6 factors would improve hospital stays, says N.B. Health Council after patient survey
Patient-centred care is key to overall positive experience, says CEO Stéphane Robichaud
About 80 per cent of New Brunswick hospital patients report having a very good overall experience, according to a survey released Tuesday by the New Brunswick Health Council.
But the comments from those who had a negative experience reveal the extremes within the system, said CEO Stéphane Robichaud.
"When it was not good, it was really not good," he said.
One patient, for example, said their hospital stay was one of the worst experiences they've ever had to endure.
"I was treated like a NUMBER, a nonhuman, a disease, a condition, but never as a PERSON," the unidentified patient said about their stay at one of the province's medium or large hospitals.
"I was disrespected, humiliated, talked about very casually among the staff at the nursing station, and generally disregarded," said the patient, who left a day early because of staff behaviour "and extremely bad food."
Overall care experience is an important measure because it can affect health outcomes, length of hospital stays, and re-admissions, according to the council, a Crown corporation whose mandate is to report publicly on the performance of the provincial health system, and engage citizens in the improvement of health services quality.
The 2023 Hospital Acute Care Survey, which was conducted between June and November 2023, and is the council's first post-COVID-19 pandemic survey, provides valuable insights, said Robichaud.
6 key factors
Sometimes it can boil down to which employees are working when a patient receives care, he said.
But based on the responses of 4,719 patients, the council has identified six key issues that influence a patient's experience — all of which need to be improved, he said.
These include: internal co-ordination of care, emotional support, information received about conditions and treatments, communication with nurses, pain control and safety.
The first three are crucial to patient-centred care and require the most attention, said Robichaud.
Only 58 per cent of respondents said they always felt there was good communication between hospital staff and that staff were informed about their care.
Only 61 per cent said they always received the emotional support they needed to help with any anxieties, fears or worries.
And only 64 per cent said they always received information about their condition and treatment.
Type of service a factor
The type of service patients received also played a role in their overall experience, the survey found.
Surgical patients, for example, were most satisfied, at 84 per cent, while only 75 per cent of maternity patients reported a good overall experience.
This seems to have been influenced by "perceived gaps" in internal co-ordination of care and "whether hospital takes their safety seriously," according to the health council.
One woman said she was given "no info" on how to take care of her Caesarean section. She also alleged "miscommunication between pre-op nurse/nurses in OR and anesthesiologist about when to stop drinking [water] before surgery." The nurses said 12 hours and the doctor said three, which resulted in her being very dehydrated, she said, adding that nurses were also "confused about COVID rules."
Regional differences
The survey also highlighted some regional differences, said Robichaud.
Patients in the Edmundston region, or Zone 4, reported having a better experience than the New Brunswick average, while those in Campbellton, Zone 5, reported a worse experience.
Understanding the reasons for these disparities is crucial for identifying best practices, he said, and the regional health authorities will be looking into them.
But the use of temporary workers, such as travel nurses, may be a factor, he suggested.
"It can be well understood that when you have temporary workers coming into a network that the standards of quality can vary, that you don't have people that are used to working together or or used to being part of that team, per se."
Vitalité and Horizon respond
Vitalité Health Network will analyze the results in depth, said Jenny Toussaint, vice-president of logistics, patient flow, intensive care and internal medicine.
But she noted Zone 4 is one of the "best-resourced within the network, which could explain the mostly positive responses.
"Conversely, Zone 5, which faces the greatest staffing challenges, records lower satisfaction rates," Toussaint said in an emailed statement.
Vitalité regularly collects feedback through a satisfaction survey and improving the patient experience is one of its top priorities, she added.
Meanwhile, Horizon Heath Network's quality and patient safety department has reviewed the data and will be working closely with patient care teams throughout the organization to share results and identify key areas for improvement, said president and CEO Margaret Melanson.
Horizon also recently launched an ongoing patient experience survey to obtain real-time feedback from patients who have visited an emergency department, urgent care centre or have been discharged after staying at least one night in hospital or Horizon's Stan Cassidy Centre for Rehabilitation, she said.
The results will soon be available online.
Optimistic about system 'reset' under Liberals
Robichaud said health care is complex, with a number of players, such as the regional health authorities, extra-mural, Ambulance New Brunswick and provincial departments, as well as the "various views and wants and asks as far as what people expect from their health-care system."
But he believes New Brunswick has the elements it needs to improve care.
He points to the survey results, which show many professionals provide excellent care, and there being a "reasonable consensus around what needs to happen."
He's also optimistic having the a newly elected government is an opportunity to reset the system, he said.
Premier-designate Susan Holt said the survey highlights what the Liberals have been hearing from New Brunswickers who have had experience with the health-care system over the past few years.
"This is why we must work on opening community care clinics all across the province as they will ease the pressure on the hospitals in general and allow them to function as designed," she said in an emailed statement.
The report also "indirectly sheds light on the environments in which doctors, nurses, and other healthcare professionals work," said Holt.
"Both from a patient and an employee perspective, we have to transform the system so that we can improve their conditions and ensure New Brunswickers are getting the best quality of care."