Q1 by taoyni

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									Appendix 4- Choice at the Point of Referral in Cardiac Care. The Essex Model 2005-6 Report



Choice Cardiac Patient Questionaire
Collated information and responses




The choice questionaire was given to 893 patients
Number of responses received to date                                    134 15% of total
Number included in chart data                                           120

Number of second questionaire sent                                       46
Number of responses to follow up                                         29 63% replied
1. Has being able to Choose the hospital made a difference to your experiences?




                  39%

                                                                                  Yes
                                                                                  No

                                                    61%
                      1a. Has being able to Choose the hospital made a difference to your experiences?




                                                          Increased confidence in NHS
                                                                      8%


                                                                            Able to go to a familiar hospital
          Comparison of hospitals / knowledge                                             5%
           of e.g. infection rates and mortality
                            rates                   Having a say
                             9%                         9%                                             Increased concerns about operation
                                                                                                                      1%
                                                                                   Being able to stay with same
                                                                                            consultant
     Being able to choose the shortest                                                          5%
               waiting time                                                                                                         Additional difficulty of making a choice
                    9%                                                                                                                                  1%

                                                                                                                                                 No difference
                                                                        Other                                                                         1%
                                                                         9%

Able to choose hospital with good
           reputation                                                                  Having control over future treatment         Explanation of procedure /
              10%                                                                                      2%                          Reassurance / 'Peace of Mind'
                                                                                                                                               4%


                                                   Able to choose a hospital which is
                                                   most convenient / easisest to get to
                                                                 36%
2. Had you heard about the Patient choice before you had your angiogram




                                           23%




                                                                          Yes
                                                                          No




                  77%
3. If you did know about patient Choice before you had your angiogram please briefly describe how
                                             you knew




                                           Media
                                           42%




                                                                               GP
                                                                               8%




                                                                                       Work
                                                                                       4%




                                                                                 Leaflets at hospital
                                                                                         8%




          Through pre-assessment process
                       17%
                                                            Other patients / friends
                                                                     21%
4. When you came for your angiogram were you given an information pack about patient
                                     choice?




                              8%




                                                                                       Yes
                                                                                       No




                                        92%
5. How useful would you say this information pack was in helping you to choose where
                      to go for the next stage of your treatment




                                 4%

                                          14%



              44%                                                                 Poor
                                                                                  Adequate
                                                                                  Helpful
                                                                                  Very Helpful


                                           38%
   6. What was the most helpful information or advice you were given to help you make your choice?


                                                                  Influenced by media / reputation
                                                                                4%
                            Facilities for visitors / relatives
                                            5%                                      Mortality rates
                                                                                         3%
                     Consultant / links with DGH
                                 6%


      Details of Procedure / follow-up care
                       6%


                                                                                                      Other
                                                                                                      19%
Consultant or other clinicians opinion
                 7%



                                               MRSA /
                                           infection rates
                                                 7%                                     Location / How to get
                                                                                         there / travel details
                                                                                                  19%

                                                  Blank
                                                   9%



                                                                    Waiting times
                                                                        15%
 7 What was the least helpful information or advice you were given to help you make your choice?

    No Success / Failure Rate of theatre team
    The waiting time reported as 2.5 to 3 months. In reality 4 to 5 months (for by-pass surgery)
    The telephone number given in the folder
    Up to the time, there is only one Hospital which done this work then being informed that there were now 2 and in December 2005 there could be more, it puts you in a daze
    I think the pack should be available to out patients when attending Cardiac Assessment Clinic, should further surgery be required we are aware of Choice
    Longer wait for operation
    Mortality rates
    General information about car parking, hotel accommodation, menus, etc - all of little consequence at this stage and risk of information overload
    Information on Guy's/St Thomas' Hospitals
    Royal Free did not include waiting times, mortality rates, infection rates
    Information being only on websites, eg UCLH mortality rates, not everyone has access to internet
    I did not know any of the hospitals or where they were located or how much the fares were going to be
    No specific info on where partner to stay if any accommodation is available on the Barts leaflet
    Travel arrangements
    Waiting lists!
    Too much Choice! Without an indepth reason
    No information on consultant
    The inclusion of case histories as all illnesses and patients are different
    Royal Brompton - did not give any infor on train, tube or bus to help you decide if you can travel there
    Waiting times for one hospital and not the others. Accommodation nearby for one hospital and not the others
    Lack of info about accommodation available for the relative/friend to stay near the Hospital
    Information about how to choose which hospital to go to - lack of advice
    Too much about timetables of bus and trains and virtually nothing about hospital - eg Guys & St Thomas's. Royal Brompton Hospital are best for me in giving information
    Abbreviations. What is PCI, CABG, OPA?


