Tag Archives: patient experience

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Have you used ambulance services in the past year? We would be interested to hear from you for a CaHRU study

If you have used the ambulance service in the previous 12 months and are happy to take part in an interview for a new study we would like to hear from you.

PREMposter

This study is part of doctoral research being undertaken by Fiona Togher, Graduate Research Assistant at CaHRU, to develop a Patient Reported Experience Measure (PREM), a brief questionnaire for measuring experiences of ambulance service users. This will enable NHS ambulance services and their commissioners to routinely assess differences in patient experiences between and within organisations and to stimulate positive changes to the experiences of ambulance service users through feedback, training and education to clinicians; it could also be an opportunity to identify the strengths of ambulance service care and provide evidence of good practice.

The purpose of this study is to try to understand how people interpret the questions that have been developed so that we can improve them. In order to do this we are conducting interviews with ambulance service users, showing them the latest version of the questionnaire, and asking them to respond to the questions and share their thoughts and opinions of the questions.

If you would like to take part please contact Fiona Togher on ftogher@lincoln.ac.uk or 01522 837731.

Fiona Togher

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Article on patient experiences of ambulance care published in Ambulance Today

photo2italiccolourWORDSAn article entitled, ‘Feeling reassured: the glue that holds together patients’ experiences of ambulance service care’ was published in the autumn (September) issue of Ambulance Today. The article by Prof Niro Siriwardena and Fiona Togher, based on work undertaken as part of the National Institute for Health Research funded five-year Programme for Applied Health Research co-led by Prof Siriwardena together with doctoral research by Fiona Togher, describes findings from a recent paper published in Health Expectations.

NThe article, ‘Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study’, describes how healthcare quality incorporates the important of patient experience as well as safe and effective clinical care and what patients feel contributes to a good experience. The original study involved 22 patients who had recently experienced care from the ambulance service together with eight spouses. The interviews revealed that the ability of ambulance staff to reassure patients was the ‘glue’ that held together patients’ experiences: if patients did not feel reassured during their care this adversely affected their overall experience.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2015/09/Siriwardena-Togher-Feeling-reassured-AT-2015.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]Patients expected the clinical care delivered by ambulance staff to be safe and effective, but what affected their experience and their feeling of being reassured were other aspects of care such as professionalism (demeanour and conduct), good communication (sensitive to the needs of patients and their relatives), responsiveness (timeliness that met needs rather than simply a rapid response), and continuity (effective handover to hospital or community pathways). The research is part of the Prehospital and Emergency Quality and Outcomes (PEQO) workstream at CaHRU and has contributed to Fiona’s doctoral research on the development of a Patient Reported Experience Measure (PREM) for use in NHS ambulance services.

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CaHRU presents at European Forum for Primary Care Conference in Amsterdam

EFPC-logo-4-k new versionMembers of CaHRU, Dr Coral Sirdifield, Ana Godoy and Prof Niro Siriwardena attended the annual conference of the European Forum for Primary Care (EFPC), ‘Integrated primary care: research, policy and practice’, at the Tobacco Museum in Amsterdam from 30 August to 1 September 2015 to meet with colleagues and present an invited workshop on patient experience at the meeting. Niro Siriwardena is a member of the advisory board of the EFPC and attended a board meeting on the day before the conference.

Coral Ana Niro3The workshop, entitled ‘QUALICOPC in the UK, the patient perspective, took place on the first afternoon of the conference and was informed by work from CaHRU on the EU funded Quality and Costs of Primary Care in Europe (QUALICOPC) study. The session was well attended, enabling participants to discuss different approaches for measuring patient satisfaction with primary care and how satisfaction could be improved. Coral and Ana presented an innovative approach called Importance-Performance Analysis, using the QUALICOPC data from England, to demonstrate how the technique could help practitioners, researchers and policy makers to identify where one most needed to focus to improve patient satisfaction.

riverboatThe conference included excellent keynotes from Prof Chris van Weel, Emeritus Professor of General Practice at Nijmegen (‘The history of Dutch General Practice or: how Primary Care saved the nation’), Dr Isabel Moulon from the European Medicine Agency (‘Bridging the gap between medicine development and clinical practice: is primary care out of the picture?’), Ellen Nolte from the European Observatory on Health Systems and Policies (‘Integrating care: what we know and what we do not know’), Prof John Øvretveit of the Karolinska Institute (‘Priorities for actionable research to speed and spread improvements in caring for chronic illnesses’), Dr Tonka Poplas Susič and Metka Žitnik Šircelj (‘Model practices in family medicine in Slovenia’) and a closing summary from Prof Marc Bruijnzeels of the Jan van Es Institute (‘Challenges for the future of integrated primary care’). A range of parallel research, debate and workshop sessions, lunch on a riverboat and an excellent conference dinner provided a full, interesting and enjoyable programme for delegates.

