The National Patient Experience Survey Call for proposals Secondary analysis of qualitative data
The National Patient Experience (NPE) survey programme has made 50,000 in funding available for secondary analysis of qualitative responses to its survey of adult inpatients in acute hospitals. Applications for funding should be submitted to the NPE Survey by August 31 st 2018, with the successful project announced during September 2018. Funded activity should take place between October 2018 and September 2019. Background: The National Patient Experience Survey Programme is a partnership between the Health Information and Quality Authority (HIQA), the Health Service Executive (HSE) and the Department of Health (DoH). The programme aims to gather data on the experiences of Irish patients and use this information to drive quality improvement within the health service. The first National Patient Experience Survey explored the experiences of adult patients admitted to an Irish acute hospital in May 2017. In total, 13,706 people responded to the survey, representing a response rate of 51%. The majority of questions in the survey were in tick-box format, however three open-ended questions allowed patients to describe what was good about their care, what could be improved, and provide any other comments or suggestions. Participants provided over 20,000 comments in response to these questions. The survey is being repeated in May 2018. Framework analysis was used to categorise participants qualitative comments into 23 themes (outlined in Appendix 1) covering areas such as hospital staff, the physical environment, and food and drink. These themes have further been grouped into 10 summary themes. However, given the breadth and richness of the data, there is scope for further in-depth analysis. More information on the survey and the results for 2017 may be found at www.patientexperience.ie. The NPE Survey is seeking proposals for a research project to explore the qualitative responses to the 2017 and 2018 surveys in more detail, with a view towards identifying insights to enhance quality improvement within the acute hospital system. Projects may focus on particular themes or sub-groups within the overall corpus of responses, or a more general study including all qualitative responses. Patients are involved at every level of the NPE Survey and the applicants are expected to demonstrate material involvement of patients in their proposed research project. Page 1 of 7
The application process: Applications will be evaluated by a review panel which includes representatives from the NPE Survey, patient groups and other relevant stakeholders. Proposals will be evaluated using the following criteria: Strength of the suggested programme of activity Contribution to quality improvement and knowledge Strength of the project team Project costing (up to a maximum of 50,000) Funding is expected to cover all research and reporting costs associated with the successful project. Applications for funding should be submitted to the NPE Survey team by August 31 st 2018. The successful project will be announced during September 2018. Funded activity should take place between October 2018 and September 2019. Proposals will form the basis for a contractual agreement. Preparing an application: Applications for funding should be submitted to cfoley@hiqa.ie. Applicants must complete the designated application form. This form contains the following headings: 1. Applicant details 2. Project title 3. Details of proposed research 4. Research design and methodologies 5. Contribution to improving the quality and safety of acute care in Ireland 6. Project plan 7. Patient involvement 8. Dissemination and knowledge exchange 9. Overview of the project team 10. Project costing Annex - Brief two page CVs for the lead applicant and other relevant team members should be included in an annex. Page 2 of 7
Conditions of award: The successful project will be subject to a number of conditions in relation to delivery of outputs and oversight from the funder. A report on the findings of the project must be produced. This report will be published on www.patientexperience.ie. Any further outputs including presentations and publications must be approved by the NPE Survey steering group prior to submission, and acknowledge the support of the NPE Survey where possible. The project team are expected to produce a project plan outlining key timelines, milestones and risks, with detailed provision for mitigation of the latter. Regular progress updates must be provided to the NPE Survey steering group and failure to meet agreed timelines may results in suspension or termination of funding. Contact: For further information on the call, please contact Dr. Conor Foley, NPE Survey Senior Analyst, at cfoley@hiqa.ie Page 3 of 7
