Patient experience

How Netcare monitors patient feedback to ensure patients and families have a positive experience.

Patient-centred care is central to the Netcare quality leadership programme. We are guided by international best practice and the guidelines set out by the Department of Health, including the Batho Pele principles1 and the Patients’ Rights2 Charter as summarised below.

Batho Pele principles

The eight Batho Pele principles were developed to serve as acceptable policy and legislative framework regarding service delivery in the public service:

  1. Consultation: Listening to and taking account of patients’ views and paying heed to their needs when deciding what services should be provided.
  2. Access: Ensuring that patients are able to access the services provided easily and comfortably.
  3. Courtesy: Treating patients with consideration and respect.
  4. Setting standards: Making sure that the promised level and quality of services are always of the highest possible standard.
  5. Information: Providing patients with good information on the services available to them.
  6. Openness and transparency: Allowing patients to ask questions and responding to their queries honestly and frankly.
  7. Redress: Responding swiftly and sympathetically when standards of service fall below the promised level
  8. Value for money: Adding value to patients’ lives.
The Patients’ Rights Charter

The Patients’ Rights and Responsibilities Charter states that all patients have a right to:

  • A healthy and safe environment.
  • Participate in decision-making.
  • Access to healthcare.
  • Knowledge of one’s health insurance and medical aid scheme.
  • Choose health services.
  • Be treated by a named healthcare provider.
  • Confidentiality and privacy.
  • Informed consent.
  • Refuse treatment.
  • Be referred for a second opinion.
  • Continuity of care.
  • Complain about health services.

In addition, every patient or client is considered to have responsibilities with respect to their own health and their engagement with the healthcare system.

1 Department of Public Service and Administration. 1997. White Paper on transforming service delivery (Batho Pele White Paper) A guide. Capte Town: Siber Ink. http://www.info.gov.za/whitepapers/1997/18340.pdf (accessed 2015).

2 National Patients’ Rights Charter. 2008. Health Professions Council of South Africa. http://www.hpcsa.co.za/downloads/conduct_ethics/rules/generic_ethical_rules/booklet_3_patients_rights_charter.pdf

Netcare patient feedback system

Patient and family-centred care is an important quality goal in all of our hospitals. Our leaders, staff and healthcare professionals are dedicated to ensuring the highest level of service excellence and to providing clear communication to patients and their families so that they can understand their care programme and know how to best engage in managing their health.

All of our hospitals use the electronic Netcare patient feedback system to obtain regular feedback directly from patients using our services. In addition, patients are able to inform our healthcare leadership team of specific issues (compliments and complaints) through the Netcare customer service centre or by emailing the hospital manager or its customer care team directly.

The leadership teams at our hospitals also make personal rounds to ask patients and families about their experiences. This gives the leadership direct feedback of what is going well and also enables them to identify areas for immediate action or general improvement.

The Netcare hospital patient feedback systems reporting suite includes trends, summary dashboards and ward-level reporting. Using iPads, web-based and mobile surveys to engage with patients, the system provides reliable feedback on a daily basis, to help us improve our responsiveness, understand required changes to meet patient needs and improve patient-centred care.

Our patient feedback questions for hospitals are based on the United States’ (US) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which allows us to benchmark ourselves against 4 000 US hospitals and health facilities that make use of this methodology. The survey asks patients questions about the clarity of communication, medication information, discharge planning, the hospital environment and the patient’s overall experience.

The table below shows top-box (best possible) responses for the five specific areas that we have focused on in our quality leadership goals.

Netcare hospitals Definitely recommend Pain management Nursing communication Discharge information
(US 2015 average: 71%) (US 2015 average: 71%) (US 2015 average: 79%) (US 2015 average: 86%)
Number of responses 2015 2014 2015 2014 2015 2014 2015 2014
2015: 276,696
2014: 236,762
78.25% 75.89% 84.49% 81.21% 85.28% 83.27% 77.55% 72.29%

Netcare hospitals

Definitely recommend

2015: 78.25%
2014: 75.89%

(US 2015 average: 71%

Pain management

2015: 84.49%
2014: 81.21%

(US 2015 average: 71%

Nursing communication

2015: 85.28%
2014: 83.27%

(US 2015 average: 79%

Discharge information

2015: 77.55%
2014: 72.29%

(US 2015 average: 86%

Number of responses

2015: 276,696
2014: 236,762

Ref [www]: US 2015 average: http://www.hcahpsonline.org/Files/October_2015_Summary_Analyses_Survey_Results.pdf

All patients admitted to our hospitals, across all medical schemes operating in SA, as well as private-paying patients, are asked to complete the survey. A total of 78.25% (US 71.0%) patients responded that they would ‘Definitely recommend’ our facilities, and the overall rate out of 10 awarded to the hospital they were treated at was 8.62 (US 7.1). Since 2012, the use of the HCAHPS survey in our hospitals has resulted in steady year-on-year improvements in performance, both individually and collectively, due to initiatives implemented in response to feedback.

The HCAHPS survey measures ’top box’ performance and reflects the percentage of patients that score the most positive response. For example:

  • The ‘Yes, definitely’ score excludes ‘Probably yes’, ‘Probably’ and ‘Definitely no’ responses.
  • The ‘Always’ score excludes ‘Usually’, ‘Sometimes’ and ‘Never’ responses.
  • For ratings out of 10, only the 9 and 10 responses are included.
  • For ‘Yes’ and ‘No’ responses, only the ‘Yes’ responses are included.

We continue to measure patient experience results from all divisions and initiate business-specific improvements.

Responding to patient feedback

We have achieved improvements in patient satisfaction on discharge information received, pain management while in hospital and medication information received when at home. A collaborative team of pharmacists working with nursing colleagues at each hospital have made great strides in developing a medication information process for patients while in hospital and after discharge. These efforts have improved our patient feedback scores from a 66% “top box” score in 2014 to 74% in 2015.

Patient feedback indicates that we need to improve the information provided to them on symptoms and health problems that they should be aware of once discharged from hospital. In addition to over 50 procedure-specific discharge information leaflets, we have worked with nursing and doctor groups to develop and test general patient information leaflets for four major categories: emergency, maternity, surgical and medical. We are tracking the impact of this initiative at six pilot hospitals, with early indications showing positive results. Pilot findings will inform the next stages of the project.