1. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 ENQual workshop 2 report on patient satisfaction Center for Healthcare Quality National Institute of Public Health Czech Republic A. Bourek

2. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

3. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 evolution  Before year 2000 sporadic in-house attempts to address patient satisfaction, based on locally devised patient survey questionnaires  Break-off point - fulfilling Government decree No. 458/2000, „National program of preparation of the Czech Republic for accession to the EU“ and meeting tasks of the Top Level Administration Meeting of Ministry of Health from 30.10. 2000.

4. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 steps 1.Modular project of the quality support in health care, proposed by the Center for Health Care Quality – call for projects for years 2001-2002 2.Accepted project „Quality through the eyes of the patients“ (main contractor Stem Mark a.s) 3.Based on Picker Institute framework 1.Used previous materials of Dr. Bílek (Plzeň Teaching Hospital) 2.Supplemented by questionnaire on Quality of Life evaluation EuroQol-5D 3.Modified after pilot study on sample patients

5. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 project characteristics 4. Survey effected on patients of internal wards of collaborating hospitals discharged 18.11.2002 to 8.12.2002 one day before discharge. Minimal hospitalization span 3 full days, 3 nights. 5. 2000 questionnaires were collected and evaluated. 6. Validizing follow-up interviews performed on 700 respondents by means of CATI (Computer Aided Telephone Interviewing) 14 days after the respective discharge.

6. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 goal / target 6. Weighted correction assuring better fit to the yearly socio-demographic distribution of patients was performed by the Stephan- Deming method with help of data provided by the Institute for Healthcare Informatics and Statistics. Weights assigned to responses in the range of 0.33 to 3.00 to balance the absence or dominance of certain socio-demographic groups during the surveyed interval.

7. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 % representation of categories HOSPITAL15-54 years55+ yearsMaleFemale VFN Praha27734951 FN Královské Vinohrady Praha23775149 FN Thomayerova Praha19814555 FN Motol Praha287250 FN Na Bulovce Praha21794555 FN Brno34665149 FN U sv. Anny Brno24765743 Cheb22784753 Karlovy Vary19814753 Mariánské Lázně24764654 Ostrov23774654 Sokolov23774654 Havlíčkův Brod20804753 Jihlava16844753 Nové Město na Moravě21794951 Pelhřimov19814654 Třebíč20804555 Velké Meziříčí19814555 FN Ostrava22785248 FN Olomouc25755248 FN Plzeň24765347 FN Hradec Králové28725347 Celkem (pro CATI)247650

8. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

9. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 sample results

10. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 sample – emotional support

11. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 continuing project year 2003  2003 – participation of 15 hospitals (internal medicine wards)– each ward collected 100 subsequent forms  FN Hradec KrálovéFN Plzeň  VFN Praha  N Sokolov  FN Královské Vinohrady  N Karlovy Vary  ON Vsetín  FN Motol  N Uherské Hradiště  MN Valašské Meziříčí  N Baťova Zlín  FN Olomouc  FN Thomayerova  N Kroměříž  ON Nové Město na Moravě

12. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 overall patient satisfaction

13. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 hospital admission

14. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 respect, consideration

15. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 care coordination, integration

16. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 information, communication

17. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 bodily (physical) comfort

18. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 emotional support

19. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 family integration

20. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 discharge and continuity

21. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 outpatient care - mammacenters Czech Rep. has 120 mamodiagnostic centers –55 accredited centers CATI response rate at 90 % 55 % of respondents compliance with face-to-face questioning

22. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 mamma-center outpatient survey

23. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 referred by and informed

24. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 choice of center

25. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 waiting times in center

26. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 procedure and result perception

27. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 follow-up interventions If follow-up was needed, patients described how it was effected and with how long waiting times.

28. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 following surgical treatment Patients commented on waiting times for surgical treatment and level of explanation of the necessity of the procedure.

29. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 overall assessment of facility

30. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 information on preventive measures

31. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 mamma-centers survey

32. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking – overall satisfaction

33. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking - admission

34. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking - respect

35. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking - coordiantion

36. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking - information

37. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking - discharge and follow-up

38. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 benchmarking - patient education

39. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 inpatient questionnaire

40. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

41. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

42. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

43. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 mamma-center questionnaire

44. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

45. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

46. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2

47. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 lessons learned Quality from patient prospective „not so bad“ Interest on behalf of collaborating centers Use of professional interviewing teams Use of professional system analysts Use of socio-demographic data collected by Institute of Healthcare Statistics and Informatics Feasible CATI methodology Initial interest in benchmarking

48. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 problem areas Financing (of course) Sustainability of evaluations Medialization – publicity REPORTING (formats, volume of revealed data, need for explanatory materials for „lay community“ to interpret presented facts Lack of interest on behalf of „payers“ Feeble legislative framework Problems with feedback to the basic level of care providers in respective facilities

49. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 ongoing and improvement PHP format of all questionnaires enabling „on- line“ collection of patient perceptions (accessible from web-pages of each respective facility), collection directly into structured database with „intelligent“ data cleaning Construction of outpatient specific questionnaires (much greater heterogenicity when compared to inpatient care) Medialization and centralization of result presentation – one-spot access

50. ENQual workshop 2 Helsinki April 2 to April 3 ENQual wrkshp 2 contact: bourek@ivf.cz