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Dignity and Respect
Respect | Manaaki is one of our core values so it’s particularly good to see us
performing well in this domain. When we first started surveying patients in
2011, 79 percent told us they were always treated with respect and dignity.
We have increased this rating by a statistically significant five percentage
points since then to 84 percent. Nearly three-quarters of our respondents say
there was a member of staff they could talk to about their worries or fears
Whilst dignity and respect is rated as important to 35 percent of patients
overall, for our Pasifika and Asian populations it is far more important, with
nearly half (45%) telling us that being treated with dignity and respect is one of
the three things that makes the most difference to their care and treatment.
They also tell us that we are doing well at meeting their need to be treated
with dignity and respect, rating us 9.0 (Pasifika) and 8.9 (Asian) out of 10 on
this measure over the past 12 months. This is a great result and one we should
be justifiably proud of.
Overall, being treated with dignity and respect is one of the three dimensions
we rate most highly on, with 85% rating our performance at 8, 9 or 10 on a 10-
point scale (second equal along with confidence).
Patients tell us that dignity and respect means:
- being treated with care and compassion;
- polite, courteous staff;
- having their privacy and dignity actively respected; and
- having their views listened to and taken into consideration.
One area patients do tell us we can improve is talking in front of them as if
they weren’t there. One in every five respondents say that staff sometimes or
often do this so it’s timely to reflect on the role of the patient and the family as
partners in their care and to take opportunities to include them.
Dr. Andrew Old
Chief of Strategy, Participation & Improvement
Communication is the aspect of our care most patients (51%) say makes a difference to the quality of their care and treatment.
“I was kept very well informed of what was happening at each stage of my stay by all members of staff and any questions I had were always promptly replied to.” (Rated excellent) How are we doing on communication?
6 75 Poor Very good
Our inpatients are asked to choose the three things that matter most to their care and treatment.
POOR AND EXCELLENT RATINGS @2 YEARS
TOP THREE
Two in every five patients (44%), say that feeling confident about their care and treatment is one of the top three things that matter to the quality of their care and treatment.
“Before our son received [medication] … the nurse called another nurse to double check her calculations. It seemed to be standard procedure and I felt reassured to know the dose had been checked twice.” (Rated excellent) How are we doing with patients feeling confident about their care and treatment? 4 85 Poor Very good
Four out of every 10 patients (40%) rate getting consistent and coordinated care while in hospital as one of the things that make the most difference. “The team I dealt with were very proactive and productive.” (Rated very good) How are we doing with consistent and coordinated care? 7 72 Poor Very good
‘ + ’ = positive change; = no change; ‘ - ‘ = negative change
ADHB Inpatient Report July 2016: 1
Our “excellent” ratings have had a continual upward trend over the past 24 months, rising by a small but statistically significant two percentage points over this time (from an average of 48 to 50 percent). The differences are significant and sustained when demographic factors such as the age and gender of respondents are controlled for.
INPATIENT OVERALL EXPERIENCE OF CARE RATING, AUGUST 2014 TO
JUNE 2016 (n=7891)
The following data are from July 1, 2015 to June 30, 2016. The comparative data is
taken from the previous report on Information, in May 2014.
Staff talking about patients, not to them.
One in every five respondents say that doctors, nurses or midwives and allied health sometimes or often talked in front of them as if they weren’t there.
Percentage of patients who say staff talked in front of them
Doctors n= 3831; Nurses/Midwives n=3743, Allied Health n=
Percentage of patients who could find someone to talk to about their worries
and fears
Adult Community and Long-term Conditions n=121; Adult Medical Services n=393; Cancer and Blood n=130; Cardiovascular Services n=373; Child Health n=915; Surgical Services n=1255; Women’s Health n=474 Overall n=3662. Note that NA answers have been excluded and the data recalculated
Percentage of patients who said they were treated with dignity and respect
Adult Community and Long-term Conditions n=138; Adult Medical Services n=441; Cancer and Blood n=139; Cardiovascular Services n=419; Child Health n=958; Surgical Services n=1364; Women’s Health n=501 Overall n=3961.
76 78 80
10 9 6
13 13 14
Doctors Nurses/Midwives Allied Health No Yes, Sometimes Yes, often
73 60 65 76 79 76 72 72
24 35 31 20 19 23 24 25
3 5 4 4 2 2 4 3 Overall Adult Community and… Adult Medical Services Cancer and Blood Cardiovascular Services Child Health Surgical Services Women's Health Yes, definitely Yes, to some extent No
84 78 81 91 91 84 83 83
14 20 17 8 8 14 15 15
2 3 2 1 1 2 2 2 Overall Adult Community and… Adult Medical Services Cancer and Blood Cardiovascular Services Child Health Surgical Services Women's Health Yes, always Yes, sometimes No
FOCUS ON DIGNITY AND
RESPECT
Ensuring that patients are treated with dignity and respect is
important; one in every three say it is one of the three things that
makes the most difference to their care and treatment.
