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Using the Citizen's Charter Mark to Measure the Quality of Service to the Public by a Physiotherapy Service
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Using the Citizen’s Charter Mark to Measure the Quality of Service to the Public by a Physiotherapy Service Carol Groom Physiotherapy Services, Mid-Kent Healthcare NHS Trust The Citizen’s Charter Mark is a n award for public organisations which provide a n excellent service. A Charter Mark means the organisation has demonstrated that it puts its users first. The nine criteria that are assessed are standards; information and openness; consultation and choice; courtesy and helpfulness; putting things right; value for money; user satisfaction; measurable improvements in the last two years; and an innovative improvement with no additional cost. In June 1993 the first meeting of representatives from all grades of physiotherapy staff met to look a t setting standards for the service. This group (quality circle) has continued to meet regularly and has produced a quality assurance manual. From this work it became evident that outcome measurement of the effectiveness of intervention of physiotherapy was required. Work began with the University of Brighton to establish a tool that would provide information for our local service. In the summer of 1994 the chief executive nominated the physiotherapy service to apply for the Citizen’s Charter Mark. As guidelines on application showed much of our previous work was in line with criteria for
Applying the Project Concept to Promote Competence in Quality Development ~
~~~~~~~~
Hanne Lode Norske Fysioterapeuters Forbund, Oslo, Norway
Objectives: The Norwegian Physiotherapists Association has made systematic efforts in building competence in quality assurance and development, thus launching its special project ‘Quality in Physiotherapy’. Its primary purpose was to be a project for education and development. Its main objective is: ‘To develop concepts, standards, quality-systems and quality-processesfor physiotherapy in municipal primary health care and in somatic hospitals,to ensure high standard services for clients.’
Design: The project was carried out by 20 physiotherapists, an external adviser, a project manager and an administrative task force. The project period was October 1992 to October 1994, with a follow-up seminar in March 1995. The education of the 20 project participants was an essential part of the programme, carried out by joint seminars focusing on various subjects related to quality development, assurance and management, with the opportunity of individual counselling. Each participant managed her own sub-project. The
application, the decision was made t o apply in July 1995. The nine criteria gave a focus t o quality initiatives undertaken and highlighted shortfalls that could be addressed. Following consultation with staff, decisions on which aspects should be presented in each criterion were made. From this a ten-page application was compiled with supporting evidence to the Citizen’s Charter Mark representative a t the Cabinet Office. Following review of the application the service was visited by a n assessor which was encouraging as it meant a certain standard had been achieved. The visit of five hours included interviews with staff, patients and members of the quality circle.
At the end of last year we received a letter suggesting some changes in our working practices. We have now put these into effect and are making another application for a Charter Mark this year. Positive benefits of the application are that the service has been provided with a goal to work towards. All applications have a written evaluation of their work (even if unsuccessful) and therefore have an audit of quality of service from an objective assessor which will help in focusing efforts for future developments. Changes implemented following application include publication of out-patient information and a back care leaflet; arranging a patient feedback session, and improved signing. Work will continue to inform patients of the standards and involve them in future development of the service. project as a whole was mainly financed by the Fund for postgraduate training of physiotherapists.
Results: The project participants were given theoretical and practical knowledge in quality development. They report applying their new skills in their daily tasks a s physiotherapists. All participants finished their sub-projects, publicised in a report, showing the substantial and interesting results that they reached. All together 115 people participated in the various work groups during the project period. The results of the subprojects had t o be related t o the main target, ie a n educational and developmental project, rooted in each participant’s work and workplace. The set goals were all reached, and concrete results produced, which in turn have indirectly produced wider effects. One example is a n enhanced awareness of the necessity of systems and documentation in physiotherapy. Conclusion: Competent professional work requires a conscious and systematic approach. In order to obtain enduring effective changes, it is imperative to have quality assurance methods in mind, and put into practice. Total Quality Management must be made a n overruling and strategic measure. The Norwegian Physiotherapists Association will use the results and experiences gathered, and will continue to implement quality development as a tool for advancing competence.
