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ALBERTA HOME CARE CLIENT EXPERIENCE SURVEY REPORT Provider - level results Personal Care Services Christenson

September 2016

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Health Quality Council of Alberta. Alberta Home Care Client Experience Survey report. Provider-level results. Christenson. Calgary, Alberta, Canada: Health Quality Council of Alberta; September 2016.

Please contact the Health Quality Council of Alberta for more information ([email protected], 403.297.8162).

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TABLE OF CONTENTS

INTRODUCTION ................................................................................................................................... 1 FINDINGS .............................................................................................................................................. 4 Section 1.0: Overall ratings of client experience ............................................................................. 5 Section 2.0: Drivers of client experience ......................................................................................... 7 Section 3.0: Client concerns with personal care services ............................................................. 15 APPENDICES ...................................................................................................................................... 16 Appendix I: Client characteristics .................................................................................................. 17 Appendix II: Additional methodological details .............................................................................. 20 Appendix III: Question-level responses ......................................................................................... 24 Appendix IV: Client comments ...................................................................................................... 31 LIST OF TABLES ................................................................................................................................. 32 LIST OF FIGURES .............................................................................................................................. 32

INTRODUCTION 1

INTRODUCTION

The 2015 Alberta Home Care Client Experience Survey (AHCCES) was conducted by the Health Quality Council of Alberta (HQCA) in collaboration with Alberta Health Services (AHS) and Alberta Health (AH). The purpose of the survey was to capture the experiences of, and obtain feedback from, seniors who represent the largest group of home care clients (70.8%).1 These clients had the following characteristics:

Long term supportive and maintenance client category

Ages 65 and older

No cognitive impairment

The results of the survey are presented in two reports: (1) the provincial report, and (2) the provider-level report. The provincial report provides an overview of client experiences with home care in Alberta. As well, variation by geographic area within Alberta and AHS zones are reported. The provider-level reports are unique to each provider and present detailed results on topics that are within the scope of provider’s roles and responsibilities. As a result, this report does not include questions that relate to case management, care planning, and professional services. However, if clients addressed these topics in their comments they are included in the comments analysis in this report. Therefore, it is suggested that the provider-level report is used in conjunction with the provincial report to more fully understand client experiences and to assist in identifying areas of excellence and opportunities for improvement.

Survey process

The AHCCES is a 55 question self-reported assessment of various topics about home care and the services home care delivers and/or manages.

The survey was mailed to clients between March 27, 2015 and July 31, 2015. The provincial response rate for the survey was 64.3 per cent (7,171 clients out of a possible 11,150). For more information, see Appendix II.

1 Reference: Alberta Health Services Analytics. Tableau Dashboard. Seniors Health, Community and Continuing Care. Client Counts by Client Group – Type Group by Zone (fiscal year 2014-15) workbook [Internet]. Alberta, Canada: Alberta Health Services; [cited 2016 Feb 12].

2 INTRODUCTION

Provider classification

Providers were identified by using administrative data, and this list was then verified by AHS. To ensure client feedback was directed to the correct provider, clients who received personal care services2 from only one provider in 2014 were included in the analysis. Therefore, if a client received personal care services from more than one provider, they were not included in provider-level reports. This is a limitation of this report. In interpreting results, it is also important to recognize that providers deliver services to a client base that extends beyond long term supportive and maintenance clients that were surveyed in this project. For a complete discussion of limitations, see Appendix II.

Analytical and reporting methods

Provider comparators

Your provider-level results are presented together with results from the AHS zone in which you provide services, and the overall results for the province.

Reporting of top box results

A “top box/top 2 box” approach presents only the most favourable response(s) for a question and is used to simplify reporting and increase understanding of results.3 Research supports the use of this approach among best practices in identifying client-driven improvement opportunities and in predicting future business performance.4,5 In this report, the “top box/top 2 box” approach identifies areas of success and provides a goal to work towards.6 For example in Question 47: Overall, how would you rate your Home Care Personal Care Services ?, while clients rated services from Poor to Excellent, only the percentages of Excellent and Very Good responses are reported. Complete responses for each question can be found in Appendix III.

