At ScotSTAR (Scottish Specialist Transport and Retrieval), we had tried online and paper questionnaires to measure patient and service user satisfaction, and in FY 2015-16 these had been 0% successful (for patients) and 10% successful (for referring units) in gathering responses (the average being around 7%).
In July 2016 I initiated a QI project to gather meaningful feedback for the ScotSTAR neonatal team, for 30% of referring units and 20% of patients.
Based on feedback from a real patient representative and simulation testing, I developed self-addressed postcards for patients and referring units, explaining why we needed their input, with only 5-6 questions on the other side that took less than 1 minute to complete.
The project involved 4 PDSA cycles – testing over different hospitals, and also testing different change ideas such as a checklist and email reminders, relying heavily on support from the neonatal coordinator and wider neonatal staff.
Low response rates at the end of the 2nd cycle were explored further using the 5 Whys technique, and unearthed issues regarding coordinators working 9-5 not being aware of postcards handed out during retrieval missions undertaken out of hours.
A simple tweak to number the postcards changed that, as on Monday morning they would simply be able to see how many postcards had gone out over the weekend for example.
At the end of the final testing cycle in December 2016, the project enjoyed a 35% response rates from referring units and 25% from patients, exceeding the expectations of the aim.
The true value however lay in the information the postcards gave us, in terms of how many referring units were provided an estimated time of arrival (ETA) or informed of delays; and whether the patients were given the opportunity to touch/hold their baby prior to departure, and to travel with their baby (where appropriate).
100% of referring units were given an ETA and 100% of parents agreed we had explained what was happening during the stabilisation of their baby.
95% units said their call was answered promptly, and 84% patients were given the opportunity to touch/hold their baby before departure.
92% patients said a seat was available, of which 61% accepted the offer to travel with the team.
One postcard unearthed the perceived issue of staff without uniform examining a newborn in a woollen jumper, leading us to review the policy on uniform wear.
The postcards were also amended to capture the details of the respondents if they wished, so we could invite them at a later date to see how we had used the changes suggested by them to improve our service, thereby closing the feedback loop.