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ESA 4 - HaDSoc > Patients Evaluations of Healthcare > Flashcards

Patients Evaluations of Healthcare Flashcards

1
Q

Why is there interest in patients view of health services?

A

Evidence that patient satisfaction is an important outcome in its own right and is linked with other outcomes
There is humanitarian and ethical impetus
There is a growing rejection of paternalism, and growth of consumerism
There is increased external regulation of health services, with an emphasis on accountability
It is a means of securing legitimacy

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2
Q

What did the NHS Plan (2000) put an emphasis on?

A

Organising care around the patient

Accountability to patients

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3
Q

What did NHS Plan (2000) say that every NHS organisation is required to do?

A

Publish, in a Patient Prospectus, an annual account of patients’ views and action taken as a result

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4
Q

What does the Patient Prospectus set out?

A

The range of local services available, and the ratings they have received from patients

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5
Q

Who published ‘Involving patients and the public in healthcare’?

A

The Department of Health

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6
Q

What did ‘Involving patients and the public in healthcare’ put forward?

A

A set of proposals building on the NHS Plan

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7
Q

What duty did the NHS Act of 2006 introduce?

A

Duty on organisations to ‘involve and consult’ patients and the public in;

  • Planning services they are responsible for
  • Developing and considering changes in teh way those services are provided
  • Decisions that affect how services operate
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8
Q

What does the latest White Paper set out to do, regarding patients evaluations of healthcare?

A

Strengthen the voices of patients

Encourage use of patient feedback

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9
Q

What did the latest White Paper say regarding all sources of feedback?

A

They are used to assess the quality of services

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10
Q

Which of the NHS 5 domains is related to patients evaluation of healthcare?

A

‘Ensuring that people have positive experience of care’

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11
Q

What are the ways to give feedback to the NHS?

A

NHS friends and family test
Can rate and comment on NHS services on the NHS choices website
Range of other non-NHS websites and forums
Healthwatch England
Local Healthwatch
PALS (Patient Advice and Liaison Services)

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12
Q

What is Healthwatch England?

A

The national consumer champion in healthcare

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13
Q

What do Healthwatch England do?

A

Ensure the voice of the consumer is heard by those who commission, deliver, and regulate health services

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14
Q

What do Local Healthwatch have the responsibility to do?

A

Seek the views of local people regarding health and care services, and pass them onto those responsible for commissioning or providing care

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15
Q

What do PALS do?

A

Offer support and information on health related matters;

  • Advice on complaints procedures
  • Give information about the NHS
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16
Q

How many written complaints does the NHS get a year from hospital, community, and family health services?

A

200,000

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17
Q

Is the number of complaints likely to be representative of number of unhealthy people?

A

No, likely to be more unhappy people as complaining isn’t easy

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18
Q

What does the NHS hospitals complaints system review look at?

A

How complaints about care in NHS hospitals are listened to and acted on

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19
Q

What do the NHS hospitals complaints system review recommend?

A

Improving quality so complaints don’t need to be made
Improving how complaints are dealt with
Ensuring independence in the complaints procedure

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20
Q

What does the Parlimentary and Health Service Ombudsman undertake?

A

Independant investigations into complaints that the NHS in England has not acted properly or fairly on, or has provided a poor service

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21
Q

What does Parlimentary and Health Service Ombudsman provide?

A

The ultimate independant view of what has happened

22
Q

Are complaints a direct or indirect approach to investigating patient views?

A

Indirect

23
Q

What are the categories of direct approaches to investigating patient views?

A

Qualitative approaches

Quantitative approaches

24
Q

What qualitative approaches are there to investigating patients views?

A

Interviews
Focus groups
Observations

25
Q

What is the advantage of qualitative approaches to investigating patients views?

A

They are effective at identifying how patients evaluate care and what their priorities are

26
Q

Why are quantitative approaches to investigating patient views more commonly used?