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EU: FP7 QUALICOPC study shows potential for improving primary care in 34 countries

VTeams from the Netherlands Institute for Health Services Research (NIVEL) and the Scuola Superiore Sant’Anna have recently published a paper in the WHO Bulletin, ‘Assessing the the potential for improvement of primary care in 34 countries: a cross-sectional survey (Schäfer et al., 2015). The paper was based on data from the Quality and Costs of Primary Care in Europe (QUALICOPC) study, funded by the EU Framework 7 programme, for which data for England were collected by Dr Sirdifield from the Community and Health Research Unit (CaHRU).

Meeting1Schäfer et al’s paper draws on data from questionnaires on patient experiences and values relating to general practice assessing what patients from each of the 34 countries felt there was to improve five aspects of primary care: accessibility, continuity, comprehensiveness, patient involvement in treatment decisions, and doctor-patient communication. Overall, the authors concluded that “accessibility and continuity of care show relatively low potential for improvement, while in many countries comprehensiveness was indicated to be a priority area”. Nine countries had a moderate level of improvement potential for patient involvement in decision-making about treatment but all countries performed well on doctor-patient communication. The UK data indicate low patient-perceived improvement potential across all aspects of care with the exception of ‘comprehensiveness’, which had  moderate potential for improvement.

Desk1The team from CaHRU (Dr Coral Sirdifield, Ana Godoy Caballero, Prof Niro Siriwardena and Dr Karen Windle ) are currently working with colleagues in the College of Social Science (Prof Steve McKay and Dr Christine Jackson) and Nivel (Dr Willemijn Schäfer) to further explore the data for England, investigating how satisfied patients are with primary care by identifying their expectations of care, the extent to which expectations are being met, variations in expectations and experiences, and how patient satisfaction could be improved.

Reference: Schäfer et al., (2015) Assessing the potential for improvement of primary care in 34 countries: a cross-sectional survey, Bull World Health Organ, 93: 161-168. doi: http://dx.doi.org/10.2471/BLT.14.140368

 

Coral Sirdifield

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Reassurance important for ambulance services users: new qualitative study published in Health Expectations

photo2italiccolourWORDSResearchers from CaHRU with colleagues from the School of Health and Related Research (ScHARR) at the University of Sheffield have published a new study: “Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study” in the journal Health Expectations. The study’s lead author was Fiona Togher, PhD student and Graduate Research Assistant in CaHRU. She was supported in the work by Alicia O’Cathain, Professor of Health Services Research at the University of Sheffield, Viet-Hai Phung, Research Assistant in CaHRU, Janette Turner, Research Fellow at the University of Sheffield and Professor Niro Siriwardena, director of CaHRU. The study is part of a five year NIHR Programme for Applied Health Research, Prehospital Outcomes for Evidence Based Evaluation (PhOEBE).

EMAS - PTS 2_750The authors aimed to investigate the aspects of emergency ambulance care that were most valued by users of the service. Fiona and Viet-Hai interviewed people (patients and carers) that had used the ambulance service for a range of different conditions such as diabetes, suspected stroke, breathing difficulties and falls. The participants had also received various types of ambulance service response i.e. ‘hear and treat’ in which the participants received enhanced clinical assessment and advice over the telephone only, ‘see and treat’ in which the participants were treated on-scene by appropriately skilled clinicians without the need for hospital admission and the more familiar, ‘see and convey’ in which the participants received pre-hospital assessment and treatment before transportation to acute care.

NThe authors found that regardless of their specific clinical problem people valued similar aspects of their emergency ambulance service experience. Participants had often been extremely anxious about their health, and they most valued the reassurance they felt from receiving appropriate advice, treatment and care from ambulance service staff. It was found that the ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service.

The qualitative interview data collected from this research is now being re-analysed as part of Fiona’s doctoral studies to develop a Patient Reported Experience Measure (PREM) for use in UK ambulance services.

 

Fiona Togher