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Transcript of Health Connection: Evaluating the quality and impact of a public health telephone response service...
Health Connection: Evaluating the quality and impact of
a public health telephone response service
CHNC Conference: Knowledge to Action - June 17 th, 2010Presenters: Reina Barker, RN, BSc.N
Joyce Fox, RN, BSc.N, MHS
22
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
OutlineOutline
Overview of Health ConnectionOverview of Health Connection Review Health Connection Client SurveyReview Health Connection Client Survey
Purpose & ObjectivePurpose & Objective Methodology Methodology Survey limitationsSurvey limitations Findings Findings RecommendationsRecommendations Implementation enablers & barriersImplementation enablers & barriers
33
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Health ConnectionHealth Connection local public health information and referral servicelocal public health information and referral service
serves as the first point of contact for the public seeking serves as the first point of contact for the public seeking access to public health information and the services, access to public health information and the services, programs and resources programs and resources
service consist of 8 separate linesservice consist of 8 separate lines access is primarily by phoneaccess is primarily by phone staffed by public health nurses, public health inspectors and staffed by public health nurses, public health inspectors and
customer service representativescustomer service representatives inquiries relate to the full spectrum of public health topicsinquiries relate to the full spectrum of public health topics
health promotion approach used to help clients get the health promotion approach used to help clients get the information, knowledge and skills required to make choices information, knowledge and skills required to make choices that support health that support health
44
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Client Survey Client Survey conducted as part the data gathering activities of a larger conducted as part the data gathering activities of a larger
Health Connection reviewHealth Connection review
external researcher hired to conduct the survey of clients who external researcher hired to conduct the survey of clients who access HCaccess HC
to identify changes to improve the client experience and to identify changes to improve the client experience and service deliveryservice delivery
undertaken as a way of obtaining information directly from undertaken as a way of obtaining information directly from users with respect to:users with respect to:
client characteristicsclient characteristics client satisfaction client satisfaction how clients use the service and the information providedhow clients use the service and the information provided the impact of the service on clientsthe impact of the service on clients client needs and expectations client needs and expectations barriers to using and accessing the servicebarriers to using and accessing the service
55
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Research QuestionsResearch Questions
Does Health Connection provide information and service Does Health Connection provide information and service that meets the needs and expectations of its users?that meets the needs and expectations of its users?
How satisfied are users with the information and service How satisfied are users with the information and service provided?provided?
What are the barriers to using and accessing the What are the barriers to using and accessing the service?service?
What changes are needed to improve the effectiveness What changes are needed to improve the effectiveness and the quality of the service?and the quality of the service?
66
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
MethodologyMethodology
telephone surveytelephone survey
eligible clients solicited by staff between October 9 – eligible clients solicited by staff between October 9 – November 16, 2007November 16, 2007
clients contacted 2-3 weeks later by independent surveyorsclients contacted 2-3 weeks later by independent surveyors
sample size = 290 sample size = 290
data analyzed using SPSS software and descriptive statistics data analyzed using SPSS software and descriptive statistics complied for each itemcomplied for each item
77
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
SampleSample
60% of clients solicited to participate actually completed the survey60% of clients solicited to participate actually completed the survey
Target and Actual Number of Survey Solicitations and Completions
0
100
200
300
400
500
600
700
800
Solicitations Completions
Survey
Nu
mb
er
Target # Acutal #
70% of Target
83% of Target(n=290)
88
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
LimitationsLimitations
Reliance on human reporting as the primary data source Reliance on human reporting as the primary data source
Potential respondent bias related to social desirability of Potential respondent bias related to social desirability of responses responses
Potential selection bias related to staff soliciting clients to Potential selection bias related to staff soliciting clients to participateparticipate
Small sample size and resulting sensitivity to Small sample size and resulting sensitivity to respondents responses. respondents responses.
99
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Client CharacteristicsKey Findings: Client Characteristics
predominantly female (88%)predominantly female (88%) majority had completed post secondary education (60%)majority had completed post secondary education (60%) geographical breakdown of respondents close to population distribution in geographical breakdown of respondents close to population distribution in
Simcoe and Muskoka Simcoe and Muskoka
Financial Status among Survey Respondents
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Not enough money for necessities Enough money for necessities Enough money for necessities & someextras
Enough money for necessities, extras &saving
Financial Status
Per
cen
t
1010
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Access to ServiceKey Findings: Access to Service
service was accessed equally throughout the dayservice was accessed equally throughout the day
Number of Times Called Health Connection in the Past Year
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1st time caller 1-2 3-5 > 5
Frequency of Calling in the Past Year
Per
cen
t
Among Repeat Callers (N=113)
1111
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Access to ServiceKey Findings: Access to Service majority of respondents heard about the service through a notice to majority of respondents heard about the service through a notice to
callcall most were seeking informationmost were seeking information
Reason for Calling Health Connection
To Obtain Information77%
To Access Service5%
To Book an Appointment16%
To Report Something2%
1212
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Access to ServiceKey Findings: Access to Service
86% of respondents reported being satisfied to very satisfied with 86% of respondents reported being satisfied to very satisfied with their overall experience of how their call was directedtheir overall experience of how their call was directed
most respondents who went to voicemail reported feeling most respondents who went to voicemail reported feeling comfortable doing socomfortable doing so
Direction of Health Connection Client Calls
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Put right through and spoke toone person
Put right through; spoke to morethan one person
Call w ent directly to voice mail Other