2 46 AHS and 36 contracted providers and/or local home care offices delivering personal care services. 3 Reference: American Institutes for Research: How to Report Results of the CAHPS Clinician & Group Survey [Internet]. Aligning Forces for Quality; 2010 Sep 1 [cited 2016 Apr]. Available from: http://www.rwjf.org/content/dam/farm/reports/reports/2010/rwjf69357 4 Reference: Morgan NA, Rego LL. The value of different customer satisfaction and loyalty metrics in predicting business performance. Marketing Science. 2006 Sep-Oct;25(5):426-439. 5 Reference: Garver M. Customer-driven improvement model: best practices in identifying improvement opportunities. Industrial Marketing Management. 2003 Jul;32(6):455-466. 6 There was statistical support for reporting top 2 box responses separately. For example, for the overall ratings of client experience there was a statistical difference between clients who answered Excellent and clients who answered Very Good. Therefore, it is appropriate to present the ratings for Excellent and Very Good independently.

http://www.rwjf.org/content/dam/farm/reports/reports/2010/rwjf69357

INTRODUCTION 3

Overall ratings and drivers of client experience

Overall ratings of client experience at the provider level is measured by the Global Overall Care rating and the overall rating of personal care services. Five drivers of client experience were identified at a provincial level (see provincial report); however, only drivers applicable at the provider level are presented in the provider-level reports.

The two drivers in order of priority from the strongest to weakest in relation to overall ratings of client experience and their importance according to client comments are:

1. Relational Care7

2. Client Needs and Expectations

Suggested use of report content

1. Section 1.0 to assess overall ratings of client experience.

2. Section 2.0 to understand specific areas within each driver of client experience.

3. Section 3.0 for additional feedback informed by client comments.

4. Appendices to understand the methodological details, the client-responder sample, and client comments specific to your organization.

7 Relational care as a concept is recognized within nursing and healthcare in general as an aspect of care with regards to relationships between staff and client/patient. Relational care developed from what is considered the relational core of nursing, and is widely applicable to other healthcare relationships. For an example of the relational core of nursing, see: Jonsdottir H, Litchfield M, Pharris MD. The relational core of nursing practice as partnership. J Adv Nurs. 2004;47(3):241-250.

http://www.pubpdf.com/pub/15238117/The-relational-core-of-nursing-practice-as-partnership

FINDINGS

SECTION 1.0: OVERALL RATINGS OF CLIENT EXPERIENCE 5

SECTION 1.0: OVERALL RATINGS OF CLIENT EXPERIENCE

Global Overall Care rating Clients were asked the following question about their overall experience of home care: (Question 51) OVERALL, how would you rate the quality of your Home Care Services (including both Professional and Personal Care Services), where 0 is the worst and 10 is the best?

Please note that this question reflects the overall client experience of home care, and may reflect experiences unrelated to the services your organization provides. The average rating from 0 to 10 across comparators is presented in Figure 1. For all response categories see Table 4 in Appendix III.

Figure 1: Global Overall Care rating (Q51) across comparators

Christenson(N = 26)

Edmonton Zone(N = 2,292)

Alberta(N = 6,647)

Average 9.0 7.8 8.1

0.0

2.5

5.0

7.5

10.0

Glo

bal O

vera

ll C

are

ratin

g (0

to 1

0)

6 SECTION 1.0: OVERALL RATINGS OF CLIENT EXPERIENCE

Clients were asked the following question about their overall experience of personal care services:

Q47: OVERALL, how would you rate your Personal Care Services? (please think about all Personal Care staff together)

The top 2 box responses (ratings of “Excellent” and “Very Good”) across comparators is presented in Figure 2. For all response categories see Table 5 in Appendix III.

