Patient Outcomes Experience Measurement in Podiatry Results from

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Patient Outcomes & Experience Measurement in Podiatry Results from two NHS departments

Patient Outcomes & Experience Measurement in Podiatry Results from two NHS departments

Outcomes are easy to see - aren’t they? Clinician “I see your ulcer is

Outcomes are easy to see - aren’t they? Clinician “I see your ulcer is healing nicely” Patient thinks “maybe but I still can’t get to the shops” Carer/relative thinks Commissioner “prove these treatments “is the best treatment available? ” actually do any good” Co. Metrica © 2010 2

So how can you measure Outcomes & Experience? � of everyone � � accurately

So how can you measure Outcomes & Experience? � of everyone � � accurately � � recognised , benchmarked qualitatively � � the right measures at the right time quantitatively � � not a skewed sample fast direct feedback to the department continuously � not an annual survey – “ticking the box” Co. Metrica © 2010 3

Choose your census points along the patient pathway Referral 1 st visit After treatment

Choose your census points along the patient pathway Referral 1 st visit After treatment • Generic PROM • Specific PROM • Pre - Tx • Generic PROM • Specific PROM • Pain management • Communication • Organisation • information • Accessibility • Cleanliness • Facilities • 1 st impressions • Privacy &Dignity • Competency • Information Key: Clinical Outcomes Patient Experience Co. Metrica © 2010 Short-term follow-up 6 - Long-term follow-up 6 12 weeks months+ • 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 4

Example measures available � � � standard PROMS and local measures clinical AND experience

Example measures available � � � 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 Co. Metrica © 2010 5

Image based questions � clinical images e. g. What do your feet look most

Image based questions � clinical images e. g. What do your feet look most like? � comparative data � follow-up � use Co. Metrica © 2009 any images 6

South Birmingham Podiatry Service Mandy Cadge – Podiatry Services Manager � Pilot scope �

South Birmingham Podiatry Service Mandy Cadge – Podiatry Services Manager � Pilot scope � 500 patients in summer 2010 � Measures: generic health foot health patient experience �+ continuous daily feedback from patients Co. Metrica © 2010 � 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 7

Overall results Scale Responses n At treatment start 127 (51%) After 60 days Discharged

Overall results Scale Responses n At treatment start 127 (51%) After 60 days Discharged 121 (50%) 23 (50%) Average results Generic health PROM 0= feel like “death” 1= perfect health – EQ 5 D 0. 55 0. 63 0. 56 0. 57 0. 59 87% 85% Foot health PROM FHS 0= maximum pain, mobility restriction 1=no pain, concern, restriction 0. 52 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% Co. Metrica © 2010 8

Foot Health Score • Gain reduces with age • Patient groups likely to be

Foot Health Score • Gain reduces with age • Patient groups likely to be more significant than age Low volume bands excluded Co. Metrica © 2010 9

Patient Experience • High scores generally • Recall of being provided with information lowest

Patient Experience • High scores generally • Recall of being provided with information lowest • Further breakdown by location, staff etc. valuable Co. Metrica © 2010 10

Solent Healthcare (Portsmouth) Podiatry Mathew King – Project lead � Project scope � ALL

Solent Healthcare (Portsmouth) Podiatry Mathew King – Project lead � Project scope � ALL patients going through prevention team � 1000 patients over 5 weeks in Sept/Oct 2010 � Measures: � � Responses � 560 returned, 56% response rate 2% on-line 98% on paper � Consistent response rate across service generic health foot health patient experience Health advice reception & impact + continuous daily feedback from patients Co. Metrica © 2010 11

Overall results Scale Responses n At treatment start After 90 days 178 189 Average

Overall results Scale Responses n At treatment start After 90 days 178 189 Average results Generic health PROM – EQ 5 D 5 0= feel like “death” 1= perfect health 0. 50 0. 57 Foot health PROM - FHS 0= maximum pain, mobility restriction 1=no pain, concern, restriction 0. 51 0. 58 Clinical Competency perceived 0% = “poorest” 100% = “best possible” Experience: Overall satisfaction 0% = “poorest” 100% = “best possible” Health Advice (only for relevant patients) Diabetes Explanations understood of impact & specific care advice given 84% 91% 93% Motivational Made a difference 79% Smoking 53% 50% Weight Management 68% 0% Co. Metrica © 2010 12

Foot Health Score 2 • Marked improvement in all areas Co. Metrica © 2010

Foot Health Score 2 • Marked improvement in all areas Co. Metrica © 2010 13

Detailed reports • Demonstrating reduction in pain frequency as a result of treatment Co.