Summary:
What is useful to some patients is not useful to others.
The information needs to be standardised within each. i.e. the same information for each hospital in the same format.
With a minimum of:
  Success Rates
  Mortality Rates
  Real Waiting times
  Infection Rates
  Map of all Locations
  Travel details inc. fares
  Accommodation
  General advice on how to choose
  Explanation of terminology and abbreviations
  Average Length of Stay (taken from Q10 response)
  London Congestion Charge (taken from second questionnaire response)
8. Did you have a chance to discuss Patient Choice with a member of staff




                     18%




                                                                            Yes
                                                                            No




                                          82%
9. How would you describe your experience of the Patient Choice Initiative




                                 8%


                                          10%


          42%                                                                Poor
                                                                             Adequate
                                                                             Helpful
                                                                             Very Helpful



                                         40%
10
Do you have any comments about how we could improve the information and support that we offer to help patients make their
choices in the future. Please comment below.

We were very happy with the information and support given in the pack and Basildon Hospital
Though the pack is adequate since I require angioplasty / Bypass procedure I want to know the success/failure rate of "my" theatre team.
Satisfied with all the information given
No the staff very helpful
The only thing I would like to see is that you could make an appointment with some one at the hospital to discuss the best thing to do.
Regarding the information pack after reading it through I must praise the service
On info sheets explain technical terms ie "CABG and PCI (revascularisation)" and "all other procedures"
The subject under discussion should have been in a quieter location, not a busy ward where 3 other patients were in conversation with nurses. This made what we were
discussing with our nurse rather fragmented
BHF booklets are very helpful. The treatment, procedure, etc, does not correspond to the information within the booklets.
The support and information I received was excellent
The nursing staff in Elmstead day ward were very helpful and looked after me very well. They gave me all the information I needed
I could suggest that prime members of staff discuss the information with the patient after the angiogram
I found the people at Broomfield very helpful
Telephone numbers and contacts for information on waiting lists and times
It would have been considerate for someone to have sent to my home address the full information about "Patient Choice" then I'd be more prepared. Thank you.
Level of information has been more than adequate
Just carry on being up front with patients with their care and safety while in the care of the NHS
Originally from Wales, hence my comments based on poor local (ie South East England) knowledge
The information provided was necessarily brief however, I don't think patients would be competent to assess fuller data. The most important criterion is survival with
improved health, but doctors should reject difficult cases in fear of poor outcome
You could do more heart surgery outside London, which is an awful place to get to and from
As a carer it would be very helpful if we could have longer notice before going in hospital
Cannot really think of anything. Most questions seem to be answered adequately
We can look at "success" rates and waiting times but we can't judge medically which might be better. We need a medical recommendation from the referring hospital
Colchester Hospital staff were excellent and very professional in the way they treated me and my husband
All hospitals in the choice of options should provide information on waiting lists, experience/track record in relevant area and indication of average length of stay for the
operation/treatment
More info on parking for visitors
A shorter waiting time for angioplasty
I could not think of anything I could say to improve anything but I would like to say a big thank you to doctor Sayer and his team, they are marvelous and once again, thank
you very much for all your help and good work
The choice between the hospital groups is biased toward Barts/London Chest because the information is more than that for Guy's/St Thomas'
Satisfied with information given!
To be pre-advised would seem a good idea but obviously not everybody having an angiogram goes on for further treatment
The practicality of learning the breathing and coughing exercises prior to the operation
We do not have any comments on how you could improve matters as we found staff and conditions excellent
The information given should be more structured. Each hospital giving information on predetermined topics. Other information could be given on supplementary sheets
Information should be comparable in like-for-like terms eg infection rates - Barts 0.18 cases per 1,000 bed days, UCLH 0.5% (of what?)
Possibly BBC TV hospital programmes
Everything seems to have been covered. I'm very impressed.
Need more input from senior staff who have had patients who have been to both Choice hospital and given helpful feedback
If patient choice is a necessity, rather than just getting treatment ASAP, then perhaps more actual figures - or figures for the same indicators in all choices offered
I feel I have been very fortunate at this hospital. There is team cohesion and a professional but warming atmosphere/climate
In certain circumstances some patients have ill people to take care of and would like to be nearer home
I will say there is nothing wrong with the service and advice from the consultants and/or staff there. You could send a larger envelope
I had 3 angio over the past 10 years at Colchester. I felt I was treated as a person and not as an object. Unlike London Chest staff and some doctors at Dedham Ward
By a member of ward staff having a chat for a few minutes on advice regarding what hospital choice and what happens next before I left the ward
I think everyone was extremely helpful and very kind and courteous
Information pack supplied immediately upon completion of angio operation (to own for patient to absorb satisfactorally - ???? (answer from no. 7- Information discussed
almmost immediately after operation - patient certainly in no emotion to exclude information. Surgeon and staff understanably too committed and under pressure for
waiting workload - to abate meaningful time. Eg surgeon/staff, involved in patient are extremely limited in time available for instructive discussion. Patient involved really
adversely affected - traumatised???????????????)
Information should be given when a relative is also present as it’s a lot to take in
More up to date information regarding waiting times on the various hospitals
To give comparisons between options regarding mortality rates, infections (MRSA). other compllications, etc
As a lay-man, I missed the input of a professional (ie Consultant) who would normally make the choice of referral on the basis of his experience
Information supplied should be standardised so that you can compare like for like (information supplied differs between hospitals)
A map of the London underground showing the hospital choices
Give the same information for each hospital so can compare. A map showing where the hospitals are in comparison would be helpful as don't know London that well
Give the pack to patients as soon as they "check in" rather than when they are about to be discharged so that they can make a better informed choice
"First class" information by all staff
A one sheet comparison chart listing the choice of hospitals and columns comparing the facilities ie columns headings could be: location, parking, waiting times, etc
All at Clacton, Colchester, Guys & St Thomas' were very pleasant and most helpful and informative. The standard of service was excellent all round
I welcome the choices and believe guidance should come from the doctor who knows what has to be done and the best available hospital to meet the individual's
To be given the information when attending for the angiogram in order that one could discuss it with senior staff
I would like some advice about how to choose which hospital to go to
Have details about what the hospitals have available - their success - how patients are cared for - to make choices all hospitals need to offer these
I found that after having angiogram I could not take in or discuss the option which hospital I should use. The staff was very kind and explained the option in some detail
but it would not sink in.
Give the patient more time to decide after their surprise at having a choice
Ability to make an appointment for discussion
Explanation of terminology
Discuss in a quiet location
BHF booklets are helpful
Telephone numbers and contacts for waiting times etc.
More choice outside London
Longer notice of admission dates
Recommendation / help in assessing information
Shorter waiting time for angioplasty
Informed before Angio
BBC TV hospital programmes
More input from senior staff
More choice nearer home
Allow more time for discussion
Have relative / friend present
Give information when patient able to take it in (not directly after procedure)
More up to date information
A map of London underground showing hospital locations
Information on one sheet comparing hospitals
More time to decide
Send information to home address
           11