Figure 2: Top 2 box responses for overall rating of Personal Care Services (Q47) across comparators

Christenson(N = 24)


Alberta(N = 5,689)

Excellent 45.8 20.7 24.7Very Good 41.7 37.7 37.9

0

25

50

75

100

Perc

enta

ge

SECTION 2.0: DRIVERS OF CLIENT EXPERIENCE 7

SECTION 2.0: DRIVERS OF CLIENT EXPERIENCE

In this section, drivers of clients’ experiences are presented in order of strength of relationship to the ratings of overall client experience and importance based on client comments, and can be used by a provider to assist in prioritizing improvement opportunities.

Driver 1: Relational Care. The survey items associated with this driver include:

Treatment by Personal Care Services Staff score from 0 to 100

o Questions 37 to 45

How clients felt about the number of staff they had (Question 31)

Driver 2: Client Needs and Expectations. The survey items associated with this driver include:

Percentage of Met Needs-Personal Care Services

o Questions 32 to 36

8 SECTION 2.0: DRIVERS OF CLIENT EXPERIENCE

Driver 1: Relational Care Provincially, Relational Care was the most important driver of overall experiences. This driver includes survey Questions 31, and 37 through 45. Overall, how clients felt they were treated by personal care staff had the strongest relationship with the ratings of overall client experience.

Treatment by Personal Care Services Staff

This composite measure is comprised of multiple questions about how clients were treated by personal care staff (Questions 37 to 45) and is presented as a score on a 0 to 100 scale, where 0 was the least positive response and 100 was the most positive response, and is presented across comparators in Figure 3. Overall, clients rated their home care experiences better when they felt they were treated more positively by their personal care staff.

Figure 3: Treatment by Personal Care Services Staff across comparators

Figures 4 and 5 present the top box results (per cent “Yes”) for the questions that comprised the measure Treatment by Personal Care Services Staff across comparators. For all the response categories see Table 7 in Appendix III. The survey questions that comprise this measure are presented below in order of how strongly each question is associated with the measure Treatment by Personal Care Services Staff, with Question 40 the strongest, and Question 41 as the weakest in this question set.

Christenson(N = 18)


Alberta(N = 5,285)

Average 97.3 86.6 88.6

0

25

50

75

100

Trea

tmen

t by

Pers

onal

Car

e St

aff s

core

(0 to

100

)


Figure 4: Top box results for questions that comprise Treatment by Personal Care Services Staff Q37 to Q45 (1of 2)8

8 For the number of responses by question and comparators, refer to Table 6 in Appendix III.

Q40: In the lastyear, Personal Care

staff listenedcarefully to my

wishes and needs

Q43: In the lastyear, Personal Care

staff explainedthings in a way that

was easy tounderstand

Q39: In the lastyear, Personal Carestaff treated me with

kindness evenduring difficult or

embarrassing tasks

Q38: In the lastyear, Personal Carestaff knew what kind

of care I neededand how to provide

it

Q44: In the lastyear, Personal Carestaff treated me asgently as possible

when providing care

Christenson 100.0 94.7 100.0 100.0 100.0Edmonton Zone 77.4 77.1 88.4 76.8 89.1Alberta 80.9 80.7 90.6 80.7 91.5

0

25

50

75

100Pe

r cen

t "Ye

s"


Figure 5: Top box results for questions that comprise Treatment by Personal Care Services Staff Q37 to Q45 (2of 2)9

9 For the number of responses by question and comparators, please refer to Table 6 in Appendix III.

Q45: In the last year,Personal Care staff

made me feel safe andthat my belongings were

safe

Q42: In the last year,Personal Care staff keptme informed about when

they could arrive

Q37: In the last year,Personal Care staff letme know when they

could not come

Q41: In the last year,Personal Care staff

encouraged me to dothings for myself if I could

Christenson 100.0 94.7 100.0 73.7Edmonton Zone 89.5 67.5 68.3 67.2Alberta 91.2 69.5 71.9 72.5

0

25

50

75

100Pe

r cen

t "Ye

s"


How clients felt about the number of staff they had

Survey Question 31 asked clients how they felt about the number of different personal care staff they had. Figure 6 reports the top box results (response of “I’m very happy with the number of different staff I’ve had”). For all the response categories see Table 9 in Appendix III.