Detailed reports • Demonstrating reduction in pain frequency as a result of treatment Co. Metrica © 2010 14

Foot Health Score 2 • Change in foot health by department’s own severity/ treatment

Foot Health Score 2 • Change in foot health by department’s own severity/ treatment classification Co. Metrica © 2010 15

Patient Experience • Can review by: • Location • Staff • Pt Age •

Patient Experience • Can review by: • Location • Staff • Pt Age • Category • Treatment Clinic A Co. Metrica © 2010 Clinic B Clinic C Clinic D Clinic E Clinic F Clinic G Clinic H 16

Conclusion � Highly � No visible patient engagement, inclusive reach front line effort, standard

Conclusion � Highly � No visible patient engagement, inclusive reach front line effort, standard reports save time � Continuous results linked to patient data � Operational � PROMS qualitative tool – daily feedback & benchmarks are powerful commissioning levers � Differential value by patient groupings evident- prioritisation? Co. Metrica © 2010 17

Thank you Stuart. Mathieson@Co. Metrica. co. uk 07973 212306 Co. Metrica © 2010 18

Thank you Stuart. Mathieson@Co. Metrica. co. uk 07973 212306 Co. Metrica © 2010 18

Patient 1 Patient 3 Patient 5 Patient 6Patient 1 Patient 3 Patient 5 Patient 6
The Patient Experience Team Xanthe Gunn Patient ExperienceThe Patient Experience Team Xanthe Gunn Patient Experience
Patient Experience Eleanor Carter Patient Experience Facilitator BlackpoolPatient Experience Eleanor Carter Patient Experience Facilitator Blackpool
Measurement Scales and Error of Measurement Measurement MeasurementMeasurement Scales and Error of Measurement Measurement Measurement
RAIN MEASUREMENT RAIN MEASUREMENT RAIN MEASUREMENT RAIN MEASUREMENTRAIN MEASUREMENT RAIN MEASUREMENT RAIN MEASUREMENT RAIN MEASUREMENT
Improving patient care Improving patient care Patient safetyImproving patient care Improving patient care Patient safety
Patient Questionnaire 2008 09 Patient Comments Patient CommentsPatient Questionnaire 2008 09 Patient Comments Patient Comments
Patient 1 Patient 2 Patient 3 Normal LungPatient 1 Patient 2 Patient 3 Normal Lung
Patient Patient Presentatieformat versie 2020 Patient Reden vanPatient Patient Presentatieformat versie 2020 Patient Reden van
Patient 5 ALS Patient Background and Problems PatientPatient 5 ALS Patient Background and Problems Patient
Patient Compliance With Medical Advice Patient compliance patientPatient Compliance With Medical Advice Patient compliance patient
Mission Patient Connect Patient Portal 2015 Patient PortalMission Patient Connect Patient Portal 2015 Patient Portal
Patient Care and Monitoring Systems Patient care PatientPatient Care and Monitoring Systems Patient care Patient
Patient Care and Monitoring Systems Patient care PatientPatient Care and Monitoring Systems Patient care Patient
Patient A Patient A Patient Normal Ranges HbPatient A Patient A Patient Normal Ranges Hb
Patient Safety An Overview Patient Safety Patient SafetyPatient Safety An Overview Patient Safety Patient Safety
PATIENT ASSESSMENT PATIENT ASSESSMENT Patient assessment in emergencyPATIENT ASSESSMENT PATIENT ASSESSMENT Patient assessment in emergency