We report independently on the performance of the NSW healthcare system to inform improvements to care for patients, and enhance transparency and accountability
Find out what thousands of people have told us about their healthcare experiences in NSW. The results show where public health services are performing well and where they need to improve
The unique value of BHI patient experience surveys
Hilary Rowell
1 March 2024
Each month, thousands of people in NSW tell us about their recent experience with the public healthcare system as part of the NSW Patient Survey Program, which BHI runs on behalf of NSW Health.
A recent stocktake identified several hundred active patient experience survey data collections across NSW Health. In the context of this crowded landscape, what is it that makes BHI patient surveys a particularly valuable source of information on patients’ experiences of care?
They provide important measures of the quality of healthcare
Alongside safety and clinical effectiveness, patient experience is a crucial measure of healthcare quality. BHI surveys allow patients to report not just on how they felt about their care but also on the extent to which the right things happened at the right time for them.
The surveys are based on well-established evidence on what matters most to patients and what drives positive outcomes of care – covering key areas like information provision, effective communication and involvement in decision-making, as well as respect, kindness, safety and comfort. Taken together, patient survey results encompassing these issues provide a valuable perspective on organisational culture, while results for individual measures can point to positive achievements and opportunities for improvement.
They are a unique source of statewide benchmarks and trends
Our surveys seek feedback from thousands of patients attending more than 200 hospitals across the state and therefore provide robust and reliable results at hospital, local health district (LHD) and NSW levels. This means they can be used to make fair comparisons between hospitals on different aspects of patients’ experiences of care. We also publicly report and enable comparisons of results for different patient populations (e.g. by age, gender and language mainly spoken at home).
For our core ongoing surveys – the Adult Admitted Patient and Emergency Department Patient surveys – we have more than 10 years of historical data, meaning we can also report accurate trends over time.
Robust benchmarks and trends are essential for an accurate picture of performance and for guiding strategic improvement priorities for health services that benefit patients across NSW.
They are representative
Unlike many other patient surveys, the results from our surveys are representative, meaning that although we ask a selected ‘sample’ of patients about their experiences, the results we report accurately reflect the results that would be achieved by surveying the entire NSW patient population. The more representative survey data is, the higher its quality and the more value it provides.
We achieve this representativeness in three ways:
Stratified random sampling – Ensures the proportions of patients we survey across demographic groups and hospitals reflect the actual proportions across NSW. For example, younger people typically have lower response rates, so we intentionally send more surveys to them.
Weighting – Once survey responses are received, results are weighted to account for any differences in response rates across different patient groups and hospitals. This ensures that they are representative of the experiences and outcomes of the overall patient population.
Standardised comparisons – Given some patient groups tend to respond more positively to surveys, comparisons between individual hospitals’ and LHDs’ results and the NSW result are standardised. This involves taking into account differences in patient characteristics (e.g. age, gender, education level and language spoken at home) at each hospital/LHD before a hospital/LHD is flagged as having a significantly higher (green) or significantly lower (red) result than NSW in our supplementary data tables.
They are reflective
Many people are surprised to find out that BHI surveys are reflective by design; that is, we deliberately send questionnaires to patients several weeks after their contact with the health service. This ‘lag’ means we are able to ask patients to reflect on both their experiences while in hospital and how things have gone for them afterwards, including how prepared they were for their discharge from hospital, how well their post-discharge care was coordinated with other healthcare providers and whether they experienced any complications afterwards.
While more rapid or ‘real-time’ surveys provide quick and useful feedback to drive continuous local improvement, our carefully designed reflective surveys are a unique source of robust and reliable statewide benchmarks and trends that both ensure transparency for the community and guide improvement action.
More information on BHI patient surveys is available here.
Hilary Rowell is BHI’s Senior Director, Communications and Strategic Relations. Her role is focused on strengthening BHI’s engagement with key stakeholders and maximising the value and impact of our information. Hilary’s previous experience includes extensive work in healthcare policy and strategy, principally in the UK.