We Asked, You Said, We Did

Below are some of the consultations that have recently been completed in Metro North Hospital and Health Service.

We Asked

For feedback on the revised draft Consumer Engagement Procedure and Guideline.

You Said

Common themes that emerged in the feedback and where clarification was required included:

  • Language and tone - needed to be clearer and consumer orientated. Some language reflected staffing/employment and undervalued the contribution of consumers
  • Vaccine preventable diseases (VPD) - information was confusing and it wasn’t clear what consumer activities it was applicable to
  • Payments - amounts and examples of the ‘standard’ and ‘special’ payment were confusing and people were concerned how there will be consistency across Metro North.
  • Succession – section in guideline needed to be elaborated, including that existing consumers will continue to be supported
  • Engagement agreement– confusion around who explains this to consumers
  • Diversity of consumers-  ensure a diversity of consumers is involved that is reflective of our community
  • Termination – this section requires more detail on the process for staff to follow and steps to address conflict as it arises, before it gets to this stage
  • Criminal history check – clarifications needs to be provided on when this required
  • Opportunities to network with other consumers across Metro North
  • Providing feedback to consumers on their involvement and outcomes
  • Consumers accessing support resources referred to in the guideline  (that are on QHEPS)

We Did

We sought clarification on some feedback from consumers and engagement leads and incorporated feedback where appropriate.

Some consumer feedback showed confusion on the intent of these resources and overall intent of consumer engagement across Metro North. We modified the resource to make to make this clearer.

We also sought clarification and support from Metro North executive on the final draft.

We Asked

In 2016, we commenced the  "Connection and Respectful Experience" (CaRe) survey in Community, Indigenous and Subacute Service (CISS) to understand our consumer experience and to improve our services.  The CaRE survey asked you how we are going in following key areas:

  • connection to reflect the importance of taking time to establish  trust and relationships
  • respect  to ensure that you experience respect in the way you are treated and in all communication
  • empathy  to ensure that compassionate care was provided to you
  • information to see if you received all the information you needed, in a way that you understood, and was helpful and timely
  • continuity and consistency to ensure that all healthcare professionals involved in your care were consistent and worked as a team to support you
  • involvement as a way of understanding if you felt you were involved in the decisions about your care as much as you wanted to be. We also asked if you wanted your family to be involved and how well we did that.

You Said

A total of 140 people completed the survey.

Across all of the domains, overall scores were given.

  • The lowest questions scored was “Were your family and/or friends involved in your care as much as you wanted them to be?”  followed by “Were you involved in decisions about your care as much as you wanted to be?”.  These two questions had the highest ‘never’ responses.
  • Four other questions scored below 90%:
    • Did staff take time to get to know you?
    • Was information provided to you in a way you could understand?
    • Were you able to ask any questions that you had?
    • Do you feel staff involved in your care worked well together?
    • How likely are you to speak highly of your experience?
  • In response to the request for further information, the following specific issues were identified:

  • Specific issues identified at CISS by consumers included:

  • Comfort and environment of Interim Care – including food, maintenance, comfort and temperature.
     
  • Parking “Car parking a problem”

     
  • Appointment system: “Hard to get appointments that work with everyone” and “I wasn't sure if I could request an earlier appointment if I had issues with my medications”.  Appreciative comments focused on the flexibility of appointments that allowed patients to manage their time, and fit with their schedules.
     
  • Continuity of care “Always changing educators, hard to build a relationship…” .
     
  • Need for understanding of elderly and carer needs and support needs of patients.  Comments reflected this and the appreciative of a helpful and supportive service were echoed.
     
  • Respect and communication: “I felt inferior and not listened to.” 

