HSE’s new goal: 2:1 ratio of compliments to complaints

The first national patient experience survey gets under way this month, which is really good news for the health services. Up until now Irish patients have had little input into how health services are planned and delivered. The 2016 Euro Health Consumer Index showed that their involvement in decision-making was only “so-so”.

Most developed countries conduct patient experience surveys, and there is strong evidence that significant benefits can be gained from the findings. The Health and Information Quality Authority’s recently published an international review on patient experience surveys shows that “the benefits of national patient experience surveys are significant for all those involved, that is the patient, service providers, regulators and policy developers”.

The use of these surveys can “lead to enhanced patient recovery, improved productivity and efficiency, informed choice by patients, and lower staff turnover and absenteeism”, Hiqa found. Countries reviewed in the report were Denmark, England, New Zealand and Scotland, all of which have implemented national patient experience surveys.

England and Scotland have also carried out surveys on maternity services, which, unfortunately, are not included in the Irish survey, although they may be in future years.

Core values

Listening to patients and service users and encouraging feedback on how services are planned, delivered and evaluated is one of the core values of the HSE.

According to the organisation's corporate plan Building a High Quality Health Service for a Healthier Ireland 2015-2017: "We will listen to the views and opinions of our patients and service users and consider them in how we plan and deliver our services". Also: "We will enable patients to provide real-time feedback on the quality of services, which staff can use to make practical and timely improvement to the services they provide."

The HSE currently gets feedback mainly through the National Patient Forum and the complaints and compliments system. In 2016, 23,086 complaints were made about the HSE and voluntary hospitals and agencies. In addition, the HSE and voluntary hospitals and agencies received 23,891 compliments. The HSE’s goal is to have a ratio of 2:1 of compliments and complaints. A majority of complaints were to do with “access”, “safe and effective care” and “communication”.

While complaints and compliments are a valuable source of information and learning for HSE managers and frontline workers, the numbers received are minuscule in comparison to the millions of people receiving services.

More then five million patients will be seen in acute public hospitals during 2017. More than one million will partake in screening and immunisation programmes, and 1,549,256 will avail of different therapies. So few complaints must mean the HSE gets it right most of the time. However, no one knows how satisfied patients and service users are, or about outcomes, because services are not evaluated in a systematic way.

The national patient experience survey, conducted by the HSE, Hiqa and the Department of Health, is a first step of a more holistic and comprehensive approach to get feedback from patients.

Invitation to participate

During the month of May 2017, all adult patients who are discharged from a public acute hospital and some of the voluntary hospitals will be invited to participate in the survey. Up to 27,000 patients will be eligible to take part, making it the largest ever survey of the healthcare system in Ireland.

There were several surveys conducted in the past by the Irish Society for Quality and Safety in Healthcare, the last one in 2010, but participation by hospitals was voluntary and only about half of acute public hospitals took part.

It is expected that almost all acute public hospitals will take part in this new survey. Patients will receive the questionnaire by post a few weeks after discharge, and can complete it online or return it by post.

The questionnaire has 61 questions that cover the patient experience, from admission to discharge.

Questions

There are questions about privacy, dignity and respect, and cleanliness of the hospital. Questions about whether staff wear name badges and introduce themselves are also included.

The quality and choice of hospital food is covered, as well as all aspects of care and treatment received while in hospital. There are questions about confidence and trust and whether there was a member of staff to talk to about worries and fears.

The questionnaire has been developed in accordance with international best practice and takes about 10 minutes to complete. If you or a member of your family receive the survey during May, please complete and return it.

Doing so will really make a difference and help to improve the quality of hospital services.