Flashcards in HaDSoc 9.1 patients evaluations of healthcare Deck (33):
Why should we have an interest in patients views of healthcare?
-patient satisfaction is important
-humanitation and ethical
-moving away from paternalistic apprroach to medicine and torwards a consumeristic approach, therefore need to know the patients views
-increased external regulation
What policies have been put in place with regards to patients evaluation of health care?
NHS organisations are required to publish a prospectus in which the range of local services available are listed and the patients experiences of these are published.
Shows patients views and the actions that have been taken as a response.
-patients and public involved in planning services they are responsible for, helping to develop changes to services and helping to make decisions about how those services operate.
How can patients give feedback about their experiences with health care?
-via friends and family test (asks whether service would be recommended to friends and family)
-NHS choices website (more qualitative feedback)
What issues are there surrounding the ways patients feedback their experiences?
-the way the feedback is admnistered can have effects on who complete it, eg if through the post, or via a touch screen in the waiting room.
This can subsequently affect results
What is the role of healthwatch England?
To seek the views of local people about healthcare services, and pass the information onto commissioners and care providers.
Done by direct relationships with commissioners and providers, and by seat on areas health and wellbeing board.
What is PALS (HaDSoc)?
Patient advice and liason services
What is the role of PALS (HaDSoc)?
-to provide info on the NHS
-to help with health related questions
-to help resolve concerns around NHS
-to advise on complains procedure.
How common are complaints in healthcare?
Over 500 are made a day, and this is thought to be an underestimate due to the complexity of the complaints process.
Whats suggestions did the 'NHS hospitals complaints system review' make regarding complaints?
-to improve healthcare so that less complaints need to be made
-to make the complaints process easier so that if people want to make a complaint, it's straight forward.
-ensure independance during the complaints procedure.
When complaining, what are the 2 options you have about who to complain to?
-directly to the hospital, who will deal with that complaint
-to the CCG, who will evaluate complaint and either transfer it to the hospital to deal with, or will deal with it themselves if they see appropriate.
What are the outcomes of making a complaint?
Either the hospitals/ CCGs deal with complaint and you are satisfied,
OR you are not satisfied and it goes on to the health service ombudsman
What is the Health service ombudsman?
They take investigations into complaints when the patient doesnt feel satisfied with the way it has been dealt with.
Provides the final view of what has happened.
Why are there still problems with regards to complaining?
-people lack information on complaining
-people lack confidence it will lead to any change
-complex and confucion
-people need support
-people want to know that services listen to, and act on their complaints
What methods are there of investigating patients views?
Directly- qualitative and quantitative
indirectly- patient complaints, obudsmen reports
What qualitative methods are there for seeking patients views?
-interview, focus group, observation
-successful at identifying HOW patients evaulate care and their priorities
Why are quantitative methods used more commonly for evaluating patients views?
-quick, cheap and easy
-less staff training
-easier to analyse
-anonymity more easily garunteed.
Why are locally developped DIY isntruments not recmmended for getting patients views of healthcare?
-not proven reliability and validity
-dont comply with general standards for questionaire design
Give examples of the main patient satisfaction surveys:
-GP patient survey
-Accident and emergency suvery
-children and young peoples survey
-maternity services survey
-community mental health survey
What are the 2 main catergories that lead to patient dissatisfaction?
-poor interpersonal skills
-poor content of health care
Give examples of poor interpersonal skills which lead to patient dissatisfaction:
-patients not being able to fully report thier concerns
-feeling like the doctor isnt listening properly, or not getting to the full history taken
-staff not being reassuring
-staff not giving appropriate advice.
Give examples of content of healthcare which can lead to patient dissatisfaction:
-incontinuity, poor hygeine, foodstandards etc
-culturally inappropriate care
-hotel aspects- food, bedding
What challenges may the NHS face when responding to patients concerns and dissatisfaction?
-may not have resources to make change (eg may agree but dont have the money to do anything)
-may not be rational or reasonable
-may not know how to respond
-may not be able to divert enough resource into making that change (oppertunity costs)
What are the 4 sociological approaches to patient- practitioner relationships?
What is the functional approach to patient-practitioner relationships?
-patient has a problem which only the doctor knows how to fix,
-lay people dont have technical competence to remedy health
sick person is 'helpless'
medicine restores them to health and restores social equilibrium
What is the sick role?
the role someone takes when in a state of illness.
What are the rights and duties of the sick role?
-sick person freed of normal social obligations and responsiblities
-sick person should want to get well and not abuse freedom of responsiblity
-sick person expected to seek medical advice
-sick person placed in position of dependacy
What is the doctors role with regards to the sick role?
-doctors should use skills to benefit the patient and try to restore them back to health
-doctors are granted intimate access to patients
-doctors should act for the interest of the patient, not themselves
What are the criticisms of the functionalist approach to the patient-practitioner relationship?
-sometimes the sick role doesnt apply- eg cant get better (chronic illness), who is legitimate, who is illegitimate?
-assumes patients must have a passive role and is incompetent
-assumes beneficence of medicine
What are the conflict approaches to medicine?
-doctors are the 'gatekeepers' for defining health and illness
-can medicalise certain conditions and pathologise aspects of social life, eg pregnancy
-patient has little choice but to submit to dominance of the doctor
-lay ideas are discounted
What are some criticisms of the conflict approaches to medicine?
-lay people also push for the medicalisation of conditions, eg Gulf war syndrome
-patients are not always passive
-patients may appear differential in consultation but assert themselves outside
What is the interpretive/interactionist approach to medicine?
interested in how order emerges through interaction, and how infromal and unwritten rules govern aspects of life more than formal rules
What is the patient centered approach to patient-practitioner care?
-seen as equals
-work together to come to decisions
-patients views and prioritied explored and considered
-enhances relationship between doctor and patient