TransformingPatient Experience:

The essential guide

www.institute.nhs.uk/theguide

Transforming Patient Experience:the essential guide

This resource is for people with designated

responsibility for improving the  patient

experience – both as providers of services and as

commissioners. It is intended to provide

you with the evidence you need to influence others – both

at board level and team level, to focus on improving patient

experience.

The resource provides a rich source of research evidence,

stories from patients and staff, along with many examples of

innovative ideas. It illustrates a range of well-tested

techniques to help you work more closely with patients to

understand their experience and use it to improve

services.

The Research

In 2010 the Department of Health and the NHS Institute commissioned King’s

College London and The King’s Fund to undertake research into: What Matters

To Patients? Developing the Evidence Base for Measuring and Improving

Patient Experience. The research featured interviews with patients, case

studies from across health services and resources provided by people working

to improve services.

The research includes:

• What matters to patients – particularly in the non-acute sector.• What do NHS organisations in England currently measure in relation to what

matters to patients?• Examples of NHS organisations who are using information and insights into

patient experience to improve the quality and productivity of health care services.

Why Improve Patient Experience?

Understanding what matters

to patients

Start with the patientExperience is personal and although some

experiences are common to many, everyone experiences things differently

Each experience is made up of a Number of experiences or ‘moments

What matters to patients

• Feeling informed and being given options

• Staff who listen and spend time with the patient

• Being treated as a person, not a number

• Patient involvement in care and being able to ask questions

• The value of support services

• Efficient processes

Commissioner and provider challenges

The challenge to providers: How will you transform

the experience of patients in your care?

The challenge to commissioners:

How will you work in partnership with the services

you commission to enable them to deliver a

positive patient experience?

Key factors to consider

Patient Experience Improvement Programmes

need to be:

• Embraced by leaders• Connect to the role of

staff experience• Use the power of stories

• Central to the organisations

vision and culture

Functional or Relational?

Why Improve Patient Experience?

Making the case for patient

experience

Making the case for patient experience

• It is imperative that the NHS now makes a concerted effort to collect a body of evidence that will convince business leaders across the service of the importance of investing in improving patient experience.

• The business case for experience includes: the evidence of the impact of experience on organisational reputation, the impact of patient choice and increased control of care and treatment on experience, the link between experience and health outcomes, the link between experience and cost of care and the relationship between staff and patient experience

Making the case for patient experience

“The experience of patients have of the treatment and care they receive – how

positive an experience people have on their journey through the NHS can be even more

important to the individual than how clinically effective care has been"

Lord Darzi, The Next Stage review

Making the case for patient experience

• Patient experience is a key element of quality alongside providing clinical excellence and safer care

• The staff experience and the organisational culture that supports it are the most important elements of any customer experience programme

• Senior leadership and support for experience is essential

How to Improve Patient Experience?

Measuring Experience

Measuring experience

Methods of collecting and reporting patients' feedback should be tied as closely as possible to clinical services so that clinicians identify with the results.

Middle managers and clinical teams should monitor quality of care as often as they monitor budgets

NHS trust commissioners, planners and policy makers should make use of the data collected to support management and improvement of front line services and should avoid demanding fresh collections of data for their own purposes

What does good measurement look like?

• Commit resources to develop local infrastructure for collecting, analysing, interpreting and reporting on patient experience data

• Collect information about patient experience in a variety of ways

• Use feedback to improve services

• Facilitate and support the ongoing involvement of patients

• Prepare staff and equip them to respond

• Triangulate data from different sources to try and get a more complete picture

The 7-step measurement process

The seven step process makes the link

between data collection, analysis,

finding and reports patterns and

communicating both the decisions and

the process to patients and the public.

We collect data from patients about their

experience (both qualitative and

quantitative), we analyse it (turn it into a

format that helps us see patterns, trends)

and then review our service in the light

of this intelligence. In other words the

data we have gathered help use make

better decisions about how to move the

service forward.

Why Improve Patient Experience?

The

importance of

organisational

culture

The journey of culture change

Themes for organisations to focus on

• A Board that is accountable for and committed to patient experience and its continual pro-active improvement.

• An organisation engaged with patient experience that understands the value of it to the organisation, its staff and patients.

• Patient Experience is built into the organisation’s short and long-term business plan

• The organisation has a clear vision (together with values and standards) for patient experience – known and understood by everyone in the organisation – including staff and patients

• Patient Experience is considered an equal partner in Quality, alongside Clinical Effectiveness and Safety

Themes for organisations to focus on

The link between staff experience and patient

experience is recognised; staff experience is also

captured and linked into patient experience.

The role of teams is recognised.

The organisations maximises and values the value of

hearing the patient voice.

A resource (budget, staff, systems) is dedicated for the

capture of feedback, analysis of data and

implementation of quality improvement to services as a

result of that measurement activity.

The organisation knows what it costs them to improve

patient experience and can measure the impact

resulting from that investment

How to Improve Patient Experience

Helping leaders to

Improve Patient

Experience

Helping leaders to improve patient experience

“The two main attributes of the organisations that were collecting experience data and using it to make changes were visible leadership and an organisational culture in which staff know that

Patient Experience was a priority”

King’s College London and The King’s Fund, What Matters to Patients, 2011

Key features of organisations who are successfully delivering patient experience

• Committed board members – with nominated

Board Experience Champions

• Strong direction and leadership from the top

• Grass roots/front line involvement – backed by

top level support

• Individual leaders can make a significant

impact in enabling services that have not

been in the forefront of gathering Patient

Experience feedback data to embrace a more

modern approach to doing so.”

The role of the board/managementteam

• The board should support the development of the patient experience improvement priorities, vision and strategy for patient experience.

• By linking patient experience with clinical effectiveness and safety the board has the opportunity to develop a clear picture of quality in the organisation

• In addition, the board members can ensure that patient experience is always on the agenda and by playing a positive role in gathering feedback, “walking the floor” regularly, talking to staff and patients.

Top Ten Things the board can do

Why Improve Patient Experience?

Commissioning for a Positive Patient

Experience

“You have the right to expect your local NHS to assess the health requirements of the local

community and to commission and put in place the services to meet those needs as considered

necessary”.

NHS Constitution

The critical list - Commissioners

Commissioners need to ensure that their decisions are

informed by knowledge of the patient experience.

• Providers and commissioners need to develop share

patient experience goals as part of developing good working relationships

• Incentive systems need to be aligned so that they recognise and reward innovative patient experience measurement and improvement in local organisations

Key themes from the research

• Work in partnership• Consider patient experience as

a key dimension of Quality• Provide personalised care• Ensure continuity of care and track

experience along patient pathways as well as

individual service• Understand the challenge and scope for improving patient

experience in individual organisations• Evaluate and support provider organisations to deliver a positive patient

experience

Top Ten Things commissioners can do