Assessing the impact of a

change management

procedure on homecare

medicines patients

Michael Butterfield Specialist Technician for Homecare Medicines

Jane Kelly Procurement Project Pharmacist

Background

• What is ‘Homecare’?

• 5000+ patients

• 30+ therapy areas

• 32 million spend (¼ of overall medicine spend)

• Services often covered by local or regional contract

Aim of project

• Develop and implement a Standard Operating Procedure to ‘manage’ the change

• Evaluate the effectiveness of SOP

• Ultimate objective: Change should be seamless and virtually invisible to the patient

HELP!!!

Objectives

• Stage 1: Review current practice

• Stage 2: Write the SOP

• Stage 3: Evaluate the SOP

Stage 1: Review current practice• Completed in 2008

• 45 patients

• ‘Low Tech’ medicine

• Regular quarterly deliveries

• Observed ‘learning points’

Stage 2: Write the SOP

• Mapped out the process observed

• Tasks grouped by:• Clinical team• Homecare providers (incumbent and new)• Pharmacy

• 2 sections– Detailed description of each activity– Summary and checklist of tasks by task group

SOP ensures that:

• Project manager assigned

• Transfer of patients data

• Informed patients

• Seamless delivery schedule

• Transfer of hardware

• New service specification

• Clear agreed start date

Stage 3: Evaluate the SOP

• Spring 2009

• 700+ patients

• ‘High Tech’ medicine

• Regular quarterly deliveries

• Patient survey conducted

Stage 3: Evaluate the SOP

• Surveyed 514 patients

• Questions on service and changeover

• No previous evaluation work

The Survey

     

Clinical waste collection

     

Quality of product (packaging, labelling, ease of use etc)

     

Quality of ancillary items

     

Driver assistance

     

Delivery times

     

Patient care coordinator

4Good

2Poor

1Very Poor

How do you rate (new supplier) on the following areas of service?

3Av’ge

5Excel’

The Survey

     

Clinical waste collection

     

Quality of product (packaging, labelling, ease of use etc)

     

Quality of ancillary items

     

Driver assistance

     

Delivery times

     

Patient care coordinator

5Much Better

4Better

2Worse

1Much Worse

Is the service you receive from [new supplier] better or worse than [old supplier]?

3Same

The Survey

• How do you think the changeover to the new provider was managed?– Very Well – Well – Could have been better– Poor

• Comments…….– Free text section

The Responses…..

• 286 out of 514 returned (57%)

• Shared with new provider and clinical teams

• Patient feedback document

The Results?.....97.9% 96.3%

88.0%89.7%

12.0%10.3%3.7%2.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Notification fromTrust?

Welcome pack? Phone call fromthe new supplier?

Seamlessservice?

Questions

Pe

rce

nta

ge

of

pa

tie

nts

YES

NO

The Results?.....

0 1 2 3 4 5

Customer Services

Delivery times

Driver assistance

Quality of ancillaries

Product

Clinical waste collection

How do you rate [NEW PROVIDER]?1 = POOR; 5=EXCELLENT

The Results?.....

1 2 3 4 5

Customer Services

Delivery times

Driver assistance

Quality of ancillaries

Product

Clinical waste collection

"New Provider vs Old Provider" 1= much worse, 3=same, 5=much better

The Results?.....

How do you think the changeover to the new provider was managed?

59%

34%

5% 2%

Very Well

Well

Could have been better

Poor

Comments

• Resistance to change

• ‘Why are we changing?’

Summary of results

• High level of satisfaction with changeover

• 96% of patients experienced seamless service

Limitations

• Scope of survey

• No ‘before’ data to compare

Progress……

• Shared with Yorkshire and Humber consortia

• Included in tender specifications

• Shared with National Homecare Medicines Committee

• Available on Commercial Medicines Unit (CMU) Website

Questions?