A

They are relatively cheap and easy to conduct
Less staff training is required
Anonymity is more easily guaranteed
Standardised responses make analysis easier
Facilitates monitoring of performance

27
Q

What is the problem with locally developed DIY quantitative approaches to investigating patient views?

A

They can have advantages, but often don’t comply with basic standards, have proven reliability or validity, or lack comparability

28
Q

What are some of the main patient surveys?

A

GP patient survey
Maternity services survey
Adult inpatient survey

29
Q

What things cause dissatisfaction in healthcare?

A

Interpersonal skills

Content of healthcare

30
Q

When can poor communication from health professionals cause dissatisfaction?

A

Patients not able to report their concerns
Full histories not always taken
Staff do not convey reassurance
Staff do not provide advice

31
Q

How can the content of healthcare cause dissatisfaction?

A 
Inconvenience, continuity, access, poor hygiene standards
'Hotel' aspects of healthcare
Waiting times
Culturally inappropriate care
Competence 
Health outcomes
32
Q

What are the challenges of using patients evaluations to assess quality?

A

Sometimes patients’ views may not be reasonable or rational
How to locate responsibility and/or know what to do
How much resource should be diverted to satisfying issues that give rise to complaints
How should patients’ concerns about someone’s clinical competence and/or fitness to practice be viewed

33
Q

What is the significance of the patient-professional relationship?

A

It is a very important component of the experience of illness
Become increasingly central to improving the delivery of healthcare

34
Q

In what respects is the patient-professional relationship of interest?

A

Professional
Legal
Ethical

35
Q

What are the sociological approaches to patients evaluation of healthcare?

A

Functionalist Approach
Conflict Approaches
Interpretive/Interactionist Approaches
Patient-Centred Models

36
Q

What does the functionalist approach say?

A

Falling ill is a socio-cultural experience, and although people may possess some knowledge of their condition, on the whole lay people don’t have technical competence to remedy their situation. The sick person is placed in a state of helplessness, and medicine restores them to health and restores social equilibrium

37
Q

How should the sick person fulfil their role in the functionalist approach?

A

Receiving their rights to be free of obligations, and be dependant on others
Fulfilling their responsibilities of seeking out help and to co-operative with the healing process

38
Q

How should doctors fulfil their role in the functionalist approach?

A

Using their skills to benefit the patient

Being objective and non-discriminatory

39
Q

What are the criticisms of the functionalist approach?

A

Sick role is not well thought out
Assumes patient is incompetent
Doesn’t explain why things go wrong

40
Q

What does the conflict approach say?

A

Doctor’s control is based on a monopoly and the patient must submit to their dominance

41
Q

What happens to lay ideas in the conflict approach?

A

They are marginalised and discounted

42
Q

What does the conflict approach suggest?

A

Some social experiences have become ‘medicalised’ and are now seen as illnesses

43
Q

What are the criticisms of the conflict approaches?

A

Patients and doctors not always in conflict

Patients are not always passive and can have control

44
Q

What does the interpretive/interactionist approach focus on?

A

The meanings that both parties give to the encounter, and how they conduct themselves within it

45
Q

What does the patient-centred model say.?

A

There should be an aspiration that the patient-professional relationship could be less hierarchal and more cooperative if patients views were taken more seriously

46
Q

What does the patient-centred model shift away from?

A

Traditional ‘professional-centred’ model

47
Q

What happens in a patient-centred consultation?

A

It will explore the patient’s reason for coming, and their concerns, with the goal of finding common ground on what the problem is and mutually agreeing on management

48
Q

What is shared in patient-centred models?

A

Information

Decision making

49
Q

What do patients provide in patient-centred models?

A

Priorities, perceptions, judgements, and trade-off issues in terms of survival and quality of life

50
Q

What are the challenges of the patient-centred model?

A

Some people do not want to be part of the process
There are unknown consequences of a patients involvement
Who does responsibility rest with?

ESA 4 - HaDSoc (13 decks)

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