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National Patient Experience Survey - UL Hospitals Group

CEO Colette Cowan - ULH
Colette Cowan, CEO, UL Hospitals Group: "Each day, our staff deliver outstanding levels of care to the people of the MidWest."

80pc of patients rate overall UL Hospitals Group experience as 'good or very good'

More than 1,000 patients across the MidWest have provided rich and detailed feedback on their experience in hospital which is already being used to drive improvements in quality.

The results of the third annual National Patient Experience Survey show that in UL Hospitals Group there were high levels of patient satisfaction with hospital staff and the cleanliness of their environment. Communication and discharge planning were identified by our patients as areas requiring improvement.

Within UL Hospitals Group as a whole, 80% of patients rated their overall experience as good or very good, compared to a national average of 84%. In University Hospital Limerick 75% of patients described their overall experience as good or very good, as did 83% of patients in Ennis Hospital; 79% in Nenagh Hospital; 93% in St John's Hospital and 98% in Croom Orthopaedic Hospital.

The survey also assigns as overall rating of hospital experience, with a national average of 8.2 out of 10 in 2019. In UL Hospitals Group, UHL scored 7.8 out of 10; Nenagh 8.2 out of 10, Ennis 8.6 out of 10, St John's 8.7 out of 10 and Croom 9.4 out of 10.

The NPE Survey asked every patient who had spent at least one night in an acute hospital during May 2019 for their feedback through over 60 detailed questions and UL Hospitals achieved an overall response rate of 45%, above the target of 40%.

Patients are asked for their feedback and observations on each stage of their journey through hospital and the survey is broken down into sections on Admissions, Care on the Ward; Examination, Diagnosis and Treatment; and Discharge/Transfer.

Colette Cowan, CEO, UL Hospitals Group, said: "Each day, our staff deliver outstanding levels of care to the people of the MidWest and it is heartening to see this reflected in the survey results. It is important that we pay particular attention to those areas where our patients are less satisfied and even dissatisfied with our services.

"Many of the understandable frustrations expressed by our patients will be addressed through the wider structural reforms of our healthcare system as set out in Sláintecare. But we know from the results of the National Inpatient Experience Survey over three years now that there are positive measures we can take in the short and medium-term that can have a real impact on patient experience. We are committed to continuing this work. In every hospital and in every service, our staff are taking a keen interest in the survey results and in translating them into service improvement."

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University Hospital Limerick

At University Hospital Limerick, the overall patient response rate to the NPE Survey was 43%.

Patients at University Hospital Limerick reported high levels of satisfaction on questions around the trust and confidence they had in the staff; pain management and hygiene standards. Feedback around patient meals has continued to improve.

Nineteen in every 20 patients described their room or ward at UHL as very clean (68%) or fairly clean (27%). Almost nine in 10 patients said they had always (67%) or sometimes (22%) been treated with dignity and respect in ED.

Other responses to the questionnaire at University Hospital Limerick included:

  • Did you have confidence in the hospital staff treating you 79% always; 17% sometimes; 4% no.
  • Overall, did you feel you were treated with respect and dignity while you were in the hospital 73% always; 21% sometimes; 5% no.
  • Do you think the hospital staff did everything they could to help control your pain 67% Yes definitely; 15% Yes to some extent, 4% no; 14% N/A.

The survey has again identified several areas for improvement for UHL. These include how we communicate with patients and families and our discharge planning.

Higher than average levels of dissatisfaction are evident in the patient experience of admissions - particularly in long wait times in ED.

We acknowledge that the ED wait times described by admitted patients in the survey are excessive and contribute to a poor experience of admissions for too many patients at a time when they are vulnerable. We continually strive to minimise this through various patient flow initiatives.

The 60-bed ward block currently under construction at UHL is the first step in addressing the region's acknowledged deficits in bed capacity. Our quality improvement plan outlines the expansion of services such as the Medical Assessment Unit and Surgical Assessment Unit as means of avoiding long waits in ED, while specific admissions avoidance pathways for patients with specific conditions (e.g. DVT) have also been established at UHL. Various initiatives are also underway to improve the experience of those patients who do remain in ED.

