P145
Patient Experience of the Renal Dietetic Service in Pre-Dialysis Clinic
Campbell, R. Renal Dietitian, Central Manchester University Hospitals NHS Foundation Trust
Introduction: Patient experience is one way of measuring quality to ensure care provided is effective,
safe and person-centred care. NHS services must prove their value in terms of effectiveness. Patient
involvement is important in considering future service developments. This project was designed to
determine patients’ satisfaction of the predialysis outpatient renal dietetic service, dietetic
effectiveness and patients’ views for future service improvement.
Methods: Tick-box self-completed paper questionnaires with pre-paid return envelopes were offered
to patients in the predialysis clinic. Questionnaire translation, printing and postage were funded by
Kidneys for Life. Two different groups of patients were targeted- A: Patients in the renal dietetic
service ≥ 1 year. B: Patients new to the renal dietetic service, who had their initial appointment, plus 1
review with the Dietitian. Questionnaires were given out until ≥50 from cohorts A and B were
returned. Response rate- A: 62/145 = 42%, B: 52/122 = 43%. Results were collated, reviewed and an
action plan of service improvement work formulated.
Results:
Patient Experience - 98% of A and 96% of B felt welcome by the Dietitian. 98% of A and B
felt the Dietitian communicated clearly to them. 95% of A and 98% of B had confidence in
what the Dietitian said. 97% of A and 96% of B felt respected and cared for. 90% of A and
96% of B felt reassured they were in safe hands.
Dietetic Effectiveness - 60% of A and 52% of B reported that diet had little or no effect on their life. 79%
of A and 85% of B felt their predialysis diet knowledge was good. 56% of A and 69% of B thought that
the Dietitian had provided sufficient information. 68% of A and 85% of B reported that the Dietitian had
an impact on their ability and confidence to manage their diet. Of those who said the Dietitian had little
effect on them, 84% in A and 83% in B also thought that the diet itself had little or no effect on their
lives. Of those who felt their diet did affect their life, 80% in A and 96% in B said the Dietitian had a
positive impact on their ability and confidence to manage their diet. Of those who said the diet did not
affect their lives, 54% in A and 81% in B felt the Dietitian had a positive impact on their ability and
confidence to manage their diet.
What Patients Want (A only) - 16% reported contact with the Dietitian only once since being in the
service, while 21% reported contact ≥5 times. 13% wanted to be seen by the Dietitian every 1-3
months, while 39% only wanted to be seen if they had a dietary issue. Of those who wanted to see the
Dietitian every 1-3 months, 89% rated their diet knowledge as good. Of those who only wanted to be
seen if they had a dietary issue, 75% rated their diet knowledge good. 65% prefer the Nurse, Doctor or
Dietitian to decide when they need to be seen by the Dietitian; 92% would like this dietetic contact
within the clinic.
Comments - A: 17 positive and 8 usable suggestions for improvements, B: 12 positive comments, 3
negative and 2 suggestions. Themes were patients wishing to be seen more often and wanting more
information.
Conclusions: The experience of the Dietitian in predialysis clinic for most patients is positive. The
predialysis clinic Dietitian is effective in providing dietary knowledge to patients and ensuring they
can manage their diet; although diet may not always be important to the patient. Patients had the
opportunity to have their say about the predialysis renal dietetic service. The clinic system was altered
to allow patients to be seen more regularly and patient newsletters and posters produced in response to
patient wishes. Patients’ experience of the dietetic service may be affected by other factors e.g. overall
experience of the predialysis MDT; or patients’ educational level or health-related QOL may impair
their judgement. Future surveys are planned to monitor effect of service improvement and enable
between group comparisons. Improving patient experience will only be realised with the effort of all
staff and support from the wider organisation.