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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
• 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• 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:
• 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
• 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
Clinical waste collection
Quality of product (packaging, labelling, ease of use etc)
Quality of ancillary items
Driver assistance
Delivery times
Patient care coordinator
4Good
2Poor
1Very Poor
How do you rate (new supplier) on the following areas of service?
3Av’ge
5Excel’
The Survey
Clinical waste collection
Quality of product (packaging, labelling, ease of use etc)
Quality of ancillary items
Driver assistance
Delivery times
Patient care coordinator
5Much Better
4Better
2Worse
1Much Worse
Is the service you receive from [new supplier] better or worse than [old supplier]?
3Same
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?.....97.9% 96.3%
88.0%89.7%
12.0%10.3%3.7%2.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Notification fromTrust?
Welcome pack? Phone call fromthe new supplier?
Seamlessservice?
Questions
Pe
rce
nta
ge
of
pa
tie
nts
YES
NO
The Results?.....
0 1 2 3 4 5
Customer Services
Delivery times
Driver assistance
Quality of ancillaries
Product
Clinical waste collection
How do you rate [NEW PROVIDER]?1 = POOR; 5=EXCELLENT
The Results?.....
1 2 3 4 5
Customer Services
Delivery times
Driver assistance
Quality of ancillaries
Product
Clinical waste collection
"New Provider vs Old Provider" 1= much worse, 3=same, 5=much better
The Results?.....
How do you think the changeover to the new provider was managed?
59%
34%
5% 2%
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 (CMU) Website
Questions?