Bernadette Murphy, Operational Director of Nursing, University Hospital Limerick, commented: "Taking part in this survey is one of the methods we have of using the patient voice to drive quality improvement at UHL. The National Patient Experience Survey is by now well established and I want to thank all the staff who made such a great effort to maximise patient participation as well as all the patients who took to the trouble to provide their feedback and observations.

"We now need to demonstrate that we have listened to our patients and that we can respond in the right way. We know we can do this. Quality improvement projects introduced as a result of previous surveys appear to be making a positive difference. Last year, for example, we introduced a patient information booklet which we hoped would help alleviate anxieties patients had about their journey through hospital and their discharge. This year's survey results show our patients feel they have better written information about the discharge process. A number of quality improvement initiatives are already underway in response to the latest survey results. These include projects to improve communication with patients and their families and how we can continue to improve patient meals and mealtimes, said Ms Murphy.

Niamh Hogan, Patient Advocacy and Liaison Services Manager, UL Hospitals Group, commented:

"Over 700 patients at UHL completed this year's survey and we thank each of them for providing such detailed information which we can use to further improve our services. It is encouraging to see such positive feedback from patients around the trust they place in our staff and the cleanliness of the environment. It is also encouraging that quality improvement plans adopted following last year's results are reflected this year. We are already working on areas for improvement identified by our patients this year, including communication and discharge planning."

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Ennis Hospital

At Ennis Hospital, with a 41% response rate to the NPE Survey, 69% of patients rated their overall experience as very good, compared to a national average of 56%.

Patients at Ennis Hospital reported high levels of satisfaction on questions around the levels of privacy afforded patients, how their pain was managed while in hospital and the respect and dignity with which they were treated by staff.

One hundred per cent of patients surveyed in Ennis described their room/ward and bathroom facilities as very clean (87%) or fairly clean (13%). Nine out of 10 patients described their food as good (27%) or very good (63%).

Other responses to the questionnaire at Ennis Hospital included:

  • Did you have confidence in the hospital staff treating you 77% always; 18% sometimes; 5% no. 
  • Overall, did you feel you were treated with respect and dignity while you were in the hospital 85% always; 13% sometimes; 2% no. 
  • Were you given enough privacy on the ward Yes always; 95% Yes sometimes, 5%.

The survey has identified a number of areas for improvement for Ennis. These include how we communicate with patients and families and our discharge planning.

A number of quality improvement initiatives are already underway in Ennis in response to this year's survey results. A new patient information booklet is being developed which will not only provide clear written information on their journey through the hospital but will also empower them to ask the right questions of medical and nursing staff to allay any anxieties. Ennis Hospital has also committed to introducing a patient befriender as part of its established PALS service.

Patricia O'Gorman, Operational Director of Nursing, Ennis Hospital, commented: "We strive for excellence for all our patients in Ennis and we are delighted with the acknowledgement within the patient feedback. Patients and staff play a critical role in developing a service that is patient-centred and sustaining the positive feedback is a priority for the Ennis staff. This survey highlights that patient response and empowerment can become a key requirement to encourage a more innovative practice that will underpin healthcare and improve our patients' experience in Ennis.

"The results are an acknowledgement of the care, compassion and dedication of the Ennis staff. The results also highlight some areas that we can focus our work on over the next year. We are very conscious of the need to improve our education to assist a seamless discharge for patients; to improve meal times and to work with our patients to make it as good an experience as possible. The 'What Matters To You' project will assist the hospital to improve communication and conversation with patients and we look forward to the year ahead."

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Nenagh Hospital

In Nenagh Hospital 79% of patients described their overall experience as good or very good, and the overall rating of hospital experience assigned was 8.2 out of 10. The patient response rate to the NPE Survey at Nenagh Hospital was 41%.

