A new way to measure quality in healthcare
Not so long ago it was thought difficult or even impossible to measure quality in healthcare. The measurement of quality was considered the preserve of widget manufacturers and their quality control inspectors with micrometers. Now, process mapping could be the answer.
The Healthcare Quality Improvement Partnership (HQIP) document A guide to quality improvement methods states:
The purpose of this guidance is to signpost those working within, leading, commissioning and using healthcare services to a broad range of quality improvement methods.
Many examples of how patients can be involved in healthcare quality improvement are given and a couple caught my eye as being less well-known but potentially very useful:
Shadowing the patient journey to identify quality shortfalls
Patient led assessment of the healthcare environment
Patient satisfaction surveys are essential and can be very useful. Inevitably, they record a person's view of a situation they would probably rather not be in and are relieved when it's over. So how about taking up the theme of the above two examples and inviting a patient or group of patients to complete (without treatment, of course) the patient journey when not under duress, suffering anxiety or in pain?
Here's a simple example of the potential different viewpoints of an 'actual' patient and a 'volunteer' patient. A friend recently had a cataract operation. On entering the clinic she became very stressed and tearful and was comforted and generally reassured by the nurses that the operation was not at all painful. That proved to be the case and my friend came away smiling and happy. She would have given a very positive response in a patient satisfaction survey. However, speaking to her a little time afterwards she told me how difficult it had been to find the clinic and that the map and directions provided were unclear. This had added to her stress. Another friend who visited the same clinic agreed that it was 'hard to find'. I suspect that a volunteer patient given a 'dummy' appointment at this clinic in order to follow the patient journey would have highlighted the difficulty of locating it.
The HQIP document refers to this sort of quality improvement method as process mapping and explains when it is most effective (when the patient journey is complex), what the prerequisites are (a patient journey and stakeholders – including service users) and how to use it.