Is there a hospital not offered which you wold like to be available in the choice menu? If yes, which hospital would you

Broomfield              Convenience for visitors and travel
Papworth in Cambridge   I live in East Anglia, Walton-on-the-Naze, Essex. Cambridge is nearer to me
Southend General        For reasons of closenest to home and relatives being closer to home and after op/follow up
Southend General        It is local
Wellesley               Because it is the nearest
A selection of comments
Disappointed no facilities available nearer to home
Have I made the right choice?
Choosing the London Chest Hospital - particular reason this Hospital's Consultant attends Colchester General on Mondays - no trip to London (until operation).
Very difficult due to severe arthritis
Knowing that a Doctor in St Barts also comes to the Colchester General
Made me feel an individual rather than one of a pack
We both found the choice after the angiogram very difficult as we both know nothing of either hospital. We felt unsupported in this matter and the staff couldn't
comment on either, we both feel that the Consultant would have been the right person to speak to us about both choices as he specialises in heart problems
and would obviously have more knowledge than us. We feel his choice would have been enough for us.
Too much Choice! Without an indepth reason
Was requested to make decision on choice of hospitals before leaving cardiac department. Requested couple of days to decide due to this my angiogram was
sent to wrong hospital originally
Give the patient more time to decide after their surprise at having a choice
Give the same information for each hospital so can compare. A map showing where the hospitals are in comparison would be helpful as don't know London
A one sheet comparison chart listing the choice of hospitals and columns comparing the facilities ie columns headings could be: location, parking, waiting times,
We can look at "success" rates and waiting times but we can't judge medically which might be better. We need a medical recommendation from the referring
Pleasant to have so much information and choice to assist me and family

								
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