1. A new tool for measuring client experience
Catherine Joyce
Research & Innovation Manager Anglicare Australia Conference September 2017

2. Background

3. What is ‘client experience’?
Client satisfaction
How satisfied are you with information about your care?
Associated with expectations – high satisfaction is common
Low satisfaction is hard to interpret or act on without further information
Client experience
Have you been provided with information about your care? Did staff check that you understood the information?
Associated with quality of care
Direct link to actions of provider to improve care and services
Client outcomes
Has this service assisted you to do the things that are important to you?
Impact of services/care - quality of life measures
Can be hard to link to different aspects of service/ care (what made the impact)?

4. Developing a tool Clarify purpose Review existing tools and approaches
Develop conceptual framework (domains of interest)
Adopt/adapt/design data collection tool
Don’t just develop a tool: Develop detailed procedures for all stages of the project

5. Purpose of Benetas Experience Survey
Goal: to better understand the experiences of clients accessing Benetas services in order to identify areas of service provision that can be improved or changed. Objectives:
Provide an opportunity for service users to provide feedback that informs quality improvement
Identify the extent to which Benetas’ principles and values are reflected in service user experiences
Generate evidence to contribute to monitoring of Quality Management Framework, as well as external accreditation or other standards.

6. Elements of existing tools can be used.
Review of tools: key findings
No “gold standard”
Often aligned with ‘satisfaction’ rather than experience’ approach
Often not tested or validated in Australian aged care settings
Feasibility & practicality (time, cost etc.)
No single best fit with Benetas QMF and AACQA principles
Elements of existing tools can be used.

7. Survey Tool: Domains Domain Description Dignity, autonomy & choice
Respect for inherent personhood
Autonomy, independence, individuality and choice
Staff interactions
Relationships with staff
Information and communication
Personal & clinical care
Personal care: help with dressing, eating, bathing, going to the toilet
Clinical care: nursing care, pain management, medication management, palliative care etc.
Lifestyle & support services
Lifestyle: Access to meaningful and enjoyable activities, social interaction, physical activity/mobility
Support services: Meals, cleaning
Service environment
[Residential facilities only]
Physical environment, atmosphere, sense of safety

8. Survey Tool: Domains Domain AACQA draft single quality standards
AACQA literature review
Benetas QMF Objectives
Benetas Values
Dignity, autonomy and choice
Consumer dignity, autonomy and choice
Feedback and complaints
Respect and dignity
Choice
Organisational environment & resources
1: Responsive to and respectful of the individual person and focused on their choices and needs.
Respect: We take the time to understand and value each person and respect their choices.
Staff interactions
Human resources
Staff actions and interactions
Spirit: We build a positive, energetic culture dedicated to creating fulfilling life experiences for older people.
Community: We strive to build strong relationships and communities of interest among all stakeholders by working together in an open, involving way
Personal and clinical care
Ongoing assessment and planning with consumers
Delivering personal care and clinical care
Clinical and personal care
2: Supportive of each person to fulfil their quality of health and quality of life. potential to live their best life
3: Safe and free from preventable harm.
Respect
Responsibility: We act with integrity towards our clients, their families and carers, our supporters and the broader Anglican community.
Lifestyle and support services
Delivering lifestyle services and supports
Social environment
2: Supportive of each person to fulfil their quality of health and quality of life potential to live their best life.
Spirit
Service environment
Physical environment
Functional environment
Responsibility
Not included
Organisational governance

9. Survey tool content Domain Survey section name Overall
Dignity, autonomy & choice
My rights and choices
Lifestyle & support services
My interests
Staff interactions
Benetas staff
Personal & clinical care
My care [and services]
Service environment
My environment

10. Producing the final version
Question design
Response formats
Plain language
Layout

12. But wait, there’s more…

13. Survey approach Engagement Promotion Sample preparation
Planning
Engagement
Promotion
Sample preparation
Data collection
Resource requirements
Modes of collection
Data management
Reporting
Key audiences
Actionable information

14. Engagement
Early consultation meetings with key end-users and other key stakeholders
Iterative review of draft materials and procedures
Communication Plan: Information to operational staff through multiple channels

15. Promotion Promotional materials developed
Flyers mailed to >1000 home care clients
Posters, FAQs and flyers distributed to 13 residential facilities and 3 respite centres
FAQs distributed to operational staff

16. Sample preparation Survey sample
Home care client list – generate and review
Residential client list – generate and review
Resident relatives list – generate and check
Respite clients & relatives list – generate and check
Home care relatives list – generate and check
Sample preparation

17. Data collection methods
Promotion
Recruitment method
Data collection methods
In person - assisted
Phone - assisted
Hard copy
Online
Home care clients
Mailout flyer
RAs by phone 
Respite clients
Posters, flyers, & FAQs at sites
RAs onsite, as directed by staff
Residential clients
Posters, flyers & FAQs at sites
Family members (all)
(indirect)
Mailout

18. Survey approach: key considerations
Data collection by research team, not usual care staff
Ability to report results by at a meaningful unit of analysis
Separate processes for care recipients versus families
Clear dissemination and reporting plan (“closing the loop”) which takes account of local context

19. Conclusion Purpose drives everything
There’s no need to re-invent the wheel, but make sure it’s relevant to your context
Engagement is key
Creative problem-solving and flexibility is a must