Patient Experience Case Study Analysis, Framework
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FINAL | DECEMBER 2019 Filipino Patient Experience Framework, Cross-Case Analysis, and Patient Experience Assessment Tool Contents Contents ................................................................................................................................................................................................. i Abbreviations ....................................................................................................................................................................................... ii Executive Summary............................................................................................................................................................................. 3 Introduction .......................................................................................................................................................................................... 4 Review of Related Literature ........................................................................................................................................................... 5 Research Method: Case Studies ...................................................................................................................................................... 9 Cross-Case Analysis and the Filipino Patient Experience Framework ................................................................................ 24 Health Care Facility Capacities ......................................................................................................................................... 24 Health Care Provider Competencies .............................................................................................................................. 28 Continuum of Care .............................................................................................................................................................. 31 Health Outcomes ................................................................................................................................................................. 32 Cross-Case Analysis of Thematic Areas ..................................................................................................................................... 33 Primary vs. Higher Level of Care ..................................................................................................................................... 33 Health Sector Effects ........................................................................................................................................................... 34 Tuberculosis and Patient Experience .............................................................................................................................. 35 Family Planning and Patient Experience .......................................................................................................................... 36 Patient Experience Assessment Tool ........................................................................................................................................... 37 Health Care Facility Capability Performance Indicators ............................................................................................ 37 Health Care Provider Competency Behavioral Indicators ........................................................................................ 40 Patient Experience Assessment Across the Phases in the Continuum of Care ................................................... 43 Recommendations ............................................................................................................................................................................ 43 Annexes ............................................................................................................................................................................................... 45 This publication was produced for review by the United States Agency for International Development. It was prepared by members of the HRH2030 consortium. December 31, 2019 Cooperative Agreement No. AID-OAA-A-15-00046 Cover photo: Dr. Redentor Rabino, one of the first doctors to the barrios in Bongao, Tawi-tawi, conducts the Snellen’s test to one of his patients. (Credit: Blue Motus, USAID HRH2030/Philippines) DISCLAIMER This material is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of cooperative agreement no. AID-OAA-A-15-00046 (2015-2020). The contents are the responsibility of Chemonics International and do not necessarily reflect the views of USAID or the United States Government. Abbreviations BHW Barangay Health Worker MJH Mary Johnston Hospital CHW Community Health Worker Mary Johnston Healthcare Through the Lens of the Family: Case Study A Patient Experience Case Study of Mary Canossa Journeying with the Patient: A Patient Johnston Hospital Case Study Experience Case Study of Canossa Health and Social Center Metro Doctors Caring for the Mother and Child: A Patient Case Study Experience Case Study of Metro Doctors DOH Department of Health Clinic and Lying-in Foreshore HC Foreshore Health Center OD Organization Development Foreshore HC Practices and Challenges on Patient PHC Primary Health Care Case Study Experience: A Case Study of Tondo Foreshore Health Center PGH Philippine General Hospital Foreshore LIC Foreshore Lying-In Clinic PGH When the End-Referral Hospital Becomes Case Study the Only Choice: A Patient Experience Foreshore LIC A Strong Sense of Parenthood: A Patient Case Study of Philippine General Hospital Case Study Experience Case Study of Tondo Foreshore Lying-in Clinic PX Patient Experience FP Family Planning SLMC-QC St. Luke’s Medical Center-Quezon City Fugoso HC Fugoso Health Center St. Luke’s Providing Positive Patient Experience: A Case Study Patient Experience Case Study of St. Luke’s Fugoso HC Journey Towards Recovery: A Patient Medical Center Quezon City Case Study Experience Case Study of Fugoso Health Center TMC Tondo Medical Center Fugoso LIC Fugoso Lying-In Clinic Tondo Medical Quality Health Services and Factors Case Study Affecting Patient Experience: A Case Study Fugoso LIC Patients’ Journey with Fugoso Lying-in of Tondo Medical Center Case Study Clinic: A Patient Experience Case Study TB Tuberculosis HMOs Health Maintenance Organizations TB-DOTS Tuberculosis Directly Observed Treatment HR Human Resources Short-Course HRH Human Resources for Health UHC Universal Health Care IEC Information, Education, Communication USAID United States Agency for International LGU Local Government Unit Development WHO World Health Organization 3 Executive Summary USAID’s HRH2030/Philippines is a health-systems cross-case analysis, elements of the patient experience strengthening activity that aims to improve both service framework were derived. Observations across the 10 cases delivery capabilities of public and private health providers and presented 6 Facility Capacities and 6 Provider Competencies facilities, as well as, TB/FP patients’ utilization of services in that affects the 4 phases in the Continuum of Care leading to support of the implementation of the Universal Health Care Health Outcomes in the Filipino Patient Experience (UHC) Law. USAID’s HRH2030/Philippines developed the Framework. Filipino Patient Experience (PX) Framework and the PX Assessment Tool as enablers towards the Department of Health (DOH) goal to enhance service delivery throughout Certain thematic areas are of particular focus in this cross- the continuum of preventive, promotive, curative, and case analysis. Patient experience between primary and higher rehabilitative health interventions. Subsequently, this will lead level of care facilities is compared. Similarities and differences to strengthened HRH knowledge and safeguarding of PX. in the practice of patience experience within the health sector are discussed. Finally, lessons learned in patient experience are covered, both, in addressing tuberculosis and This study adopted the definition of PX of the Beryl Institute1 in support of family planning in the Philippines showcase PX as “the sum of all interactions, shaped by an organization’s best practices in TB and FP, and to spur more conversation culture, that influence patient perceptions across the and build partnerships for improving PX resulting to better continuum of care”. The World Health Organization (WHO) services and optimal health for Filipinos. defines universal health coverage “as ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of Based on the findings of the case studies and framework, sufficient quality to be effective while also ensuring that the USAID’s HRH2030/Philippines designed a PX Assessment use of these services does not expose the user to financial Tool comprised of an HRH competency tool and a facility hardship”2. These points considered, PX serves as a lens upon tool to assess levels of PX implementation and identify areas which the effectiveness of UHC in the Philippine health for improvement. From the results of using the tools, PX system, particularly for facilities and providers may be improvement plans can be developed by the facility to evaluated and improved upon. improve PX and sustain PX efforts within their locality/province appropriate to the Philippine context. The