Connected/integrated care “Staff were confused on arrival. Did not receive information on arrival. I had to ask questions to find out what was happening…” and “Follow up phone calls don’t always happen.” Comments also reflected linkages and communication between services could be improved

We Did

In response to the findings, the following actions are underway:

  • Present the findings of the CISS CaRE Patient Experience Survey Pilot Evaluation to the CISS Engage Committee Meeting
  • Develop and implement a CISS Consumer and Community Engagement Plan that includes the roll out of the CaRE Patient Experience Survey across service lines
  • Develop strategies to provide the survey in a variety of formats such as mobile device, hard copies, email link, text link etc.
  • Investigate the feasibility of using the CaRE Experience Survey following a clinical incident and/or complaint
  • Set 'stretch' targets for each domain  (e.g. 95%)

We Asked

Keeping older people healthy and independent is our priority. What should be done to support this priority?

If three (3) things could be improved in health care for older people with complex care needs what would they be?

Carers play an important role in supporting many people who are ageing. What is working well to support carers? What could be improved for carers?

There were 70 respondents in total, noting one of these was invalid as no answers to the questions were provided. Of the respondents 70 per cent identified as an older person. More than 24 per cent of respondents stated that they look after an older family member or friend in an unpaid or informal capacity, and less than three per cent were paid carers working for an organisation.

More than 40 respondents identified a willingness to be involved in future consultation by providing their contact details.

You Said

We Did

Metro North Hospital and Health Service and Brisbane North PHN have developed a new five year healthcare plan for older people which will guide the way we deliver healthcare services to this group of people in our community. It is not the last word, but a document that will allow the vision to expand and grow.

Thank you for your support

We Asked

Through the CaRE Patient Experience survey trial undertaken at Caboolture Hospital in November - December 2016, we asked patients and carers about thier experiences through the CaRe "Connection and Respectful" Experience  (CaRE) survey.

Through the CaRE survey, we asked you how we are going in following key areas and scored us out :

  • connection to reflect the importance of taking time to establish  trust and relationships
  • respect  to ensure that you experience respect in the way you are treated and in all communication
  • empathy  to ensure that compassionate care was provided to you
  • information to see if you received all the information you needed, in a way that you understood, and was helpful and timely
  • continuity and consistency to ensure that all healthcare professionals involved in your care were consistent and worked as a team to support you
  • involvement as a way of understanding if you felt you were involved in the decisions about your care as much as you wanted to be. We also asked if you wanted your family to be involved and how well we did that.

 

You Said

176 people participated in the survey across a variety of locations (Emergency Department, Wards, Maternity).  Overall, you  said that your experience was positive; however there was also some consistent themes where you said we could improve.  The areas in which we scored lowest are:

  • the score that you gave us for your overall experience highlghted room for improvement
  • involving you and your family as much as you would have liked is another where you said we could improve
  • taking time to connect with you and understand  your individual needs is something you also said we could improve.

From the additional comments that you provided, we identified the following areas  areas of importance to our consumers:

A few specific issues were raised :

  • maternity visiting hours were restrictive and partners wanted to be able to  stay with mothers and newborns for extended hours
  • parking was a signficant issue, particularly for people who are older or those with a disability
  • the abilty to charge phones
  • care of elderly, particularly frail, and their carers

We Did

A Metro North group of consumers has reviewed  the themes that emerged to develop a Metro North patient experience strategy that will aim to improve the experience of patients in these areas.


We are now commencing our 2017 CaRE survey with the aim of ensuring we are on track to achieving 10/10 in all areas of importance to the patient.

 

We Asked

In 2016, we commenced the  "Connection and Respectful Experience" (CaRe) survey in Metro North Oral Health Services to understand our consumer experience and to improve our services.  The CaRE survey asked you how we are going in following key areas:

  • connection to reflect the importance of taking time to establish  trust and relationships
     
  • respect  to ensure that you experience respect in the way you are treated and in all communication with you
     
  • empathy  to ensure that compassionate care was provided to you
     
  • information to see if you received all the information you needed, in a way that you understood, and was helpful and timely
     
  • continuity and consistency to ensure that all healthcare professionals involved in your care were consistent and worked as a team to support you
     
  • involvement as a way of understanding if you felt you were involved in the decisions about your care as much as you wanted to be. We also asked if you wanted your family to be involved and how well we did that. 

 

   
   
   
   
   
   
   
   

 

You Said

Overall, we found that you had a positive experience and we received above 90% score in all areas except one area (involvment of family and friends); however, there were some consistent issues and area that you said we could improve. 