Call Direction
Per
cen
t
1313
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
Respondents reported a high level of satisfaction with Respondents reported a high level of satisfaction with the service, information and recommendations provided the service, information and recommendations provided
by staffby staff
92% indicated they were 92% indicated they were very satisfied/satisfiedvery satisfied/satisfied with with Health Connection service Health Connection service
87% said they would use HC service again87% said they would use HC service again
89% would recommend service to family and friends89% would recommend service to family and friends
1414
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & ImpactClient Perceptions of Quality of Interaction with Health Connection Staff
(Strongly Agree / Agree responses)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Provide the information that was requested
Was well explained
Fully understood the problem
The information was helpful
Staff were knowledgeable
Was prepared for the appointment
The information was easy to understand
Provided appropriate information and choices
Staff demonstrated sensitivity
Spoke to me in a courteous manner
Percent
1515
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
Client Perceptions of Quality of Information Provided by Health Connection Staff (Strongly Agree / Agree responses)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Staff able to assist me in accessing resources
The action recommended was effective in solvingthe problem
Information helpful to seek out other communityresources
The information will help me to better deal withthe issue/similar issues in the future
Staff able to assist me in setting up anappointment
Information helped me to better understand theissue
The information helped me to better deal with theissue
Percent
1616
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
Client perception of the helpfulness of the service
Themes Examples of responses/subthemesFrequency of responses for
this theme
Supportive staff
staff very knowledgeable staff very supportive and provide reassurance staff professional, felt very comfortable speaking with staff staff provided good advice and resources
59 %
Knowledge gained
linked to additional resourcesquestions were answered, issues addressed , second opinion very helpful mailed out additional information after call
25%
Service convenience
access to appointments 12%
1717
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
65% of respondents indicated they followed up with the recommendations 65% of respondents indicated they followed up with the recommendations made by staffmade by staff
Overall Ability to Meet Needs of Client
0%
10%
20%
30%
40%
50%
60%
70%
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Level of Satisfaction
Per
ce
nt
1818
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
Most respondents reported accessing the service had a Most respondents reported accessing the service had a positive impactpositive impact
57 % obtained new information57 % obtained new information
11% changed their behavior11% changed their behavior
4% had either increased confidence in dealing with issue, 4% had either increased confidence in dealing with issue, decreased stress and were reassured by the support decreased stress and were reassured by the support
1919
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
HC services currently being provided are meeting or exceeding client HC services currently being provided are meeting or exceeding client expectationsexpectations
Client perception of Desired Features of a Health Information Service as Compared to Actual Experience with Health Connection
(Bars = Level of Importance)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Adequate time spent discussing the natureof the call
Ability to call from any location
Timely access to a health unit service
Quick access
Opportunity to speak directly with staff
Receive helpful advice
Obtain accurate information about theproblem/issue
Percent
Actual Experience
Desirability
2020
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Key Findings: Service Quality & ImpactKey Findings: Service Quality & Impact
reported challenges/barriers to utilizing the service were reported challenges/barriers to utilizing the service were around call management (56%) and unmet needs (24%)around call management (56%) and unmet needs (24%)
long wait times before reaching staff (42 % waited 2-5 mins.)long wait times before reaching staff (42 % waited 2-5 mins.)
clarity of voicemail instructions (being unsure of what information clarity of voicemail instructions (being unsure of what information to provide)to provide)
limited access to a live person limited access to a live person
advice/information provided did not meet need advice/information provided did not meet need
limited appointment timeslimited appointment times
staff unable to answer questionstaff unable to answer question
2121
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
RecommendationsRecommendations
Call Management: increase the ability of clients to self-Call Management: increase the ability of clients to self-direct through the system and minimize number of direct through the system and minimize number of transferstransfers
Implementation:Implementation: self-direct options provided off main menuself-direct options provided off main menu
• direct access to specific linedirect access to specific line
• access to pre-recorded informationaccess to pre-recorded information
• ability to leave requested information by voicemailability to leave requested information by voicemail
call routing algorithms developed for call routing algorithms developed for switchboard staffswitchboard staff
2222
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
RecommendationsRecommendations
Service Access: improve access to live answer by Service Access: improve access to live answer by staff, service and timely responsesstaff, service and timely responses
Implementation:Implementation: Increase call response capacityIncrease call response capacity
• CSR positionsCSR positions• VPD/OH pilotVPD/OH pilot• Back-up staffBack-up staff
Electronic SchedulerElectronic Scheduler
2323
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
RecommendationsRecommendations
Web-services: increase availability of web-based Web-services: increase availability of web-based servicesservices
Implementation:Implementation: website redesignwebsite redesign secure submission of personal health information secure submission of personal health information
i.e. immunization recordsi.e. immunization records
2424
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
RecommendationsRecommendations
Implementation enablersImplementation enablers fit with agency strategic prioritiesfit with agency strategic priorities Executive sponsorship and endorsementExecutive sponsorship and endorsement broader benefit impactbroader benefit impact
Implementation barriersImplementation barriers competing prioritiescompeting priorities current economic climatecurrent economic climate stakeholder fatiguestakeholder fatigue
2525
Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
Presenter Contact InformationPresenter Contact Information
Reina BarkerReina Barker Joyce Fox Joyce FoxSimcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit Simcoe Muskoka District Health UnitSimcoe Muskoka District Health Unit
15 Sperling Drive15 Sperling Drive 15 Sperling Drive15 Sperling Drive
Barrie, On L4M 6K9Barrie, On L4M 6K9 Barrie, On L4M 6K9Barrie, On L4M 6K9
(705) 721-7520 ext 7359(705) 721-7520 ext 7359 (705) 721-7520 ext 7210(705) 721-7520 ext 7210
[email protected]@smdhu.org [email protected]@smdhu.org