Physiotherapy, July 1996, vol82, no 7
Using the Citizen’s Charter Mark to Measure the Quality of Service to the Public by a Physiotherapy Service Carol Groom Physiotherapy Services, Mid-Kent Healthcare NHS Trust The Citizen’s Charter Mark is a n award for public organisations which provide a n excellent service. A Charter Mark means the organisation has demonstrated that it puts its users first. The nine criteria that are assessed are standards; information and openness; consultation and choice; courtesy and helpfulness; putting things right; value for money; user satisfaction; measurable improvements in the last two years; and an innovative improvement with no additional cost. In June 1993 the first meeting of representatives from all grades of physiotherapy staff met to look a t setting standards for the service. This group (quality circle) has continued to meet regularly and has produced a quality assurance manual. From this work it became evident that outcome measurement of the effectiveness of intervention of physiotherapy was required. Work began with the University of Brighton to establish a tool that would provide information for our local service. In the summer of 1994 the chief executive nominated the physiotherapy service to apply for the Citizen’s Charter Mark. As guidelines on application showed much of our previous work was in line with criteria for
Applying the Project Concept to Promote Competence in Quality Development ~
~~~~~~~~
Hanne Lode Norske Fysioterapeuters Forbund, Oslo, Norway
Objectives: The Norwegian Physiotherapists Association has made systematic efforts in building competence in quality assurance and development, thus launching its special project ‘Quality in Physiotherapy’. Its primary purpose was to be a project for education and development. Its main objective is: ‘To develop concepts, standards, quality-systems and quality-processesfor physiotherapy in municipal primary health care and in somatic hospitals,to ensure high standard services for clients.’
Design: The project was carried out by 20 physiotherapists, an external adviser, a project manager and an administrative task force. The project period was October 1992 to October 1994, with a follow-up seminar in March 1995. The education of the 20 project participants was an essential part of the programme, carried out by joint seminars focusing on various subjects related to quality development, assurance and management, with the opportunity of individual counselling. Each participant managed her own sub-project. The
application, the decision was made t o apply in July 1995. The nine criteria gave a focus t o quality initiatives undertaken and highlighted shortfalls that could be addressed. Following consultation with staff, decisions on which aspects should be presented in each criterion were made. From this a ten-page application was compiled with supporting evidence to the Citizen’s Charter Mark representative a t the Cabinet Office. Following review of the application the service was visited by a n assessor which was encouraging as it meant a certain standard had been achieved. The visit of five hours included interviews with staff, patients and members of the quality circle.
At the end of last year we received a letter suggesting some changes in our working practices. We have now put these into effect and are making another application for a Charter Mark this year. Positive benefits of the application are that the service has been provided with a goal to work towards. All applications have a written evaluation of their work (even if unsuccessful) and therefore have an audit of quality of service from an objective assessor which will help in focusing efforts for future developments. Changes implemented following application include publication of out-patient information and a back care leaflet; arranging a patient feedback session, and improved signing. Work will continue to inform patients of the standards and involve them in future development of the service. project as a whole was mainly financed by the Fund for postgraduate training of physiotherapists.
Results: The project participants were given theoretical and practical knowledge in quality development. They report applying their new skills in their daily tasks a s physiotherapists. All participants finished their sub-projects, publicised in a report, showing the substantial and interesting results that they reached. All together 115 people participated in the various work groups during the project period. The results of the subprojects had t o be related t o the main target, ie a n educational and developmental project, rooted in each participant’s work and workplace. The set goals were all reached, and concrete results produced, which in turn have indirectly produced wider effects. One example is a n enhanced awareness of the necessity of systems and documentation in physiotherapy. Conclusion: Competent professional work requires a conscious and systematic approach. In order to obtain enduring effective changes, it is imperative to have quality assurance methods in mind, and put into practice. Total Quality Management must be made a n overruling and strategic measure. The Norwegian Physiotherapists Association will use the results and experiences gathered, and will continue to implement quality development as a tool for advancing competence.
Physiotherapy, July 1996, vol82, no 7