   
  • Communication, continuity and consistency, understanding what was happening, access and availability of services were key issues identified. 
  • A detailed report of what consumers told us is attached.
     
     
     
     
     
     
     
     
     

 

We Did

We understand that Metro North Oral Health consumers are grateful for the services that we provide and we are committed to improving, year on year, the overall score we receive in all of the areas of the CaRE survey.

In response to the 2016 CaRe survey, we developed a plan of action. Some of these actions have been completed; some are in progress and others are longer-term system changes.  

  1. We have introduces a montlhy orthodontic screening service in Redcliffe/Caboolture.
  2. We have updated referral guidelines to specialist services and have published a referral form on-line to improve the transition between services
  3. Staff training is now being rolled out to improve our staff's communication skills and style, ability to involve patients in decision and to improve the effectiveness of communication between staff
  4. Electronic records and digital imaging will be introduced in December 2018 and records will be available to all so that we can improve the sharing and management of information across the system. This will improve the contunuity and coordination of services for patients.

We have just completed our 2017 survey and will report back on where we achieved our goals.

 

We Asked

For your input into the revision of the Health Service Strategy 2015-2020

You Said

Health Service Strategy review and refresh – phase one consultation themes emerging

Over the past 18 months Metro North Hospital and Health Service (Metro North) has actively worked towards implementing the Health Service Strategy 2015-20. Through the commitment of all staff many priority areas identified in the Strategy have been achieved. To ensure the Strategy aligns with the Metro North Strategic Plan and continues to guide the development and delivery of health care services a review and refresh of the Health Service Strategy is underway.  

The first phase of the review included extensive key stakeholder consultation with staff, community partners and consumers.  This phase is now complete and a summary of the key themes are described below. The full consultation report is available. Please email metronorthengage@health.qld.gov.au to request a copy.  Thank you to all who participated.

Summary consultation key themes

Please note the themes described below are a summary of information heard though consultation with a broad range of stakeholders.  The information will be used to guide and inform the development of a refreshed Health Service Strategy.  The themes do not reflect MNHHS policy or position at this time.

Potential new and/or expanded priority areas:

  1. Expanding partnerships to include care of the individual ie person-centred care including role of families/carers - caring for people’s social, emotional and physical needs. Person-centred models of care rather than speciality (subspecialty) approaches to care. Patient health literacy to enable informed decision making, timely care in the right setting. Working with families and carers ensuring their health, including mental health, during the care of their loved ones, especially long term
  2. Keeping people healthy and well - public health, prevention, screening and health promotion could be strengthened in the refreshed Strategy.
  3. Preventing functional decline and long term problems for people with chronic disease or injury.
  4. Older persons care- considering three age groups individually over 65, over 75 and 85. This would include keeping people healthy and helping people to participate in healthy lifestyles eg increasing physical activity and eating better. Better managing chronic disease in community settings.  Consider care across organisations, services and settings.  Rehabilitation, end of life and palliative care included in this theme. Improve transition care, links to residential and interim care and raise awareness of services available across Metro North.
  5. Children and young people- this was a broad theme consistently discussed in consultations including:
  • Mothers health, including mental health, while pregnant (perinatal)  to enable healthy well babies
  • 0-5 health recognising improving wellness in this age group will have lifelong outcomes
  • Young people (no age definition agreed)- staying healthy and active, mental health and access to age-appropriate acute care and environment
  1. Aboriginal and Torres Strait Islander and Culturally and Linguistically Diverse populations –missing from current Strategy

Other themes that have been raised but not consistently in consultation are:

  1. Urgent care in the community and home - alternatives to the Emergency Department.
  2. Drug and alcohol complex detox services.
  3. Information and data – consultation identified opportunity to review data collected and streamline/reduce, share information, standardise and make available to improve care (eg by clinicians on the floor-real time- (similar to the Patient Access Coordination Hub), share information across providers.
  4. NDIS pathway – consideration of consequences if system failure. If successful more people will be seeking care in own home.
  5. Social model of health - connectivity with broader community.

