Measuring and monitoring patient experience
Systematic, routine monitoring of patients’ experiences of, and outcomes from, health care is an important way to ensure that the patient’s perspective drives service improvements and patient-centred care. This is the case in all health services, including those that prescribe, dispense or administer antimicrobials.
Patient experience measures
While there are no indicators in this standard specific to patient experience measurement, the Commission strongly encourages health service organisations to adopt the Australian Hospital Patient Experience Question Set (AHPEQS). The AHPEQS is a short 12 question generic patient experience survey which has been tested and found reliable and valid for both day-only and admitted hospital patients across a wide variety of clinical settings.
The AHPEQS question set is available for both private and public sector health services, and has been translated into 20 languages. It can be downloaded from this website.
Patient-reported outcome measures
In Australia, patient-reported outcome measures (PROMs) are an emerging method of assessing the quality of health care. The Commission is leading a national work program to support the consistent and routine use of PROMs to drive quality improvement.
PROMs are standardised, validated questionnaires that patients complete, without any input from healthcare providers. They are often administered at least twice to an individual patient – at baseline and again after an intervention, or at regular intervals during a chronic illness. The information contributed by patients filling out PROMs questionnaires can be used to support and monitor the movement of health systems towards person-centred, value-based health care.
PROMs are being used to evaluate healthcare effectiveness at different levels of the health system, from the individual level to service and system levels. There is growing interest across Australia and internationally in the routine interrogation of patient-reported outcome information for evaluation and decision-making activities at levels of the health system beyond the clinical consultation.
PROMs for cataract surgery
A number of questionnaires and measures have been developed to assess the impact of cataract on patients’ daily lives and the benefit of cataract surgery. Although some have serious limitations,48,49 others have been validated and evaluated in English-speaking cataract populations:48,49,66
- Catquest-9SF is a nine-item questionnaire that is recommended for pre- and post-surgery measurement of patient-reported outcomes by the International Consortium of Healthcare Improvement 50,66; it has been validated in Australia
- Cat-PROM5 is a five-item questionnaire recently developed in the United Kingdom for use in the National Health Service that compares favourably with CatQuest-9SF, but has not been validated in Australia.53,54
National Safety and Quality Health Service (NSQHS) Standards
Implementation of this standard is supported by the National Safety and Quality Health Service (NSQHS) Standards. Under the Clinical Governance Standard, health service organisations are expected to support clinicians to use the best available evidence, including clinical care standards (see Action 1.27b) and to monitor and respond to unwarranted clinical variation (Action 1.28).