Patients at Nenagh Hospital reported high levels of satisfaction on questions around privacy on the wards; how staff answered about operations and procedures; and the respect and dignity shown by staff.

Almost 100% of patients in Nenagh described their ward/room as clean (9%) or very clean (89%). More than 19 in 20 patients said they had always been given a choice of food while almost nine in 10 patients described the food quality as good (33%) or very good (56%).

Other responses to the questionnaire at Ennis Hospital included:

  • Did you have confidence in the hospital staff treating you 82% always; 16% sometimes; 2% no.
  • Overall, did you feel you were treated with respect and dignity while you were in the hospital 86% always; 12% sometimes; 2% no.

The survey has again identified a number of areas for improvement for Nenagh. These include how we communicate with patients and families and our discharge planning.

A number of quality improvement initiatives are already underway in Nenagh in response to this year's survey results. A new patient information booklet has been developed which not only provides clear written information on their journey through hospital but also empowers patients to ask the right questions of medical and nursing staff to allay any anxieties. A communications training programme will also commence in 2020 to better enable staff provide information in a way that patients can understand more easily. These initiatives form part of a comprehensive quality improvement plan staff in Nenagh and UL Hospitals Group have developed in response to the survey findings.

Cathrina Ryan, Operational Director of Nursing, Nenagh Hospital, commented: "Nenagh Hospital has again met the target response rate in the 2019 National Experience Survey and I would like to thank all members of the public who have used our service for taking the time to complete this survey. This feedback is very welcome both as an acknowledgement of the care provided and also to assist the service with identifying areas for improvement."

"Privacy; being treated with respect and dignity; and food choice scored very high again in this year's survey. Opportunities for improvement around communicating with patients and families, in particular around medication management and discharge planning, have been highlighted. Nenagh Hospital is committed to continuing work already commenced in these areas and will implement quality improvement initiatives to demonstrate to patients that we have listened to their feedback and have introduced change as a result."

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Croom Orthopaedic Hospital

OVER 1,000 patients across the MidWest have provided rich and detailed feedback on their experience in hospital which is already being used to drive improvements in quality.

The results of the third annual National Patient Experience Survey show that in UL Hospitals Group there were high levels of patient satisfaction with hospital staff and the cleanliness of their environment. Communication and discharge planning were identified by our patients as areas requiring improvement.

Within UL Hospitals Group as a whole, 80% of patients rated their overall experience as good or very good, compared to a national average of 84%. In Nenagh Hospital 79% of patients described their overall experience as good or very good, as did 83% of patients in Ennis Hospital; 75% in University Hospital Limerick; 93% in St John's Hospital and 98% in Croom Orthopaedic Hospital.

The survey also assigns as overall rating of hospital experience, with a national average of 8.2 out of 10 in 2019. In UL Hospitals Group, UHL scored 7.8 out of 10; Nenagh 8.2 out of 10, Ennis 8.6 out of 10, St John's 8.7 out of 10 and Croom 9.4 out of 10.

The NPE Survey asked every patient who had spent at least one night in an acute hospital during May 2019 for their feedback through over 60 detailed questions and UL Hospitals achieved an overall response rate of 45%, above the target of 40%. At Croom Orthopaedic Hospital, the response rate was 65%.

Patients are asked for their feedback and observations on each stage of their journey through hospital and the survey is broken down into sections on Admissions, Care on the Ward; Examination, Diagnosis and Treatment; and Discharge/Transfer.

Patients at Croom Orthopaedic Hospital reported high levels of satisfaction on the cleanliness of the environment, food quality, their involvement in decision-making around their own care and the respect and dignity shown by staff.

One hundred per cent of patients described their room as very (93%) or fairly (7%) clean. More than 19 in 20 patients said they always (94%) or sometimes (3%) had enough privacy on the ward. Nineteen out of 20 patients said staff had completely (84%) or to some extent (11%) explained their operation or procedure in a way patients could understand.

