1. What do you like the best/least about the clinic? Waterloo Region Nurse Practitioner-Led Clinic

2. Angie Kalra June 2014 WRNPLC Patient Satisfaction Survey

3. Background  As part of the clinic mandate and agreement with the Ontario Ministry of Health, a Quality Improvement Plan is being initiated.

4. Quality Improvement Focus The clinic’s approach to Quality Improvement includes:  Timely access to primary care when patients need care  Primary care that is integrated with patient’s other health experiences, including hospital stay and home care.  Patient-centered care, based on developing a partnership with patients to achieve appropriate health outcomes

5. Method  2-pronged approach  Paper and Pencil Version  Survey Monkey Version  Convenience Sample (June 2014)  Anonymized data collection

6. Changes  Added Ministry Mandated questions  Removed few questions  Added provider location

7. Demographics- November 2013

8. Demographics- June 2014

9. Changes  Demographics remain roughly the same  Female population rose 3 percent while male population decreased

11. Analysis of data  N=96 responses, all paper  All data was transcribed into the Survey Monkey site  Numeric data was analyzed and data charts created.  Short answer data was summarized by noting recurring themes  N=96 responses

12. Location of Provider- June 2014  Results:  3 patients see their provider at both locations.  Limitation: Cambridge site treats more patients

13. Hear About Clinic- June 2014

14. Office Hours- November 2013

15. Office hours - June 2014  Differences:  Results are roughly the same from November 2013 to June 2014 with no notable differences

16. Transportation to Clinic– November 2013

17. Transportation to the clinic June 2014  Differences:  Results have improved this month with a higher percentage of patients selecting “always”  Common issue is public transit to the Pioneer Park location

18. Returning Calls- November 2013

19.  Differences:  Results are roughly the same from November 2013 to June 2014 with no notable differences Returning Calls - June 2014

20. Wait Times- November 2013

21.  Differences:  Results appear to have improved this month with more patients selecting “always” Wait Times- June 2014

22. Listens to You- November 2013

23. Listens to You - June 2014  Differences:  Results are roughly the same from November 2013 to June 2014 with no notable differences

24. Answers Questions- November 2013

25.  Differences:  Results have slightly improved from November 2013 to June 2014  Roughly 80% patients feel that the staff answers their questions Answers Questions- June 2014

26. Clean Building- November 2013

27.  Differences:  Results have improved from November 2013 to June 2014 with Clean Building- June 2014

28. Feeling Safe- November 2013

29.  Differences:  Results are roughly the same from November 2013 to June 2014 with roughly 88% of patients feeling safe within the clinic Feeling Safe- June 2014

30. Referring Clinic- November 2013

31.  Differences:  Results have improved from November 2013 to June 2014 with 85% of patients who would refer the clinic to their friends and family Referring Clinic- June 2014

32. Privacy- November 2013

33.  Differences:  Results are roughly the same from November 2013 to June 2014 with no notable differences Privacy- June 2014

34. QIP Questions Ministry Mandated Questions

35. Time to See NP- June 2014

36.  Results:  Majority of patients waited 2-19 days to actually see their provider from when they first tried, with an average of 6.5 days.

37. Opportunity to Ask Questions- June 2014

38.  Differences:  Results are roughly the same from November 2013 to June 2014 with no notable differences

39. Involve Patients- June 2014

40.  Differences:  Results are roughly the same from November 2013 to June 2014 with no notable differences

41. Spends Enough Time- November 2013

42. Question 19

43.  Differences:  Fewer patients feel that their nurse practitioner spends enough time with them.

44. Short Answer Questions

45. “What do you like the best/least about our clinic?” Recurring Themes (best): Recurring Themes (least):

46. Examples of Answers Best:  “Availability of same day appointments, enough time for thorough discussion at each visit, I feel that my nurse practitioner is taking a holistic approach in regards to my well being.”  “That you take time to be thorough and are open minded to my input regarding the care of my son and myself”  “Love the empathy and time a nurse practitioner has compared to a doctor,”

47. Examples of Answers Least:  “Limited hours and few NPs to choose from”  “Location for me. There isn't always someone available in Kitchener.”  “…it is in a pretty inconvenient place.”

48. “Do you have any suggestions for improvement?” Recurring Themes:

49. Examples of Answers  “More people available at Pioneer”  “More knowledge regarding infants and infant care needed”  “Promptly answering/returning messages and phone calls. Giving more time for meetings with patients.”  “Yes, it would be nice to see a doctor in the event that the nurse practitioner cannot help the patient.”

50. Summary of Results  Majority of clients heard about the clinic through friends and family  Compared to November 2013, 24.6% more patients find that wait times are acceptable  93% of patients would refer family or friends  91% of patients feel that their information is kept private  Roughly %99 of patients feel safe when at the clinic  All categories improved from November 2013 to June 2014 by an average of %11

51. Limitations of Survey  Fewer patients at Pioneer Park  Convenience sample  Potential for response bias  Only English speaking clients were able to participate  Patients felt rushed  Many incomplete surveys

52. How to Improve Next Time  Print surveys one sided  Mail out survey  Promote online version of survey

53. Next Steps  Repeat survey at specified intervals  Translate survey if possible  Consider offering individual interviews to collect data from those who require assistance  Perhaps encourage a nominal prize for participation in online survey  Set up laptop station for patients to fill out survey while waiting for treatment