1 Patient Outcomes & Experience Measurement in Podiatry Results from two NHS departments.
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1 Patient Outcomes & Experience Measurement in Podiatry Results from two NHS departments
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Transcript of 1 Patient Outcomes & Experience Measurement in Podiatry Results from two NHS departments.
1
Patient Outcomes & Experience Measurement in Podiatry
Results from two NHS departments
2CoMetrica © 2010
Clinician“I see your ulcer is
healing nicely”
Commissioner“prove these
treatments actually do any good”
Outcomes are easy to see - aren’t they?
Patient thinks“maybe but I still
can’t get to the shops”
Carer/relative thinks“is this the best
treatment available?”
3CoMetrica © 2010
of everyone not a skewed sample
accurately the right measures at the right time
quantitatively recognised , benchmarked
qualitatively fast direct feedback to the department
continuously not an annual survey – “ticking the
box”
So how can you measure Outcomes & Experience?
CoMetrica © 2010
4
Choose your census points along the patient pathway
Referral 1st visit After visitAfter
treatment
Short-term follow-up 6-12 weeks
Long-term follow-up 6
months+
Key:Clinical Outcomes
Patient Experience
•Generic PROM•Specific PROM •Pre - Tx
•Communication•Organisation•information
•Generic PROM•Specific PROM
•Accessibility•Cleanliness•Facilities•1st impressions
•Pain•Pain management
•Privacy &Dignity•Competency•Information
•Generic PROM•Specific PROM •Post - Tx
•Generic PROM•Specific PROM •Long Term f/up
•Communication
You don’t have to see the patient again to follow them up longer term
5CoMetrica © 2010
standard PROMS and local measures
clinical AND experience multiple question types:
multiple choice image drawing free text return image recognition Visual Analogue Scales
different questions for each patient group & pathway stage
Example measures available
6CoMetrica © 2009
clinical images e.g. What do your feet look most like? comparative data follow-up use any images
Image based questions
7CoMetrica © 2010
Pilot scope 500 patients in summer
2010 Measures:
generic health foot health patient experience
+ continuous daily feedback from patients
Responses 276 returned, 54% response
rate 3% on-line 97% on paper
50% of responses back within 1 week of dispatch
results updated daily volumes provided
statistically significant results
South Birmingham Podiatry ServiceMandy Cadge – Podiatry Services Manager
8CoMetrica © 2010
Overall resultsScale At treatment
startAfter 60 days
Discharged
Responses n 127 (51%) 121 (50%) 23 (50%)
Average resultsGeneric health PROM – EQ5D
0= feel like “death”1= perfect health
0.55 0.63 0.56
Foot health PROM - FHS
0= maximum pain, mobility restriction1=no pain, concern, restriction
0.52 0.57 0.59
Experience: Communication
0% = “poorest”100% = “best possible”
90%
Experience: Clinical environment, access, facilities
0% = “poorest”100% = “best possible”
86%
Experience: Clinical competency
0% = “poorest”100% = “best possible”
88%
Experience: Overall satisfaction
0% = “poorest”100% = “best possible”
95% 87% 85%
9CoMetrica © 2010
Foot Health Score
•Gain reduces with age•Patient groups likely to be more significant than age
Low volume bands excluded
10CoMetrica © 2010
Patient Experienc
e
•High scores generally
•Recall of being provided with information lowest
•Further breakdown by location, staff etc. valuable
11CoMetrica © 2010
Project scope ALL patients going
through prevention team 1000 patients over 5 weeks
in Sept/Oct 2010 Measures:
generic health foot health patient experience Health advice reception &
impact + continuous daily
feedback from patients
Responses 560 returned, 56% response
rate 2% on-line 98% on paper
Consistent response rate across service
Solent Healthcare (Portsmouth) PodiatryMathew King – Project lead
12CoMetrica © 2010
Overall resultsScale At treatment
startAfter 90 days
Responses n 178 189
Average resultsGeneric health PROM – EQ5D 5
0= feel like “death”1= perfect health
0.50 0.57
Foot health PROM - FHS
0= maximum pain, mobility restriction1=no pain, concern, restriction
0.51 0.58
Clinical Competency perceived
0% = “poorest”100% = “best possible”
84%
Experience: Overall satisfaction
0% = “poorest”100% = “best possible”
91% 93%
Health Advice (only for relevant patients) Motivational Made a difference
Diabetes Explanations understood of impact & specific care advice given
79%
Smoking 53% 50%Weight Management 68% 0%
13CoMetrica © 2010
Foot Health Score 2
•Marked improvement in all areas
14CoMetrica © 2010
Detailed reports
•Demonstrating reduction in pain frequency as a result of treatment
15CoMetrica © 2010
Foot Health Score 2
•Change in foot health by department’s own severity/ treatment classification
16CoMetrica © 2010
Patient Experienc
e
•Can review by:
•Location•Staff•Pt Age•Category•Treatment
Clinic A Clinic B Clinic C Clinic D Clinic E Clinic F Clinic G Clinic H
17CoMetrica © 2010
Highly visible patient engagement, inclusive reach
No front line effort, standard reports save time
Continuous results linked to patient data
Operational qualitative tool – daily feedback
PROMS & benchmarks are powerful commissioning
levers
Differential value by patient groupings evident-
prioritisation?
Conclusion
