20160223 patient experience2
TRANSCRIPT
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Barcelona, February 23th 2016
Why clinicians should take into account patient experience?
Joan Escarrabill, MD PhD
Chronic Care Program. Hospital Clínic (Barcelona)
Master Plan for Respiratory Diseases (PDMAR) & Home Respiratory Therapies Observatory (ObsTRD). FORES. Ministry of Health (Catalonia)
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J A Muir Gray. Lancet 2013;382:200-1
Effectiveness
Quality
Safety
Value
Paradigm shifts
Decisions for the patient, without
the patient
From the patient's
perspective
The driver is the patient, not the doctor
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Shifts are more likely to result from new ways of
thinking rather than new technologies
J A Muir Gray
J A Muir Gray. Lancet 2013;382:200-1
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Value =Outcomes
Cost
NEJM 2010;363:2477-81
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Outcomes that mattered to patients
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Clinical status Functional status
Survival curve Lab tests
vs
Disabilities / Disutilities Cognitive disorders
Time Full health care process (medical conditions), not isolated procedures
A good car without wheels is useless
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Wolf JA et al Pat Exp J 2014;1:7-19
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How can clinicians usethe patient experience?
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1 2 3Service design Patient empowermentQuality (Value)
Information Education Life style Shared decision …BMJ 2015;350:g7714
“…lack of evaluation of other approaches makes comparisondifficult”
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Immediateresponse
“As in the treatment of postoperative pain”
“Collecting data on patient experience is not enough: they must be used to
improve care”
8Adapted from G Antoja & J Escarrabill
Looking back
Identify opportunities for improvementPrioritizing
Define key questionsMonitoring
Systematic
New actions
A Coulter. BMJ. 2014;348:g2225
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Patient experience: focus groups
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Long-term oxygen therapy
Arch Bronconeumol 2015 (in press)
Continuous subcutaneousinsulin infusion (CSII)
Improve educational strategy and adapt the pace of learning
Recommendations to manufacturers
Psychological impact
Impact in daily life
CPAP for sleep disorders
Low participation in decision-making
Good information from nurses
Bariatric surgery
Psychological aspects
Adapt the educationalprogramme to surgery time
Sedation in gastric endoscopy
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XPA-Patient Experience (Barcelona) is a community ofpractice (CoP) to:
Share knowledge.
Promote cross-disciplinary projects (use cases).
Identify and define an ICT model to collect thisexperience objectively.
Learning from best practices.
With the support:
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Challenges
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1 The role of technology
2 What do we mean by participation?
3 How to involve all health professionals?
Cultural alignment = We are all caregivers
“Everyone Must Participate, Even the Doctors
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The Emancipated Consumer
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“Driverless cars and Doctorless Patients?”
Patients will play a crucial role in the acceleration of changes
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Health Care organizations should play as Barcelona FC
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SimpleAuthomatic
Good enough
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Thank you very much for your atention
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@jescarrabill
@XPA_BCN