How do you know that your team is doing a good job ?
Health Care Professional – South East:
The community continues to support the program through donations to fund the program.
Helen Pyle – Lead Physician, Ian Anderson House, Oakville, ON:
We get a lot of positive feedback from families. I often meet patients who have sought out the team having heard about us from their friends or family. We have started to keep statistics for the last year to 18 months. We have been following where our patients die. If they die in hospital we record why they went to hospital. We have seen that fewer patients who are well supported by the team go to ER. Fewer patients die in hospital. I also believe that we have such a large regular turn out for our meetings because everyone on the team benefits from the resources, discussions, and support that we all give and receive back.
Palliative Nurse Practitioner – Niagara North:
Patients want to die at home. Most of them are able to do that and die comfortably. We follow up with families afterward, they tell us that things went as well as could be expected. If not, we ask how things could have gone better and thank them for the opportunity to learn. The team members are happy! That bodes well for good patient care. I know from a study way back that perception of teamwork correlates with positive patient outcomes.
Clinical Navigator – Niagara North:
Feedback from the family. When we hear that the family is happy with how their loved one died peacefully at home, without pain, with their loved ones around them, that tells us that we did what we set out to do.
Health Care Professional – Central LHIN:
We have a caregiver satisfaction survey. We routinely receive complements from providers, patients and families as well as physicians. We also regularly seek out patient stories. Every education session includes an evaluation component which is reviewed.
Cheryl Moore, Director, Stedman Hospice:
We just started to collect data. It started with 734 different concepts, but we’ve widdled it down to about 7. We use satisfaction surveys to family, caregivers and patients.
Denise Marshall – Chair of Ontario’s Collaborative Palliative Care Clinical Council:
We know were doing a good job with our team when we check with the people that we intend to serve. In the case of our team; a population based team, we serve primary care and the patients in the geography and the front line responders ask them if everything is going well for them. It’s as simple as asking.
Health Care Professional:
In rural communities it’s quite interesting because palliative care teams are often looking after their neighbours or friends, rather than strangers, so the feedback loop is very strong. We quickly know via the grapevine if the care has not gone well or there has been a problem. Equally as important, the team gets the feedback and the sense of appreciation that families or patients feel for the quality care that they get because it is a very personal kind of relationship. So you know you’re doing a good job when your community tells you you’re doing a good job, and frankly it’s that feedback and that pride that sustains the team to carry on.
Health Care Professional:
We know that teams are doing a good job based on some big aim measures such as reducing emergency visits or reducing ALC time in the hospital and so on. But we need to come together on some measures that are based on cost effectiveness but also on patient satisfaction, or more so, patient experience. We need to have a balance between quantitative and qualitative measure and bring these findings together in a more holistic way. We have done a lot of quantitative measuring, but we haven’t necessarily been really good at doing qualitative measurement. As a provider – we may think that lowering the cost is of really good value and a really good measure but it’s not necessarily translatable to what the patient and the families deem important for them. If we are truly a health care system that provides patient centered care, then we need to ask and engage the patients and their families to find out what is important to them. Based on that we should determine what we need to measure and track so that we can have a better idea if we’re making improvements and if we’re creating change.
Health Care Professional:
We know we’re doing a good job because of the feedback that we get from not only families or residents, from our management, but from each other also and working together as a team. It is very important to have that feedback from one another. Sometimes when we’re having a bad day or a bad week or we’re about to lose one of our precious residents, we need feedback from each other and that’s when we really know that we’ve done a good job. It’s not the thank you in the newspaper, in the obituaries that we see, that’s always wonderful, but it’s always that feedback that we get from one another and the look on a residents face when they’re okay, when they’re happy and not afraid. Lots of times in long term care, you have your residents that have lost so much and they really need somebody to be understanding and caring and compassionate. When you achieve that level of care you can see it in their face, they are comfortable and you know you’ve done your job well.