Other responses to the questionnaire at Croom Orthopaedic Hospital included:

  • Did you have confidence in the hospital staff treating you 99% always; 1% sometimes; 0% no.
  • Overall, did you feel you were treated with respect and dignity while you were in the hospital 100% always.
  • How would you rate the hospital food Very good 68%; good (22%); N/A 4%; fair 4%; poor 3%.

The survey has identified a number of areas for improvement for Croom Orthopaedic Hospital. These include how we communicate with patients and families and elements of our discharge planning.

A number of quality improvement initiatives are underway in Croom in response to the survey results. These include the introduction in 2020 of a communications programme for staff and of a patient information booklet which will provide clear written information on the patient's journey through hospital and empower patients to ask the right questions of medical and nursing staff.

Katie Sheehan , Assistant Director of Nursing, Croom Orthopaedic Hospital, commented: 

“Staff in Croom take great encouragement from the fact that 98% of our patients described their care and being good or very good. These results show that we have listened carefully to our patients and made improvements around involving patients in decisions and discharge planning. It is encouraging to read so many positive comments about the kindness of our staff, the cleanliness of the environment and the quality of our food. 

As an orthopaedic hospital, we have many elderly patients and it is great to see such positive feedback from patients who needed assistance to go to the bathroom or to eat their meals and around how staff managed their pain. We are already working on quality improvement plans on those areas with lower satisfaction ratings, including information on medications and other elements of discharge planning. I would like to thank all those who responded to the survey as it really helps us to recognise the needs of the patients and act on them.”

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St. John’s Hospital

St. John’s Hospital had a response rate of 50%, and the majority of respondents reported a positive experience overall in St. John’s Hospital.

For example:

  • 93% of patients at the hospital said that they had a “good” or “very good” overall experience.
  • 93.2% of patients said they were always treated with respect and dignity
  • 89.8% of patients rated the room or ward they were in as “very clean”
  • 92.4% of patients at the hospital said that they always had confidence in the staff treating them

Patients at St John’s identified many areas of good overall experience and where they gave above-average ratings. For example, most patients said they were given clear answers to their questions about operations or procedures. In addition, most patients said they were given enough information on how to manage their condition after discharge. The hospital food and the cleanliness of our facilities were very highly rated.

Some of the most heartening comments from patients included:

  • I did appreciate the quality of care. The staff were very kind and supportive. The food was excellent and catering staff were always willing to swap foods when I was on a restrictive diet without any hassle. Excellent, the amount of understanding shown by the nursing staff was second to none. 10/10 
  • The hospital staff were very good. Very caring in every way.
  • I found the staff absolutely brilliant so caring and helpful. Never made feel I was an inconvenience.
  • The nurses and doctors were brilliant and the hospital was very clean. The food was good and the ladies were very friendly they would always have a chat and a laugh.
  • Excellent care and attention from doctors, nurses, catering and general staff.
  • The food is first class. Catering staff should be proud.
  • I could not ask for better care. It was 100%. Nothing less.

Such positive feedback provides a great boost to all hospital staff. We all try to do our best at all times and such testaments greatly encourage everyone’s efforts to keep up the good fight. 

 The areas identified as requiring improvement represent a very low percentage of our overall response rate. We will continue to work on these areas in order to improve the patient experience in all aspects of their care in St. John’s Hospital.

Ms Margaret Finn, Acting Director of Nursing, said that St. John’s Hospital is delighted to have had such a great response rate and thanked all the patients who took the time to complete the survey. She welcomed the generally positive feedback from the survey and added that the hospital would work to address any items identified as need further attention.

Ms Emer Martin, CEO of St. John’s Hospital, thanked all hospital staff for their continuing endeavours to live the hospital’s Mission Statement which states that “Faithful to our tradition, we provide the highest possible standard of care and treatment in a professional and compassionate manner to every person who avails of our services”. She added that St. John’s Hospital will continue to work with our patients and our Patient Partnership Forum, our hospital Board and our colleagues in the University of Limerick Hospital Group and to address the shortcomings identified through our quality improvement plans.