Healthcare delivery
The patient experience: an important element of care
It is vital that patients have trust in the healthcare system as they interact with it, says Kate Woodhead RGN DMS. She highlights the need to address patient experience and discusses recent moves, such as ‘Martha’s rule’, to address the power imbalance in healthcare.
An essential part of good quality healthcare should be focused on the patient experience. Healthcare itself often proclaims that it delivers ‘person-centred care’ – but is that really so? A heart wrenching interview on Radio 4’s Today programme with the mother of a young person who died of sepsis, which was not recognised, once again brought to a large audience the fault lines which pervade some aspects of care. The interview with Merope Mills highlighted the campaign for healthcare to adopt ‘Martha’s rule’ which would enable relatives and carers an escalation of worries to a team not immediately involved in the patient’s care for a second opinion.1
Some hospitals
have reduced the number of cardiac arrests by developing a team of critical care nurses who can answer a ward nurses’ worries, or a relative with concerns about deteriorating patients by visiting and taking appropriate action. Martha’s rule is supported by the Department of Health in England, but has not yet been formulated into a national policy initiative. Improving patient experience is not an easy
ask. It needs effective leadership and a culture that accepts adaptation together with good data collection to measure and learn from patient feedback. There are many English Trusts for whom this is a step too far and with the development of the new integrated organisations, it is not clear where patient experience will fit. The concept of patient experience should be everyone’s business in clinical and healthcare leadership and learning should be enabled to ensure that negative feedback is identified, and systems reviewed with solutions implemented.
Patient experience, quality improvement and patient safety While Martha’s rule is a current campaign, a systematic review in 2012 identified that patient experience is positively associated with clinical effectiveness and patient safety. The review supports the case for the inclusion of patient experience as one of the central pillars of quality in healthcare. It recommends that clinicians should resist sidelining patient experience as
too subjective or mood-oriented, divorced from the ‘real’ clinical work of measuring safety and effectiveness.2 The addition of patient experience as a
pillar of quality is often justified on the basis of its intrinsic value – that the expectation of humane, empathic care should need no further justification. Clear information, empathic two-way communication and respect for the beliefs of the patient should lead to the patient being better informed and more involved with decisions about their care. Increased patient engagement and motivation could lead to more active participation by the patient into self-care. The systematic review adds that given the organisational fragmentation of much of healthcare and the numerous services with which patient’s interact, the measurement of patient experience may help to provide a ‘whole system’ perspective, not easily available from more discrete patient safety and clinical effectiveness measures.3 The authors specified different dimensions
of patient experience. Table 1 shows the two categories they identified as relational and functional aspects. It is clear from recent work by the King’s
Fund and HOPE (Heads of Patient Experience) network that they believe that things have gone backwards and that the proportion of patients who felt involved in decisions about their care or treatment has been falling in recent years. The pressures caused by vacancies, increased stress of the backlog and now industrial action are having a significant effect on the services’ ability to listen.4
Patient Safety Charter The World Health Organization has developed a Patient Safety Charter which outlines some of the rights and behaviours which they believe patients are owed, wherever they are treated. It was launched on World Patient Safety Day 2023 and is currently out for consultation.5 objectives are:
Its January 2024 I
www.clinicalservicesjournal.com 15
t
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
