17%
17%
18%
18%
21%
22%
30%
47%
Problem score2
20
The patients‘ perspective on information before discharge
Information on purpose of medication
Information on danger signals
Information on resuming usual activities
Information for support for relatives
Information on medication side effects
29%
42%
50%
61%
63%
Problem Score (%)
21
The patients‘ perspective on communication
Courtesy of doctors
Confidence in doctors
Important questions answered comprehensibely
Information about patient for relatives
Test results explained comprehensibly
One doctor in overall charge for care
Anxieties and fears discussed with doctor
Opportunity to talk to doctor for relatives
Involvement in decisions about care
8%
16%
20%
22%
29%
29%
32%
37%
47%
Problem score (%)
22
Picker Report 2013 Patient and employee experience
Quality of patient centered care from the patients‘ and the nurses‘ perspective1
1survy data of 27.300 patients and ca. 15.000 employees 2006-12
25 30 35 40 45 50 55 60 6505
10152025
Conditions of patient centered care (nurses)(% problem score)
Nur
se-p
atie
nt-r
e-la
tions
hip
(% p
robl
em s
core
)
0 10 20 30 40 50 6005
1015202530
Conditions of patient centered care (doctors)(% problem score)
Doc
tor-
patie
nt-r
ela-
tions
hip
(% p
robl
em s
core
)Quality of patient centered care from the patients‘ and doctors‘ perspective
23
Take home messagePatient experience• is a crucial part of high quality health care• reflects quality of care if it is measured with valid instruments
and sound methodology• is too important to be measured ‚quick and dirty‘• needs to be incorporated in quality measures for health care
planningInteraction with health professionals
• is the most important dimension for a good overall patient experience• is related to health professionals‘ experience of the conditions of patient-centered care
Communication, involvement & discharge information
• are the areas most urgently in need of improvement from the patients‘ perspective
24
Merci de votre attention!
Picker Institut Deutschland gGmbHKieler Straße 222769 Hamburg Tel.: 0049 (0)40 227 595 70Fax: 0049 (0)40 227 595 71Mail: [email protected]