35 percent of our inpatients say that being treated with dignity and respect whilst in hospital is one of the three things that makes the most difference to the quality of their care and treatment
HOW ARE WE DOING?
There have been no significant changes in these ratings since the last report in May 2014.
There has been a 2% improvement in the percentage of patients who
2% say we treat them with dignity and respect since May 2014.
AVERAGE RATINGS ON
DIGNITY & RESPECT, BY
DEMOGRAPHIC &
DIRECTORATE
(JULY 2015 TO JUNE 2016, n=1385)
AVERAGE RATING
Overall: 8.
AVERAGE RATING BY GENDER
Female: 8. Male: 8.
AVERAGE RATING BY ETHNICITY
NZ European: 8. Māori : 8.
Pasifika: 9. Asian: 8. Other: 9.
AVERAGE RATING BY AGE
17 and under: 8.
25 – 44: 8. 45 – 64: 8. 65 – 74: 9. 75+: 8.
AVERAGE RATING BY DIRECTORATE
Adult Medical: 8.
Cardiovascular: 9. Children’s Health: 8. Surgical Services: 8. Women’s Health: 8.
Note that directorate and age data with less than 100 respondents have been excluded.
STAFF WERE POLITE AND COURTEOUS (9%) STAFF WERE RUDE (3%)
Our respondents (9%) appreciated it when staff introduced themselves, asked permission, and used respectful language. Many of the patients who commented on courtesy appreciated that staff used their name. Some said these basic courtesies reminded them of their humanity, and made them feel “like a person instead of a patient.”
Staff always introduced themselves and always used my name...even asking what I preferred to be called… they made me feel that I was important and they SAW me!
Staff were fantastic, introducing themselves before the procedure made me feel far more comfortable, treated like a person, not a number!
[Staff] introduced themselves [which] reduced my anxiety and made me feel like a person instead of a patient.
Our patients are asking us to introduce ourselves, to speak kindly and to use respectful language. Some patients would also like to remind staff that they are often overheard discussing patients, and to be more careful about what they say and where they say it. I think it would be nice if Doctors introduced not only themselves but [also] students with them, it was overwhelming to have 6 people in green scrubs standing bedside staring with no introduction or explanation. I overheard a nurse say during handover that my son was vomiting and pooing all night and that she "never felt so disgusted in her life." I felt sorry for her but I felt sorrier for my [toddler] son. Sometimes staff could have spoken more quietly so other people in the room didn't hear. I heard a lot of personal details about other people in the room.
PATIENT COMMENTS (cont…)
Patients appreciate it when staff pull curtains, handle personal or vulnerable situations carefully and respectfully and take care to not divulge personal information
All the staff ensured that they did not gossip or share my information with other people in front of me or my family.
A small number of patients felt that their physical or informational privacy was compromised, mostly due to shared wards and curtains not being closed properly, or conversations that were overhead. The 4 patients in my room heard every word the doctors said about their cases at the morning round.
PATIENT’S PRIVACY WAS PROTECTED (9%) PRIVACY NOT PROTECTED (3%)
Almost 200 patients (8%) commented on how having their views considered and listened to made them feel respected and as though they mattered. Nursing staff checking what I prefer to do rather than deciding what I should be doing. I felt listened to … as though I was a human being rather than just another patient or a number that had no worth.
Whilst only a relatively small number of respondents (64) commented about not being listened to, the length of and detail in their comments would suggest that, for most, this was a very negative experience. When I asked for only Panadol (due to being tired of feeling so wasted on morphine) the [nurse] said I needed morphine to shut me up and to take it and make the most of the high.
PATIENT’S OPINIONS AND POINT OF VIEW LISTENED TO AND RESPECTED (8%)
PATIENT’S OPINIONS OR CONCERNS NOT RESPECTED (3%)
PATIENT INFORMED (4%) PATIENT NOT INFORMED (2%)
Being told what was happening in terms of appointments, treatment, surgeries or procedures and wait times made patients feel they were treated with respect.
An urgent case had to be attended to [and my operation was delayed]. The doctors promptly notified me, explaining the shift in schedule ... I felt like I was important.
A minority of respondents were not informed what was happening, or were left waiting. I felt very alone and abandoned once we first arrived on the ward and was severely disappointed in the communication. It was a very busy day in the O.R. I had to wait for four hours until I was taken in. I felt a bit alone.
OTHER OTHER
Patient’s religion, culture, ethnicity or worldview respected (2%)
As a Māori person there are certain things that we hold as personal and private this was treated with the most respect
Staff take time and don’t rush (1%)
Patients non-treatment needs are respected (e.g. whānau support, sleep, food) (1%)
A very small number of respondents (16) felt they were not respected because of their religion, culture, ethnicity, age or worldview (1%) Just because you are … over 65 … doesn't mean you are senile. Some people may be vulnerable at the moment, but that doesn't mean they're not intelligent. Staff rush and don’t take time with patient (1%) Patients non-treatment needs not respected (1%)
