For years, University Medical Center Utrecht is performing so-called tracers. These are unannounced visits to departments. A team of people, who do not work in that department, enters and discusses how care is provided. Does the department do that in the desired and agreed way?
The team works with codes: red, orange, green. It is entered on tablets and because of this the department receives collegial feedback. You immediately will see where your department is doing well and what you need to pay attention to.
In that process, we still missed the direct input of patients. Care providers can find everything, but the patient’s perspective remained underexposed. Patients always have a voice in evaluation processes, but not yet in these tracers. That has changed now. We have recruited participating patients. They had training on the purpose and method of the tracers. It is also about how to look, approach and appreciate. It is not the intention to say judgmentally, “It’s not good what you’re doing here”, but ask the learning question: “Why do you work this way and not in a different way”
Behind the scenes
After this training we started with the group patients. This way you test the transparency of an organization. You let as it were people take a glimpse behind the scenes. By fully involving a patient representative in tracers, focus is more clearly on the essence of the care process: the patient. Is the patient well informed? Is the family involved in discharge from the hospital?
We as caregivers experience that you become more aware of your own way of acting. And yes, sometimes also of your prejudices. We experience that patients are more legitimate to questioning this. One of the patient representatives in the tracer asked: “How does your team experience this patient, is he difficult or not?” That’s pretty confrontational, but it’s important to realize this. Care to the patient should not suffer from a person’s preference or disapproval.
Another question was: “When did you last shower?” This question is equally logical as human, but it did not occur in the tracers before. Ex-patients participating in tracers provide the aspect of compassion in care and that is so important. It provides very valuable feedback. This makes people feel much more heard. And in the quality process we can take into account things that have come to light. That patient perspective gives an extra dimension.
By letting patient representatives fully participate in the tracer, the focus is on what really matters, the essence of the care process.
“We started at the Oncology wards, but now we are expanding to the entire hospital. I recommend it to all organizations because we can really review all aspects of care, together with and for patients.”
This article is a free translation from the original publication of an interview with Bas de Vries (photo insert), Senior Advisor, Managing board quality of care and patient safety of the University Medical Center Utrecht. It was written in Dutch for the general public and has been published for the completion of the project “Cancer care patient-oriented and transparent” from the patient movement “Living with cancer”. Internet Resource: Levenmetkanker (2015, written in Dutch).
Patient participation is increasingly recognized as a key component in the redesign of health care processes and successfully applied to some aspects of patient care, notably the decision-making process and the treatment of chronic illness. Recently, increasing patient participation has been recommended to improve patient safety. Because patient representatives look along on a tracer round, the care revolves around the essence: patients. Start recruiting patient representatives to include them as partners to perform tracers and to monitor compliance with safe practices.
QTracer supports the implementation of tracers in the University Medical center Utrecht. We are an added value partner, delivering software and services to successfully deploy accreditation and compliance technology. Please check our website www.qtracer.com to get familiar with our solution.
Greeting from The Netherlands!