#ConsumerWatch: How well does your doctor or hospital rate?

How happy are you with your medical practitioner? When last were you admitted to hospital? And how were you treated? These are questions Discovery Health has aimed to answer in its latest annual list of 20 leading South African hospitals – as rated by patients in the annual Patient Survey Score (PaSS).

It’s the fifth such survey that the company’s published but the ninth year that it’s conducted the research, undertaken to get a broad overview of the sector.

The Top 20 list is based on aggregated surveys which were completed by members of schemes administered by Discovery Health. Members rated their in-hospital experience across various aspects of care. Last year’s PaSS list, which is modelled on a globally validated survey, reveals five newcomers and five hospitals appearing for the fifth consecutive year.

Last year, Discovery Health received about 63 000 survey responses from patients admitted to 202 hospitals across the country.

Dr Roshini Moodley Naidoo, head of quality of care at Discovery Health, says they’re encouraged by the annual increase in patient participation in the survey after their discharge from hospital. “In 2018, 19% of Discovery members who received the survey submitted a response, up from 14% in 2014.”

She says patients’ voices are being heard and they’re powerful: they have influence over how care is delivered.

“PaSS creates a systematic and standardised way to capture information about a patient’s experience of care in hospital.

“These results are then shared with members on Discovery’s website, creating transparency and driving positive change by helping health-care providers identify gaps that need attention,” says Moodley Naidoo.

The survey looked at how well nursing staff and doctors engage and communicate with patients; how well suited the hospital environment is

to the needs of patients (eg are noise levels kept to a minimum); how well pain is managed; how clearly information about medication is shared with patients; whether patients are adequately prepared for discharge (e.g. are they given information about symptoms to look out for that may indicate a need to see the doctor again); and an overall hospital rating including whether patients would recommend the hospital to others.

Moodley Naidoo says last year’s results show an improvement in five out of the eight survey categories, with the remaining three categories showing very minimal drops.

“We’re pleased to note that overall Patient Survey Scores have improved by 19% since we began publishing results in 2014, clearly showing that hospitals surveyed are increasingly meeting patient expectations of better care. Running the survey and publishing the results annually, has the same positive impact in our healthcare environment as observed internationally.”

She says the categories that patients care about most are how nurses communicate and engage with patients, information about medicine and managing pain.

All of these categories delivered higher scores last year: “We believe the survey has a positive impact beyond in-hospital care, as patients who are well prepared for discharge from hospital have better health outcomes and are at lower risk of repeat admissions. This is an important area of focus as repeat admissions are, on a global level, considered a warning sign of a care gap,” explains Moodley Naidoo.

Doctors are central to best quality care, and patients have rated doctors the highest out of all survey categories. In each subsequent year, the doctor scores have continued to increase and last year the doctor category was scored by patients at 85.7%.

Moodley Naidoo says they wanted to improve quality of care for patients from the doctor and hospital by looking at it through a clinical lens.

“This gives them a voice in how health care is designed and improved. It’s about patient centricity – not putting a premium on the funder (Discovery) but creating space to make certain that patients see that as high-quality care.

“For Discovery, we contract on the basis of value. We see it as being driven by different components of care – cost is only one aspect – and actual value in the system. It helps us put together the network of care.”

For patients, the survey is an effective and empowering decision-making tool, she says.

“So, if you have elective surgery, you might want a choice of hospitals – you can look at what they do well, where there is room for improvement.

It’s very important for patients where the doctors are.”

The PaSS survey though, is not a name and shame exercise – “you don’t drive improvement that way”. It’s important for consumers. In the

medical aid environment, there aren’t many such mechanisms that empower patients, so Discovery’s listing three years of data on its website, gives hospitals a better opportunity to improve.