A patient-centric approach to improving experience in urological cancer care

Abstract

Rationale: Patient experience data are often reported at the provider level rather than the patient level, meaning that providers receive an aggregate score of all patient experience scores across their service. This inflates positivity and makes it difficult for providers to use patient experience scores to tailor improvements for patients within specific sites, wards or pathways. Patients have different priorities for their urological cancer care experience, and improvement programmes should take these differences into account. A more granular understanding of different patterns of patient experience will allow health care providers to focus their improvement strategies differently based on the needs of the patient groups that utilise their services. Objective: This study examines what groups exist within the urological cancer patient population, and what are their respective priorities for patient experience improvement. Methods: Using urological cancers as a case study, this paper uses data from the UK National Cancer Patient Experience Survey to segment the patient population based on their scores for 14 domains of experience. TwoStep cluster analyses were carried out on two groups of survey respondents: those who had an operation and those who did not. These analyses identified previously unknown clusters within the two populations. Profiles were created for each cluster based on a series of demographic variables, and a regression analysis was conducted to assess the significance of each demographic variable in determining cluster membership. Results: The TwoStep analysis yielded three clusters for both the operations and non-operations groups based on how patients experienced care: Positive, Middling and Negative. Gender, age, cancer type and income significantly influenced cluster membership: women, younger and more deprived patients were more prevalent in the Negative experience cluster. Conclusion: This more nuanced understanding of the patient population and the variation in their priorities for patient experience improvement is the first step to more patient-centric improvement. It will allow services to make more meaningful and individualised changes based on the voices of patients. This is a proof of concept that can be applied broadly in health care to more effectively deliver on the patient-centred agenda.