Appendix 1. Qualitative Themes Table 1 shows the 23 themes used in the coding framework to categorise qualitative comments. Table 2 gives a breakdown of the number of comments received per theme for each of the three open-ended questions. Table 1. Themes, descriptions and example comments Theme Staffing levels Nursing staff Doctors or consultants Description Comments relating to overall staffing, e.g. more nurses needed; staff are under too much pressure General comment about nurses, e.g. nursing staff were fantastic; some of the nurses were unfriendly General comment about doctors, consultants or surgeons, e.g. my doctor was very kind; the surgeon and her team were great Other healthcare staff General comment about other healthcare staff such as physio, dietician, OT, care assistants [note that specific healthcare staff were anonymised in 2017 data], e.g. the [healthcare professional] was excellent Other staff, e.g. cleaner, admin General comment about other staff not covered above, e.g. the cleaners were careless; the admin staff were very friendly General staff comment Dignity, respect and privacy Comment about staff in general without mentioning specific staff, e.g. the staff were great Comments that refer to being treated in such a way as to maintain dignity, respect and personal privacy, particularly as privacy relates to medical or other personal information. Privacy could refer either to the patient or to overhearing information about another patient, e.g. I just didn t feel listened to; On discharge, I really felt that they took my needs into account; There is little or no regard for privacy I could hear the doctor discussing every detail of the other patient s diagnosis; When the nurses talked with me, they pulled the curtain and used a low voice, which was appreciated Page 4 of 7
Communication: Patient Communication: Family/relative/friend As distinct from comments about staff (codes 1-6), this relates mainly to staff-patient communication; staff-staff communication is also covered here, e.g. I was not told how my operation went; I was able to ask the doctor all the questions I had; I was hearing different opinions from different members of staff This relates to communication between staff and family or friends of the patient, e.g. my husband was not told when I was to be discharged; my family had a lot of questions about my aftercare and were not given enough time to ask them Physical comfort Covers noise levels, pain management, other aspects to maintaining physical comfort aspect of care. As distinct from Privacy, includes loud TV, noisy visitors, sense of security, heat, light levels, e.g. the patient next to me was moaning in pain and I couldn t get any sleep; the staff were very attentive and made sure that I was comfortable. ED management/ environment ED waiting times Planned procedures waiting times Food and drink Staff availability and responsiveness Relates specifically to emergency department environment, e.g. The Emergency Department felt chaotic; Some of the people in Casualty were drunk and abusive and the staff were not able to control them Relates specifically to waiting times (key word: trolley) from emergency department to ward, e.g. I had to wait about 36 hours on a trolley before I got onto a ward Relates to being on a waiting list for any planned procedure (test, operation etc.) including cancellations, e.g. the waiting lists for [procedure name] are unacceptable I was waiting 18 months Quality of food and drink provided to patients, e.g. the food was good, there was a vegetarian option; The water jugs are not refilled and impossible to get to if you are bed bound! Covers aspects such as call bell waiting times, bed pan care, help with self-care tasks, e.g. the nurses were slow to respond to call bells they were rushed off their feet Page 5 of 7
Discharge and aftercare management Cleanliness/Hygiene Hospital facilities Parking facilities Clinical information, medical history, medication dosage Health insurance General comment Other Relates to both information provided (e.g. medication explanations and side effects) and to management of discharge (e.g. wait times), e.g. I got a discharge pack which explained everything which was really good because I couldn t take in the information at the time; I was given four different medications with no explanation about what they were for and no indication of side effects Any comments relating to hygiene of toilets, ward environment, or hospital in general, e.g. toilets in A&E were filthy; toilets on the ward were spotless; the ward was spotless; cleaners used the same cloth for cleaning all surfaces!!; I saw traces of blood on the floor Any comments relating to the facilities within the hospital, including quality of the building, e.g. the canteen was really good good opening hours and nice choice of food at affordable prices; as a patient staying here for 3 weeks I would have appreciated some activities other than a shared TV; A&E is in a prefab and it s damp and not fit for purpose Any comment relating to parking, e.g. impossible to find a parking space; there should be a weekly permit to save on cost Comments relating to charts, medication, etc., e.g. I had to repeat my condition every time I met a new doctor. Comments relating to private health insurance, e.g. even though I had private insurance I was put in a ward with 5 other people. I m not getting anything for my money. Comments about a patient s general experience, e.g. everything was great from start to finish. Any other comments that do not readily fit under the above categories. Page 6 of 7
Table 2. Number of comments per theme for each question (2017 data) No. of comments per theme 0 500 1000 1500 2000 2500 3000 3500 Staffing levels Nursing staff Doctors or consultants Other healthcare staff Other staff, e.g. cleaner, admin General staff comment Dignity, respect and privacy Communication: Patient Communication: Family/relative/friend Physical comfort ED management/ environment Q59 - Good Experience Q60 - Needs Improvement Q61 - Other comments ED waiting times Planned procedures waiting times Food and drink Staff availability and responsiveness Discharge and aftercare management Cleanliness/Hygiene Hospital facilities Parking facilities Clinical infromation/history Private health insurance General comment Other Page 7 of 7