In early 2018, Ballan District Health & Care (BDHC) and the Central Highlands Primary Care Partnership (CHPCP) commenced discussions around a potential joint project focussed on service improvement. As BDHC is community-owned organisation, they advised CHPCP that they are keen to understand their consumer experience. Through further discussions, the framework for the project was agreed and the project brief, developed by CHPCP, was then endorsed by the Executive of both organisations. The CHPCP is committed to supporting local agencies undertake client and community engagement activities and provided their time, expertise and staffing resources to help with this project.
The Project – Understanding Community Healthcare Experiences
The focus of the project was to hear from community members about their recent experiences of using the allied health services at BDHC. For the purposes of the project, allied health services include Physiotherapy, Exercise physiology, Occupational Therapy, Podiatry, Dietetics and Social Work services. A Project Steering Group was established to oversee the project.
The survey instrument included open-ended questions, with prompting questions if required, to allow a richer set of data to be gathered than a written survey could provide. It also allowed people to discuss their individual experiences of the services they had received. The survey also included a small number of demographic questions as well as some direct questions focussed on finding out how long people had been using the services at BDHC and what they knew about the allied health services including the range of services and how they could access these services. The questions did not ask people about their medical/health condition or treatment, they were focused on their experiences within the service.
The Project Steering Group spent a significant amount of time discussing the options on the best ways to recruit people to participate in the project. The group agreed that for the purposes of this project, allied health services would include Physiotherapy, Exercise physiology, Occupational Therapy, Podiatry, Dietetics and Social Work services. It was also important that the experiences of community members were current so it was decided that community members who had received an allied health service within the last three months would be invited to participate.
Recruitment of participants:
The project was officially launched on 9 July 2018. It was advertised in local paper and through flyers within the health service and the Ballan & District Community House. It was also advertised via the BDHC website and Facebook page as well as emailed to association members. In order to access people with a recent experience, allied health team members were asked to raise awareness of the project as part of their consultation with patients. Participants were recruited over a four -week period through a confidential and voluntary sign up process.
During August and September 2018, confidential conversations were held one-on-one with the Project Manager, Cathy Bushell from CHPCP, either at Ballan & District Community House or over the phone. Consent was sought from all people seeking their agreement to collect their information and to the conversation being recorded. All agreed. The conversations were very informal, often over a cup of tea or coffee. The conversations went for an average 50-60 minutes. Community members who participated were very open and honest about their experiences. The conversations were recorded which allowed a free-flowing conversation between the interviewer and interviewee.
Project findings and results
Over the four-week recruitment period, 17 people volunteered to participate in the project. Most (15) were recruited through the process at Ballan. Two people had heard about it from advertising around the town. Participants came from Ballan and surrounding areas and were a mix of females and males – 11 females, 6 males. The age range of participants was from 25-44 years to 75-84 years. The majority of participants were from the 65-74 & 75-84 age groups (64%). More than half of the people who participated in the conversations have been receiving care at BDHC for over 5 years (59%). A number of these participants reported being clients for over 20 years.
The data was analysed into themes which included:
- Access to facilities
- Access to services
- Time and attention paid to clients’ care
- Meeting personal as well as clinical need
- Involvement in decision about care and treatment
- Information & Communication
- Suggestions for improvement
- Coordination/continuity of care; and
- Feedback to BDHC
The one-on-one conversations provide a great opportunity for participants to discuss their experiences with BDHC. Most of the people who provided their feedback visited at least two of the allied health team members within the last 6 – 12 months and provided feedback on these experiences with each Allied Health Professional.
Participants were asked whether they faced any barriers to accessing the facilities. Most reported no barriers to accessing the facilities at all. However, a couple of participants suggested that there needs to be more disabled parking closer to the clinic. There were a few issues raised about accessing certain areas within the building. For example, one of the participants mentioned that they had never been able to find the toilet. Another highlighted that the corridor which goes to the pool area is uneven and poorly lit. Someone also suggested seats near reception to assist people if they are not feeling well when there is a queue at reception
Participants reported varying reasons for using the allied health services at BDHC. The majority of people are accessing allied health services via a Chronic Disease Management (CDM) plan or similar type plan. Many participants also reported self-referring to a particular Allied Health Professional for a specific reason. For example, to see a physiotherapist about an injury or to see a podiatrist for a particular issue.
Most of the participants noted that usually the wait time between receiving a referral and attending an allied health appointment at BDHC was “not too long” across the different allied health types. However, a quarter of participants reported that the wait times for a podiatrist appointment are significantly longer. Participants reported that the wait on the day of their appointment was not very long – ranging from “no wait at all” to “not much”. Two of the participants mentioned that they sometimes have to wait for the physiotherapists, up to 20 minutes, but participants did not seem to be frustrated by this.
The overwhelming message from participants is that they are very happy with their experiences with the allied health team members they have seen at BDHC.
Consistent messages that came up through the conversations were that:
- Participants value the services provided at BDHC;
- They appreciate the wide range of services available in their community;
- People are happy with the quality of care provided by the allied health team;
- They feel comfortable with the staff and they feel that the team really care about their health and well-being;
- People appreciate the communication with staff which is respectful and free of medical jargon; and
- They all value the professional, friendly and helpful service provided by the team on the reception desk.
However, there were a small number of individual experiences that participants mentioned which highlighted that they weren’t fully satisfied with their experience within a specific consultation and these are explained within the report.
Many participants provided some suggestions for improvements as part of the consultation process. Participants were advised that their feedback is valued and everything would be reported back to BDHC. The improvements that were within the scope of the project have been included in this report. This out of scope feedback has been de-identified and collated in a separate document and provided to the Project Steering Group.
A significant amount of information was collected through the conversations with each of the participants. It is important that this feedback is considered by the team at BDHC. It is recommended that:
- Feedback in this report is discussed by BDHC team members and an action plan is developed to address the issues raised through this consultation process and to contribute to the organisation’s continuous improvement and quality agenda.
- The outcomes of this project are shared internally with staff and the Board, through a face to face presentation to allow further discussion.
- The outcome of the consultation process is provided to community members either verbal or in writing, which outlines what will be done with the information collected.
- In consultation with the project manager, permission is sought from relevant participants to share their story in more detail to allow a full picture of the person’s journey within BDHC. It is recommended that the Marketing & Communications team work directly with the participant to help them to share their story either in writing or via an interview process.
- Full Project report – Understanding Community Heathcare experiences
- ATTACHMENT A – Project Steering Group – ToR
- ATTACHMENT B – Survey instrument
- ATTACHMENT C – Participant consent form