Assessing the impact of a
change management
procedure on homecare
medicines patients
Michael Butterfield
Specialist Technician for Homecare
Medicines
Jane Kelly
Procurement Project Pharmacist
Background
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What is ‘Homecare’?
5000+ patients
30+ therapy areas
32 million spend (¼ of overall medicine
spend)
• Services often covered by local or regional
contract
Aim of project
• Develop and implement a Standard
Operating Procedure to ‘manage’ the
change
• Evaluate the effectiveness of SOP
• Ultimate objective: Change should be
seamless and virtually invisible to the
patient
HELP!!!
Objectives
• Stage 1: Review current practice
• Stage 2: Write the SOP
• Stage 3: Evaluate the SOP
Stage 1: Review current
practice
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•
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Completed in 2008
45 patients
‘Low Tech’ medicine
Regular quarterly deliveries
Observed ‘learning points’
Stage 2: Write the SOP
• Mapped out the process observed
• Tasks grouped by:
• Clinical team
• Homecare providers (incumbent and new)
• Pharmacy
• 2 sections
– Detailed description of each activity
– Summary and checklist of tasks by task group
SOP ensures that:
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•
•
•
•
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Project manager assigned
Transfer of patients data
Informed patients
Seamless delivery schedule
Transfer of hardware
New service specification
Clear agreed start date
Stage 3: Evaluate the SOP
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Spring 2009
700+ patients
‘High Tech’ medicine
Regular quarterly deliveries
Patient survey conducted
Stage 3: Evaluate the SOP
• Surveyed 514 patients
• Questions on service and changeover
• No previous evaluation work
The Survey
How do you rate (new supplier) on
the following areas of service?
Patient care coordinator
Delivery times
Driver assistance
Quality of ancillary items
Quality of product (packaging, labelling,
ease of use etc)
Clinical waste collection
1
2
3
4
5
Very
Poor
Poor
Av’ge
Good
Excel’
The Survey
Is the service you receive from
[new supplier] better or worse than
[old supplier]?
Patient care coordinator
Delivery times
Driver assistance
Quality of ancillary items
Quality of product (packaging, labelling,
ease of use etc)
Clinical waste collection
1
2
3
4
5
Much
Worse
Worse
Same
Better
Much
Better
The Survey
• How do you think the changeover to the
new provider was managed?
– Very Well
– Well
– Could have been better
– Poor
• Comments…….
– Free text section
The Responses…..
• 286 out of 514 returned (57%)
• Shared with new provider and clinical
teams
• Patient feedback document
The Results?.....
100%
90%
89.7%
97.9%
96.3%
88.0%
Percentage of patients
80%
70%
60%
YES
50%
NO
40%
30%
20%
10.3%
12.0%
10%
2.1%
3.7%
0%
Notification from
Trust?
Welcome pack?
Phone call from
the new supplier?
Questions
Seamless
service?
The Results?.....
How do you rate [NEW PROVIDER]?
1 = POOR; 5=EXCELLENT
Customer Services
Delivery times
Driver assistance
Quality of ancillaries
Product
Clinical waste collection
0
1
2
3
4
5
The Results?.....
"New Provider vs Old Provider"
1= much worse, 3=same, 5=much better
Customer Services
Delivery times
Driver assistance
Quality of ancillaries
Product
Clinical waste collection
1
2
3
4
5
The Results?.....
How do you think the changeover
to the new provider was managed?
5%
2%
34%
59%
Very Well
Well
Could have been better
Poor
Comments
• Resistance to change
• ‘Why are we changing?’
Summary of results
• High level of satisfaction with changeover
• 96% of patients experienced seamless
service
Limitations
• Scope of survey
• No ‘before’ data to compare
Progress……
• Shared with Yorkshire and Humber
consortia
• Included in tender specifications
• Shared with National Homecare Medicines
Committee
• Available on Commercial Medicines Unit
Questions?