Treatments and technologies matter, but patients most want to be seen as people

Patient stories are a raw and compelling new kind of online feedback. They can prompt rapid improvements in services – if the NHS is willing to embrace them | The Guardian Healthcare Network

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People have always shared their experiences of healthcare, usually privately, with family, neighbours or workmates. But online, patients and carers are increasingly willing to share accounts of their health service encounters with the wider world, often in intimate detail. There are websites devoted to collecting and publicising patient ratings and reviews of healthcare professionals, services, diagnoses and treatments.

The stories of patients and carers are becoming an unavoidable part of modern healthcare. In the US, people searching online for information about local services are more likely to read patient comments than official clinical outcome measures or patient experience metrics. In the UK, staff routinely read online patient feedback and share it on social media. NHS regulators have even started to think in terms of monitoring and analysing patient stories to provide an “early warning” for when things might be going wrong.

Read the full news story here

CQC Adult inpatient survey 2016

Read the results of the latest analysis, which looks at the experiences of adult patients in hospital | CQC

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The results of the 2016 inpatient survey indicate that there have been small, but statistically significant improvements in a number of questions, compared with results dating back to the 2006, 2011 and 2015 surveys. This includes patients’ perceptions of:

  • the quality of communication between medical professionals (doctors and nurses) and patients
  • the standards of hospital cleanliness
  • quality of food

However, the results also indicate that the results of some questions have been less positive. This includes patients’ perceptions of:

  • being involved in decisions about their care and treatment
  • information sharing when leaving hospital
  • waiting times
  • support after leaving hospital

The full overview is available here

What does patient feedback reveal about the NHS?

Research finds that staff are likely to be evaluated both positively and negatively according to their interpersonal skills.

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Objective: To examine the key themes of positive and negative feedback in patients’ online feedback on NHS (National Health Service) services in England and to understand the specific issues within these themes and how they drive positive and negative evaluation.

Results: Overall, NHS services were evaluated positively approximately three times more often than negatively. The four key areas of focus were: treatment, communication, interpersonal skills and system/organisation. Treatment exhibited the highest proportion of positive evaluative comments (87%), followed by communication (77%), interpersonal skills (44%) and, finally, system/organisation (41%). Qualitative analysis revealed that reference to staff interpersonal skills featured prominently, even in comments relating to treatment and system/organisational issues. Positive feedback was elicited in cases of staff being caring, compassionate and knowing patients’’ names, while rudeness, apathy and not listening were frequent drivers of negative feedback.

Conclusions: Although technical competence constitutes an undoubtedly fundamental aspect of healthcare provision, staff members were much more likely to be evaluated both positively and negatively according to their interpersonal skills. Therefore, the findings reported in this study highlight the salience of such ‘soft’ skills to patients and emphasise the need for these to be focused upon and developed in staff training programmes, as well as ensuring that decisions around NHS funding do not result in demotivated and rushed staff. The findings also reveal a significant overlap between the four key themes in the ways that care is evaluated by patients.

Public involvement in health research

The National Institute for Health Research has launched a campaign urging patients and the public to get involved in health and social care research.

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The #twosides campaign highlights ways for people who aren’t medical or academic professionals to play a part in shaping research, for example through suggesting research questions, reviewing research applications,
joining a study team or being a study participant.

Additional link: NIHR press release

The impact of inadequate health literacy among older adults

Macleod, S. et al. Geriatric Nursing. Published online: 12 January 2017

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Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care. Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP® Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures.

Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL.

Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures.

Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions.

Read the full article here

UK hospital patient discharge: the patient perspective

Wright, S. et al. European Journal of Hospital Pharmacy. Published Online: 13 January 2017

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Image source: Alex Williamson – Wellcome Images // CC BY-NC-ND 4.0

Objectives: Hospital discharge is a complex process that can result in errors and delays for patients, particularly around the supply of medicines and communication of information. To improve patient discharge, patient perspectives of the discharge service must be explored to determine where patients feel problems arise. This study aimed to explore inpatient perceptions and experiences of the current discharge process.

Conclusions: This study showed that certain aspects of the discharge process need improving to provide safe, quality care for patients and improve patient experience of discharge. The findings from this study will inform the development of a new model of care for patient discharge from hospital.

Read the abstract here

How well do we currently care for our dying patients in acute hospitals: the views of the bereaved relatives?

Mayland, C.R. et al. BMJ Supportive & Palliative Care. Published Online: 17 January 2017

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Background: The National Care of the Dying Audit—Hospitals (NCDAH) is used as a method to evaluate care for dying patients in England. An additional component to the 2013/2014 audit was the Local Survey of Bereaved Relatives Views using the ‘Care Of the Dying Evaluation’ (CODE) questionnaire.

Conclusions: Adopting a postbereavement survey to NCDAH appears to be feasible, acceptable and a valuable addition. On the whole, the majority of participants reported good or excellent care. A small but significant minority, however, perceived poor quality of patient care with clear and timely communication urgently needed.

Read the full abstract here