Despite concerns, a national survey shows hospital services are well regarded, writes Fiona Tyrrell
Hospital patients' safety is being put at risk due to lack of communication, according to the largest survey of patients to be carried out in the State. Overall, the survey shows high levels of satisfaction with acute hospital services and a high degree of confidence in medical treatment
However, communication practices of staff, hospital environment and the responsiveness of staff have been singled out as weakness in the system that need to be improved, according to the report carried out by the Irish Society for Quality and Safety in Healthcare (ISQSH), which was founded in 1994 to promote quality and safety improvements throughout the Irish health service. It is a charitable organisation with almost 700 members from all areas of the healthcare sector.
Based upon 4,820 patients' perceptions of their quality of care and service received during their hospital stay, the National Patient Perception Survey 2004 was carried out by ISQSH in partnership with 26 hospitals - all of whom agreed to voluntarily participate in the survey.
Overall the majority of respondents were confident about the treatments they received (94 per cent) and were also satisfied with the services they received (93 per cent) during their hospital stay.
Nine out of 10 respondents said they would return to the same hospital if they had to re-enter hospital and would recommend their hospital to a friend or family member if they needed similar attention. However, almost one in five patients said the level of service they received during their hospital stay didn't match their perception of the ideal hospital, and one in five patients also said that staff were too overworked to take care of them.
Privacy and communication were issues highlighted in the report. While 92 per cent of patients were satisfied with the level of privacy received while being examined, more than one in four (28 per cent) said staff discussed medical issues at their bedside while ignoring them, and one in five found it difficult to have a private conversation with a member of their healthcare team.
The study revealed that almost six out of 10 patients were visited by medical students during their hospital stay. However, contrary to the Patients' Charter, more than four in 10 of these patients (43 per cent) said their permission had not been sought by their consultant in advance.
Patient safety issues revealed a mixed bag in the survey, with almost one in 10 (89 per cent) patients reporting that a member of their healthcare team confirmed their identity prior to administering medication. Moreover, 97 per cent said they were identified prior to performing an operation or procedure.
However, only 47 per cent of respondents observed members of their healthcare team wash their hands prior to carrying out an examination. This was of great concern to some patients. Almost half of all patients (47 per cent) were not given any information on the possible side effects of medication prescribed to them.
The report shows that "it's not all bad", according to president of the ISQSH Marie Kehoe, who says the survey is a practical tool to help decision-makers get closer to the consumer and to put the patient back at the centre of healthcare. The report illustrates that we are not listening to or empowering our patients, says Kehoe, who believes hospital standards and patients' expectations need to be raised.
There is comfort from such high levels of satisfaction, says Stephen MacMahon from the Irish Patients' Association. However, he says in some cases patients didn't have the information or indeed the knowledge to make a judgment call on the quality of service, treatment or care they have received.
The poor performance on managing complaints is a clear challenge for 2006 and work needs to be done on improving communication, he adds. The fact that one-quarter of patients had questions they wanted to ask their healthcare team but didn't is not acceptable as part of a modern-day health service, he says.
The report showed that patients' experiences were influenced by their health insurance status, age and gender. In general, public patients, older patients and male patients recorded higher levels of satisfaction in several key areas of patient care when compared with their respective counterparts.