Monday, 12 December 2011

Module 4

Module 4 is about improving patients’ experiences. This is going to be as much about patient expectation as service delivery. For example are we supposed to accommodate people who want homeopathy and reiki? Expressed dissatisfaction will be rife but will it be vetted for justification or will it just be used as a stick to beat us, and put on our appraisal.

.....4.1 Improving patient experience of out patient care.
I don’t know what it is they imagine is a problem here. Is it the clinical care itself or other aspects, such as waiting. Here is a suggestion. Patients attending for outpatient appointments are going to be less grumpy if Trusts stop ripping them off for parking charges before they have even entered the building.

.....4.2 Improving responsiveness to in patients’ personal needs.
Ooh yes yes yes, I agree with this one. It sounds to me like a concise rehash of the “Nursing Process” which came and went a few years ago. This was a questionnaire completed for each patient by the admitting nurse. No matter what you came in for you had every aspect of your life documented in order to better satisfy your holistic personal needs. Most nurses wisely skipped the box marked sexuality, but I recall one article in a nursing journal suggesting that this was an important area that should be addressed. There was even a suggestion that young male patients in hospital for any length of time should have their sexual frustrations alleviated by a specially trained physiotherapist who would give them a helping hand, so to speak. So next time I am an inpatient I would like to be seen by the physio, the special one with the hairy armpit and a tube of KY jelly please.

.....4.3 Improving patient experience of A & E
Perhaps you could start by employing a heavy to keep out the drunks, the work shy, the unruly and all those who are there because they can’t be arsed to make an appointment with their GP for that six month old niggle.

.....4.4 Improving access to primary GP and dental care.
Are there really people out there who can’t get to see a GP? As for dentistry who exactly was it who imposed a new dental contract that so alienated dentists that most of them simply abandoned the NHS altogether?

.....4.5 Improving women and their families’ experience of maternity services
This is a particular area where patient expectation is going to affect the experience. It is an area where medical advice is often regarded with suspicion. But when the patient has, at her own insistence, a “natural” childbirth in a pool of water, at home, with acupuncture and herbs for pain relief and has an adverse outcome it will of course be the NHS’ fault.

.....4.6 Improving the experience of care for people at the end of their lives
They have at least realised that asking the dying, or dead “how was it for you?” is not a good idea. So instead they are going to assess the care by asking the carers. I think a little bias might creep in here.

.....4.7 Improving experience of healthcare for people with mental illness
I would imagine that this is likely to be difficult to assess.

.....4.8 Improving children and young people’s experience of healthcare
Another area where an indicator is yet to be developed.

The repeated use of the phrase “improving experience” implies that there is a problem with patient satisfaction. Even measuring as nebulous a factor as satisfaction is hardly precise, but what studies have been done suggest a degree of satisfaction that is already very high. To my mind this entire module presents invented problems, and the individual factors are being used to present an illusion of concern and progress.

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