 

We Did

The next step in the engagement process involves an executive stakeholder workshop that will be held in February to consider all the feedback and to discuss the refreshed Health Service Strategy. Consumers and community stakeholders will be represented at this workshop and will contribute to the discussion. It is anticipated that a refreshed draft Strategy will be available and disseminated for comment in April 2017.

We Asked

For applications for the LINK Project funding.

You Said

We received 36 applications from Metro North staff and partners.

We Did

Reviewed applications through a rigorous process and selection panel to determine who would be provided funding.

We Asked

We asked for:

- feedback about your experiences using any genetic service

- opportunities to enhance the current and future supply of services

- addionional comments

You Said

You said:

- the service was comprehensive and caring

- poor support for patients and carers of rare diseases

- reduce wait time, expand services in regional areas

- better linkages and communication with genetic specialists

- integrate IT systems

- develop fact sheets and promote services

- enhance opportunities for research, education and training

We Did

We did

- all responses were tabled at the Genetic Steering Committee held in May 2016

- all responses will be systematically analysed and considered in developing future service directions for the statewide health service plan for Genetic Health Queensland

We Asked

Whether you felt  that staff involved you in preventing and managing pressure injuries

You Said

Not many staff provided you with brochures. Some staff provided you with good information, however other staff didn't listen to your concerns.

We Did

A report with the results has been written and will be circulated. We will encourage staff to provide you with written information, and provide staff with education regarding consumer engagment strategies.

We Asked

We asked for feedback on the draft Consumer and Community Engagement Strategy 2016-18 for Metro North Hospital and Health Service (Metro North). The draft strategy proposed a direction for consumer, carer and community engagement in MNHHS over the next three years.  The final strategy resulting from consideration of all feedback is now available:  Connecting for Health: strategy for inclusive engagement, involvement and partnerships 2016-18 

A full report of feedback and our response is available on the Consultation Hub home page.

You Said

  • Terminology is important and different proposals for correct terminology  were suggested.  The language we use needs to be consumer friendly
  • Clarify the outcomes we are seeking to achieve in terms of patient and consumer-centred care and partnerships for seamless service delivery
  • Clarify the roles and responsibilities of those who will bring the strategy to life
  • Concrete and measurable actions will support our strategy with proposed examples and areas to focus on over the next three years

We Did

Clarity of language:

  • changed the title to Connecting for Health to set the tone for collaboration
  • included a glossary that defines common terminology used
  • included an explanatory note about the terminology used for the purpose of the Strategy
  • simplified the language as much as possible while still meeting legislative and health service planning requirements.  We removed jargon and acronyms wherever possible, including replacing the acronym MNHHS with Metro North
  • included a section on “Outcomes” that outlines in clear, consumer friendly language what the strategy means in practice for people who access Metro North services 
  • committed to establishing a consumer group to co-deisgn and draft  a Connecting for Health summary document.

Outcome-focused priority objectives:

  • strengthened and clarified the purpose of the strategy in terms of its outcomes for consumers by creating four priority objectives that all are essential to a culture of consumer-centred care:  Lead, Include, Respond, and Integrate. These four areas capture the key themes that emerged from feedback around leadership, inclusion, responsiveness and integration and fit with Metro North’s strategic plan and its vision for “Putting People First”.  

Concrete and measurable actions:
Under each prioroty objective, we included a number of specific actions you suggested including the following examples:

  • targeted engagement strategies to improve inclusion of specific groups including Culturally and Linguistically Diverse (CALD), Aboriginal and Torres Strait Islander, people with disabilities, and those who may be impacted by NDIS reforms
  • working towards a consistent Metro-North wide approach that is supported by tools, policies and guidelines that can be adapted to local situations and contexts 
  •  working collaboratively  with community organisations and with consumer representatives to improve seamlessness of services, and coordination of consumer and community engagement.

Clarify governance, roles and responsibilities:

  • included a “Roles and Responsibilities” section that clarifies how the strategy will be implemented.
  • ensured actions specify who/what areas will be responsible for delivering them.