E-Health Insider award winner blazes trail for NHS

Harnessing the power of public opinion electronically helped Homerton University NHS Foundation Trust take home the 2007 BT e-Health Insider award for Excellence in Health Information Management.

After winning the award last year the trust’s achievements were recognised by other trusts, policy makers and even ministers. The patient opinion capture system is not only recognised in the next-stage review of the NHS but identified as offering a blueprint for the rest of the health service to follow.

The trust is using Dr Foster Intelligence’s Patient Experience Tracker (PET) tool to gather patient opinion on hospital care in six wards of the busy east London hospital.

The trust has also been visited by health minister Lord Darzi, who saw it as “a glowing example of best practice in gathering patient views and using them” and cited the hospital in his recently published NHS next stage review. Homerton is one of the sites piloting digital dashboards which will reflect patient opinion on quality of care, and will influence how much hospitals get paid.

Patients are given electronic handsets programmed with a set of questions to evaluate their experience as a patient at the hospital. By pressing a response which best matches their experience, patients can give their anonymous opinions of their treatment, This is then transmitted wirelessly to an external database.

Staff are sent the results every fortnight, and use them to improve the quality of patient experience on their wards. To communicate these results to patients, posters are put up around the hospital explaining the results and improvements to be made.

Pie charts and improvement monitoring graphs are also displayed to show what the current score for the ward is and how the ward has been improving on a month-by-month basis.

The tool was in use for seven months before Homerton won the award, and it was the trust’s chief executive who convinced Jennie Negus, deputy director of nursing and project manager, to enter the awards.

She told E-Health Insider: “Our chief executive wanted to show off the success of this system. Having spent £15,000 on introducing it, it was helping to deliver great benefits to the trust in terms of gathering information from patients and using the feedback to identify potential improvements and review progress.”

Negus and colleagues from Dr Foster Intelligence were delighted to be shortlisted and invited to present their system to the judges, but she was even more pleased to win.

“I really didn’t think we’d win. I thought were too little to compete with our much larger competition. It was great recognition to be nominated in the first place, and winning the award was just the cherry on the cake.”

Winning the award has helped to extend the system into more wards, instead of being used in rotation, and in the next few months the trust is set to become a national reference site for other trusts interested in the project.

“Winning the award has been brilliant. I and the rest of my team, are exceptionally proud to have won this national award, which is so highly regarded by the informatics profession. After the awards, I got lots of enquiries and visits from other trusts wanting to see the system, and quite a few of them have gone onto implement the system.”

The trust has also been visited by the Department of Health, which was so impressed by the system, that together with Dr Foster Intelligence, they launched their “Patient Insight: harnessing the power of public opinion” report there, citing the trust’s use of PET as an example of best practice in gathering patient views and using it.

“To my surprise we had a full house at this event, and was able to demonstrate our system getting attendees to give responses using the terminals and presenting their results to them at the end of the session. Harry Cayton spoke at the event, launching the report, and the Healthcare Commission also came along – so all in all, the award has helped us really boost our profile, and we are very proud of that,” Negus said.

For Homerton, PET has helped them to engage with more patients, review issues and develop and implement action plans within weeks. Negus says patients have noticed the improvements, and the trust is happy to see a more representative sample of patients giving positive feedback, compared to their annual patient survey response.

“We only had 352 responses to our national patient response survey, and the results weren’t that great. However, you have to take into account that this is 80 questions and the overall report looks at the whole report, and not a question by question basis. With PET, we can look at each question in detail and see specifically which areas need improvements in real time.

“By the end of January, we hit the 10,000 patient mark, and in our first year, 8000 patients had used the system to offer their opinions to five questions, just before they leave the ward. This means we are averaging 659 patients a month – double the amount who answered the national patient survey, and we are aware how our wards are doing,” she said.

The service can be used by any patient and translators are on hand to aid patients who do not speak English. System guides are also available in 24 different languages, so anyone can use the system before they leave hospital.

As a result of the award, the trust board allowed Negus to invest in five more terminals, and have included extended use of the system in their 2008-2010 operational framework and Negus hopes the system is in use across all 24 wards in the hospital by then.

Patients are also more aware of the feedback system thanks to local press coverage and the results are often used by the trust for marketing purposes.

Negus encourages others to nominate themselves for the health information management category: “If you have something good, you should definitely go for it. The judges are quite inquisitive so you need to be able to demonstrate what you have done, and have evidence that it is making a difference to patients, who are the ultimate benefactors.

“You should also be good at showing off, don’t sell yourself short. You can get a lot back from applying, and at the end of the day, it’s the icing on the cake to win, but just to be commended or go-home as a runner up in such a prestigious competition is just as good.”