Tuesday, March 15, 2016

How to get patient opinions: Ask.

Michael Greco and his mates at Patient Opinion have developed a simple and useful way to collect opinions about medical care from patients and provide a lovely forum for interactions back and forth with the hospital and providers.  The purpose is simple: To enable and enhance issue resolution, relationship restoration, and improvement. An easy-to-use website makes it possible.

The folks at Eastern Health in Victoria have had PO in place for some time.  Here are some stories from their health system.  As you can see, things go in both directions in a helpful, direct, and friendly fashion.  In fact, this first story is actually an apology from a patient to the staff. An excerpt:

I was upset and not in the mood to talk much nor was I paying attention to what was being said, as a result I presented as being rude. When the descending red misty haze had finally settled, remorse set in. I regret deeply if I had offended this person and caused them to perform their duties to other patients in a non satisfactory manner.

If you have any idea as to who the unfortunate recipient of my bout of bad manners was, could you please forward my most sincere apologies to him.

The response from the hospital chief executive was empathic:

Thank you so much for sharing your story on Patient Opinion and I do hope that you are feeling better for having communicated your apology to us. Please be reassured that we understand how these things happen and I hope that you have relieved a burden which I imagine you have been carrying for a while.

Please be reassured that I will do my best to identify the person . . . and be sure to send on your apology to him.

Look after yourself and thanks again for getting in touch - no doubt, if I can identify who this person is, your apology will make his day.

Here's another story, in which a mother expressed concerns about her daughter's care.  An excerpt:

There have been a number of issues that I am concerned about and I believe need to be addressed, these are:

1. My daughter should never have been discharged from the Angliss as she was in pain, nauseous & unwell. Surely an indicator that something was seriously amiss!
2. This damage to her bladder has been devastating for her & us as a family.
3. No phone communication from nursing staff when I rang as the phone rang out.
4. There appears to be a shortage of staff? Why are there not more ward clerks?
5. I am not the sort of nuisance person who makes complaints just for the sake of it.
6. I am very disturbed at how my daughter has been treated and I feel angry she has had to endure so much pain and an operation that went so terribly wrong!

I suggest the issues I have pointed out require investigation & rectifying to avoid further insult & pain to others.

I also hope you take note of the staffing in your hospitals and that more thought is put into place regarding the discharge of patients.

Here are excerpts from the response from the chief executive:

First of all, let me say how sorry I am to read about your daughter’s experience at Angliss Hospital. I understand that you would be upset about this and I am alarmed too when I read the detail.

Secondly, at the outset, I want you know that we will work with you to resolve these issues and importantly, learn from your experience so that we can prevent a recurrence.

You have raised a number of issues related to lack of care and I can’t imagine why this has happened. . . . Then, when I read that you have made contact with Eastern Health and we have not responded, I am even more concerned. We really do pride ourselves on responding to all feedback and share this with our staff as part of our process of feedback for improvement.

I would like to arrange a full investigation into the issues which you have raised as well as the matter of sending a letter and an email without a response from us.

Based on the facts which have been raised, I can indeed have very general discussions and piece little pieces of information together but it would be even better and more targeted if I could have a conversation with you and discuss a plan of action. 

I would welcome your contact and if you could email me privately . . .

After some personal contact, the mother responded:

Thank you Mr Lilly,

It was very reassuring to hear from you and that the issues mentioned will be followed up. It is not about blame merely that more thought should be put into place when a patient says something is wrong....we as humans know our own bodies.

I would not like to see this happen to another person. We are only human and things happen however it just goes to show we need to listen. . . . I thank you sincerely for your compassion and concern. 

Michael notes that many stories have been viewed by the public hundreds of times.  That all of these conversations are public makes them even more powerful--in terms both of process improvement in the hospital and the messages and information that is provided to other patients and families.

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