Managing the Performance of Homecare Medicines Services
Post on 11-Feb-2016
38 Views
Preview:
DESCRIPTION
Transcript
Managing the Performance of Homecare Medicines Services
Jane Kelly, Procurement Project PharmacistMick Butterfield, Specialist Technician: Homecare Medicines
PDIG Award
Project proposal Survey other Trusts across the UK to find out how
they performance manage their Homecare Contracts On-line Survey
Distributed via primary and secondary care e-mail networks
Limitations Distribution of survey Secondary care bias
National Survey
114 responses obtained
Differing geographic locations
Homecare Provider survey 100,000 patients Top 6 companies 5 homecare companies
responded
Survey Results - BackgroundSector Response (95 responses from hospital)
Hospital83%
PCT17%
4.2%No
95.8%Yes
Is the Homecare route ever used in your organisation? (n = 95)
Survey Results - Background
Survey Results -BackgroundApproximate number of patients on Homecare medicines (n = 93)
23
96
2 16
46
0
5
10
15
20
25
30
35
40
45
50
0-100 101-500 501-1000 1001-2000 2000-3000 3000+ Don't Know
Numbers of patients
Num
ber
of re
spon
ses
Survey Results -BackgroundTop 10 Homecare therapy areas (n = 78)
0
10
20
30
40
50
60
70
Anti TNFs
HIV med
icine
s
MS Treatm
ents
EPOs
Methotr
exate
Immun
oglob
ulin
Paren
teral
Nutritio
n
IV Antib
iotics
Growth Horm
one
Efalizu
mab
Survey Results - BackgroundHomecare Providers (n = 71)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Health
care
at Home
Bupa (Clin
ovia)
Centra
l Homec
areCale
a
Fresen
ius Med
icareWillo
w
Polar Spee
d
Intecare
Grifols
Careology
Nutricia
Clinica
l care
Health
care
Logistics AAH
Perc
enta
ge o
f res
pons
es
Why is performance management important?
Puts the patient at the centre of the homecare service Aims to deliver safe and effective patient care Ensures the same high quality standards at home as in
hospital Aims to engage the clinical multidisciplinary team,
procurement, and homecare providers for the benefit of the patient
Aims to demonstrate value for money Monitors compliance and contractual obligations Helps inform at future homecare contract adjudications
Practical performance management
Contracting Key performance indicators Service Reviews Patient Surveys
Contracting
Performance management starts with a well written tender document and service specification
A ‘specification checklist’ is one of the documents on the NHMC website
The specification must include clear information about how the homecare service is going to be performance managed and / or audited
Survey Results - ContractingWho arranges the contract for each therapy area? (n = 77)
5%4%
2%
29%
60%
Pharmacy
Supplies
Clinical Team
Primary Care Trust
ProcurementHub/Confederation
Survey Results – Contracting
Pharmacist 72%Pharmacy procurement 66%
Clinician 68% Nurse 37%
Pharma. sponsored 32%
Supplies 13%
Finance 11%
Patient 10%
Practical performance management
Contracting Key performance indicators Service Reviews Patient Surveys
Key Performance Indicators
Agreed KPI’s can be used to assess the quality of the service provision
Targets are set to maintain a high level of service to our patients
KPI results are reviewed regularly with the homecare provider and action taken to resolve any issues
Survey Results -KPIsRank the following KPIs in terms of importance (62 / 32)
0
20
40
60
80
100
Com
plai
nts
Inci
dent
s
Del
iver
yw
indo
w
Invo
ices
Faile
dde
liver
ies
Emer
genc
yde
liver
ies
No.
invo
ices
No.
deliv
erie
s
Spen
d
Incidents and Complaints Monitoring
Formal incident and complaints procedures
Sharing Trust policy with Homecare companies
Define contact pathways
Collaborative reporting / resolving issues
Practical performance management
Contracting Key performance indicators Service Reviews Patient Surveys
Service Reviews
Who – involve the whole team Frequency – quarterly, half yearly or yearly
depending on contract Agenda
Review actions from last meeting Presentation of KPIs Review incidents and complaints Invoice/finance issues Staff changes Contractual changes
Survey Results – Performance managementDo you performance manage your homecare contracts? (n = 69)
10%
13%
13%
21%
43%Yes, AllMostSomeOnly when necessaryNever
Survey Results – Service ReviewsHow often is performance reviewed? (n = 40)
ad-hoc47%
at contract end5%
annually17%
half-yearly3%
quarterly15%
monthly13%
Survey Results –Service Reviews
Pharmacist 72%Pharmacy procurement 66%
Clinician 40% Nurse 44%
Pharma sponsored 14%
Supplies 12%
Finance 10%
Patient 0%
Practical performance management
Contracting Key performance indicators Service Reviews Patient Surveys
Patient Surveys
Just 17% have used patient questionnaires to review the performance of the homecare provider
Surveys are undertaken after a change of provider or every year
Patients are asked to rate the performance of their homecare service provider
Ensure results are fedback to clinical teams / homecare providers and patients
Patient consent to homecare
Current project at Leeds is to review how patients consent to homecare
Professional guidance is that healthcare professionals should obtain consent for everything involving the patient
How should consent be obtained and recorded?
Survey Results – Patient ConsentDo patients have a choice? (n = 61)
Usually39%
Never5%
Always38%
Rarely18%
Patient Consent
Are patients asked for their consent to homecare? (n = 73)
All41%
Most10%
Some6%
Don't Know43%
Don’t Know 43%
Survey Results – Patient consentIs the consent informed? (n = 71)
All35%
Most13%Some
7%
Don't Know45%
Survey Results - NHMC
72% did not know NHMC existed
15% had visited the website
70% who visited the web site used the information they found there
Summary
Contracting – ensure clear service specification that includes performance management
Formal Review – pharmacy should co-ordinate formal reviews of service at regular intervals
Homecare incidents and complaints – ensure these are reported and learned from
Patient involvement – increase patient involvement
NHMC – raise profile in the NHS
Future / Next Steps
Visit other centres
Share best practise with NHMC
top related