Patient experience

Experiència pacient

The Institut Guttmann has opted to introduce the Patient Experience approach in a cross-cutting and integrated way, thereby improving quality in all processes and continuing to make progress by building a humanised organisation. Taking the perspective of patients (and their families) into account in the decision-making process is enriching and allows us to opt for wider-reaching and more complete actions for all stakeholders, with consequent improvements in the quality of care.

During 2022, we mainly worked on 2 key projects to improve the patient experience: reception and hospital discharge.

A)    Improvements in the hospital reception process

The reception process encompasses all the activities carried out by professionals to welcome and integrate the patient and their family/companions in the hospital setting. The main aim of this process is to provide important information about the centre in a personalised way that is easy to understand, taking the patient’s opinions, needs and experiences into account.

It is essential that patients and their families feel accompanied, informed and welcomed upon reception. Interaction during the reception process offers opportunities to develop a relationship of trust and satisfaction and the inclusion of the patient in the new hospital environment.

The following actions were carried out to listen to the voices of patients, family members and professionals, and to co-design a new reception protocol:

  • Patient Journey Map (PJM) of the reception process prepared alongside the multidisciplinary working group of professionals.
  • Questionnaire for care and non-care professionals to identify pain points and proposals for improvement.
  • 4 focus groups with 10 patients and 10 family members.
  • 3 sessions of participant observation (the first 5 days after arrival at the hospital).
  • Analysis of all the information and presentation of proposals.

Points for improvement were detected in the process based on all the information collected. Some of the points identified from the patient/family perspective are related to the lack of information received before admission and during the first days in the hospital to get to know the hospital’s facilities and how it operates, as well as the importance of proactive communication from the professional staff explaining the neurorehabilitation plan that the patient will follow during their hospital admission.

Analysing all the information has made it possible to develop a new wide-ranging reception protocol. The main improvements included in the plan are given below:

  • A new Information Dossier that is delivered during the reception process has been worked on and redesigned.
  • Communication from the Admissions area prior to admission to provide relevant information to each patient and their family, helping resolve any doubts that may arise in the days before entering the hospital.
  • Streamlining administrative procedures so that admission takes place directly in the hospitalisation unit whenever possible, avoiding unnecessary waiting time in the reception area.
  • Understanding that the reception process is not just the day of arrival, but rather a period of adaptation to the centre that can last until approximately the fifth day. The nurse or referring nurse (reception manager) takes on the role of accompanying the patient and family to ensure a good welcome and settling-in period. At the end of this process, they will find out whether there are any concerns or doubts that need to be resolved to continue effectively with the neurorehabilitation process.
  • The professional staff in each area will get to know each patient and their family in an orderly way, providing the necessary information.
  • Incorporating a guided tour of the centre by the Institut Guttmann’s volunteers to learn about the hospital’s facilities and services.
The results of the evaluation in 2022 conclude that 95.38% of patients/family members express a degree of Global Satisfaction equal to or greater than 7 points during the reception process (between days 7 and 10 of hospitalisation).
70.31% of people surveyed feel that they have received adequate explanations about the hospital’s services and how it operates, and 90% feel that they have received consistent information from different professionals.
93.65% say they felt they were in good hands.
B)    Improvements in the hospital discharge process 

Hospital discharge constitutes a key moment of transition in health. Discharge from hospital can generate anxiety and uncertainty about leaving the protected environment of the hospital and having to face returning to the community. Therefore, within the rehabilitation process, hospital discharge is one of the most complicated moments and where patients and families need the most support.

The following actions were carried out to jointly design a hospital discharge protocol with patients, family members and professionals:

  • Workshop with a multidisciplinary group of professionals
  • Questionnaire for care and non-care professionals to identify pain points and proposals for improvement.
  • Interviews with those responsible for each hospital department.
  • 10 interviews with patients and family members.
  • Patient satisfaction and experience surveys.
  • Analysis of all information and presentation of proposals to the centre management to implement improvements based on patient experience.

In general terms, the following have been detected as areas for improvement: coordination of the therapeutic team to manage the discharge process and the information provided during the last days of admission.

The main improvements included are given below:

To improve the coordination of all professionals, a digital checklist shared by the entire therapeutic team has been introduced to monitor the most relevant aspects to take into account in the final days of hospitalisation and coordinate them to guarantee that support upon discharge is being carried out correctly.

brochure has also been written with key information to give to the patient and their family during the last days of hospitalisation. This is delivered in a discharge preparation meeting with the patient’s social worker and provides an opportunity to resolve doubts and concerns.

We have included a post-discharge call made by the patient’s social worker in order to guarantee that the return home has been satisfactory and to resolve any pending issues or doubts that may have arisen.

At the end of 2022, the pilot test of the new protocol began in one of the Hospitalisation Units, with an overall satisfaction result with the discharge process of 7.8 out of 10.