MEASURING PATIENT'S EXPERIENCE

Measuring Patient's Experience

Measuring Patient's Experience

Introduction

Since 2002, the Department of Health has required data to be collected from millions of patients as part of the NHS patient survey programme. However, it was not until publication of High Quality Care for All (DH, 2008a) that patients' experience was placed alongside patient safety and clinical effectiveness as integral to the government's drive to improve quality in health care.

To ensure that quality improvement remains of high importance not only in policy but also in practice, the DH will:

* Require trusts to collect 'real-time' feedback to monitor patients' experience and to publish quality accounts;

* Require that measures of patients' experience be included in the 'vital signs' in the NHS operating framework and in the national indicator set;

* Reward high-quality performance through Commissioning for Quality and Innovation (CQUIN) (DH, 2008b);

* Provide guidance on gathering and using regular patient feedback (DH, 2009a; 2009b);

* Publish the results of national patient surveys on the NHS Choices website.

This new policy context creates an imperative to measure. The next step facing acute trusts is to address the question not of whether to measure but of how to do so while also articulating to themselves, their patients and staff why measurement is important.

Why Measure?

There are many good reasons for measuring patients' experience. Those that are of the most immediate concern to trusts are highlighted in bold in Box 1.

Box 1. Purposes of measurement

The purposes of measuring patients' experience are to:

* Understand current problems in the way care is delivered;

* Inform continuous improvement and redesign of services;

* Help professionals reflect on their own and their team's practice;

* Monitor the impact of any changes;

* Facilitate benchmarking between services/organisations;

* Compare organisations for performance assessment purposes;

* Inform referring clinicians about the quality of services;

* Inform commissioners about the quality of services;

* Inform patients about care pathways;

* Help patients choose high-quality providers;

* Enable public accountability.

Measure: What to Measure and Why?

At the DH's request, The NHS Information Centre for Health and Social Care (2009) has collated 'indicators for quality improvement', which will underpin quality improvement policy initiatives such as quality accounts. This comprehensive list of indicators has been drawn up based on those already used by healthcare organisations.

It includes five indicators that make explicit reference to nursing and numerous others in which nursing makes an important contribution (see Box 2).

It must be emphasised, however, that this is a rapidly changing policy area, and final guidance on what will need to be included in quality accounts has not yet been issued.

Nursing-Specific Indicators

* Score for patients who reported that nurses did not talk in front of them as if they were not there (PE39);

* Score for patients who reported that when they had important questions to ask a nurse, they always or sometimes were given answers they could understand (PE42);

* Score for patients who reported they always or sometimes had confidence and trust in the nurses treating them (PE43);

* Score for patients who reported that nurses always or sometimes washed or cleaned their hands before touching patients (PE54);

* Score ...