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Through the patient's eyes : measuring and improving outpatient cancer and blood disorder patients' experience… Oh, Ron; MacLeod, Emily 2014

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THROUGH THE PATIENT?S EYES: MEASURING AND IMPROVING OUTPATIENT CANCER AND BLOOD DISORDER PATIENTS? EXPERIENCE OF CARE Ron Oh and Emily MacLeod N344 Synthesis Course UBC School of Nursing Background ? In 2012/2013, the BC Patient Reported Experience Measures Steering Committee conducted a province-wide survey to ask patients, who have a confirmed diagnosis of cancer or a blood disorder, for feedback about their experience of care.  ? The goal of the survey was to better understand the experience of patients in order to improve the quality of outpatient cancer care and services in BC.  Background ? Since the 2012/2013 Outpatient Cancer Care survey was fielded in BC and at St. Paul?s Hospital changes have taken place in care delivery models, including a significant increase in the use of oral chemo only agents, teleheath strategies, and the increased focus on emotional distress and support.  ? In order to account for these changes, BC PREMs created an abridged form of the provincial patient experience survey.  The Purpose ? The goal is to utilize abridged form of the provincial patient experience survey to better understand patients' experiences and needs in order to provide actionable information to support quality improvement efforts at the point-of-care.   ? Students from the UBC School of Nursing were recruited to assist the project manager in making the vision a reality. The Students? Work Plan Deliverables Dates Orientation and Project Planning October 2014 Environmental Scan/ Literature Review October ? November 2014 Create Key Informant Interview Guides December 2014 Conduct interviews and pilot surveys with staff and patients January 2014 Draft Summary Synthesis Report February 2014 Literature Review ? The students performed a literature review to discover how/if real-time data is being utilized in the health care system to improve the quality of care.   ? The literature review revealed that real-time feedback is not a common practice in the health care field, but that it has great potential to increase patient satisfaction & inform staff . Key Informant Interview Guides ? In order to test the feasibility/practicality of capturing real-time patient experience data at the point of care, the students created Key Informant Interview Guides.  ? The guides were made up of questions for both patients and staff/nurses. The patient interviews were held immediately after they completed the short form patient experience survey. The staff interviews were held at a time that was convenient for them.   Key Informant Interview Guides ? The interview questions aimed to: ? Identify processes for collecting patient experience and satisfaction information that can enhance (and not impede) patient/providers relationships.  ?Explore how collecting patient experience and satisfaction information can make available information to improve care immediately with minimal administrative burden.  The Interviews ? Examples of staff interview questions: ? Do you feel real-time information about patient experience and satisfaction would be helpful? If so, why? If no, why? ?What specific data do you feel would be most valuable to inform efforts to improve the patient?s experience of care while they are still receiving care? ? Examples of patient interview questions: ? Do you think providing your opinions about the care you receive at St. Paul?s is important? If yes, why? If no, why not? ? Do you think that the process of completing a survey about your experience of care while you are still receiving services could affect the care you receive? Interview Results ? What the staff said: ? ?Collecting real-time patient experience would improve the quality of  care, make care more individualized, and promote professional growth.?  ?All staff agreed that offering emotional support during cancer and blood disorder treatment is extremely important.  ?All staff agreed that it is extremely important to assess a patient?s level of emotional distress during treatment. Interview Results ? What the patients said: ? ?I would feel comfortable sharing my feedback directly to my health care providers...Even if  the feedback is negative, staff  need to hear it in order to avoid future mistakes.?  ? ?If  I was to criticize the care I received, I supposed it could affect the care I was receiving, but it wouldn?t inhibit me from being truthful.?  ? Some patients felt that their emotional support needs were not at all met by their care providers.  Future Implications ? Input from staff and patients will be used to inform future initiatives to collect patient experience and satisfaction data at the point of care in a way that fits into daily workflow and immediately improves care.   ? Project findings should be used to implement patient experience and satisfaction surveys on other units and in other hospitals.  

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