dr. katja stahl, picker institut deutschland, hamburg, germany 00 49 40 22 75 95 77

Dr. Katja Stahl, Picker Institut Deutschland, Hamburg, Germany00 49 40 22 75 95 77 stahl@pickerinstitut.de

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: info@pickerinstitut.dewww.pickerinstitut.de