Patient experience survey results made us change our approach to gathering feedback
Lead cancer nurse Ruth Hendy on the challenge of interpreting patient feedback on cancer services – especially when mutiple care pathways and trusts are involved
Lead cancer nurse Ruth Hendy has written an evidence and practice article (to feature in our October issue) on understanding and responding to patient feedback after receiving disappointing results in the 2014 National Cancer Patient Experience Survey. Here she talks about the challenge of interpreting patient feedback and surveys on cancer services – especially when other multiple care pathways and trusts are involved
I have worked in cancer nursing within my organisation for 30 years – and delivering the best possible services to ensure the best outcome for patients has always been my motivation.
In 2011, I took up my current post having previously been a haematology/oncology centre matron, so receiving particularly disappointing results in the 2014 National Cancer Patient Experience Survey felt personal. It felt like direct feedback on the work I had been driving forward and it did not tally with the feedback that local teams were receiving day by day.
‘These results definitely did not reflect our aspiration for cancer patient experience’
Feedback like this has the potential to become demotivating for teams who are working hard and delivering great services.
These results had the potential to damage the reputation of our organisation and they definitely did not reflect our aspiration for cancer patient experience.
I did not want my work and that of the clinical teams at the trust to be defined by poor National Cancer Patient Experience Survey results.
I took this opportunity to take stock of our position. I found many aspects of the survey methodology hugely challenging, particularly for large tertiary centres. Many patients were not just reflecting on their experience at University Hospitals Bristol, but on their experiences across the whole care pathway, including the services of other providers.
‘We decided it was time to seize the momentum and use this opportunity, taking a radically different approach’
It seemed that organisations of differing sizes, demographics and complexity of services were measured by the same methodology.
I was also frustrated because the survey results did not tally with other national and internal survey data and the direct patient feedback that my trust and our cancer services specifically received.
However, I could still see – as a crude measure – that the results showed how the cancer patient experience within my organisation was lagging behind the national average. We should not use whatever concerns we have about methodology as an excuse to ignore the results.
The bottom line was that many trusts were receiving results showing a much better evaluated patient experience, and that mattered to me and the clinical teams. We needed to improve.
Taking positive action
These poor results attracted much attention within our organisation. From patient representatives, executives, non-executives, governors and the patient experience committee to the cancer services management team, people were looking to me for explanations and assurance as to how this was going to be fixed.
This led to many discussions with colleagues, including the clinical teams, patient experience leads and patients. I realised that I could use this point in time when there was such strength and depth of clinical and organisational disappointment to galvanise the survey results into positive commitment from all parties to turn this around.
‘I have seen clinical nurse specialists and multidisciplinary teams increase their commitment to collecting and responding to patient feedback’
Rather than our usual approach of conducting a local analysis of the results and then developing an action plan, we decided it was time to seize the momentum and take a radically different approach.
Backed by organisational support to take a longer-term view, we set off on an ambitious 18-month programme of patient engagement activities to fully understand the local issues.
It was pivotal to have the clinical teams closely involved in developing this work. This way, we could gain confidence in our methodology and subsequently achieve greater clinical ownership of our local results and enthusiasm for delivering the service developments required.
Consequently, I have seen clinical nurse specialists and multidisciplinary teams increase their commitment to collecting and responding to patient feedback.
After all, they have witnessed first hand the value and benefit of their direct involvement in doing this.
- National Cancer Patient Experience Survey 2014 for University Hospitals Bristol NHS Foundation Trust