Figure 6: How clients felt about the number of staff they had

Christenson(N = 17)


Alberta(N = 5,485)

Average 70.6 39.1 44.4

0

25

50

75

100

Per c

ent "

Very

hap

py w

ith n

umbe

r of d

iffer

ent s

taff"


Driver 2: Client Needs and Expectations The degree to which clients felt their needs were being met was the second most important driver of clients’ overall experiences of home care services at the provincial level. Met Needs-Personal Care Services is comprised of survey Questions 32 through 36. From these questions, an average percentage was calculated which represents the number of times a client said their needs were met (“Yes” responses), divided by the total number of needs that the client reported having.10 Clients rated their overall experience better when their needs were met. Figure 7 reports the average percentage of Met Needs-Personal Care Services across comparators.

Figure 7: Average percentage of Met Needs-Personal Care Services across comparators

Figure 8 presents the top box results, or percentage of respondents who reported “Yes” on questions that comprise Met Needs-Personal Care Services (Q32 to Q36) across comparators. For all the response categories see Table 11 in Appendix III. The survey questions that comprise this measure are presented below in order of how strongly each question is associated with overall client experience at the provincial level, with Question 32 the strongest, and Question 36 as the weakest in this question set.

10 The per cent Met Needs – Personal Care Services is based only on the needs that were asked in the survey, therefore may not always represent a client’s complete range of personal care service needs outlined in their care plan.

Christenson(N = 20)


Alberta(N = 5,474)

Average 82.3 65.6 66.4

0

25

50

75

100

Per c

ent M

et N

eeds

-Per

sona

l Car

e Se

rvic

e


Figure 8: Top box results for questions that comprise Met Needs-Professional Services Q32 to Q3611

11 For the number of responses by question and comparators, see Table 10 in Appendix III.

Q32: In the lastyear, Personal Carestaff met my needs

for help withshowering or

bathing

Q35: In the lastyear, Personal Carestaff met my needsfor help with eating

Q34: In the lastyear, Personal Carestaff met my needsfor help with using

the bathroom

Q33: In the lastyear, Personal Carestaff met my needsfor help with getting

dressed

Q36: In the lastyear, Personal Carestaff met my needsfor help with taking

medications

Christenson 94.7 0.0 20.0 75.0 50.0Edmonton Zone 81.7 17.2 30.5 56.5 47.5Alberta 84.7 14.9 30.2 56.9 44.1

0

25

50

75

100Pe

r cen

t "Ye

s"


“Grocery delivery - once a week.”

Client Needs and Expectations - Comments Clients were asked to answer the following question:

Question 48: In the last year, was there any service of any kind that you felt you needed but didn’t get?

Client comments for Christenson were analyzed for themes in response to this question, and a summary of this analysis is provided below. It is important to note that the services described by clients may not be within the scope of services provided by home care or your organization. In addition, client comments that were about personal care services as opposed to unmet needs are discussed in Section 3.0. In total, 6 Christenson clients provided comments about services they needed but did not get, or about services that were delivered but did not meet their expectations.

Verbatim comments in response to Q48 have been included to provide a more complete picture of client experiences and can be found in Table 12 in Appendix IV.

Summary of client comments Most clients said they needed assistance with grocery shopping and delivery. In addition, one client said they needed help with housework. One client said they received help from family members for assistance with tasks.

SECTION 3.0: CLIENT CONCERNS WITH PERSONAL CARE SERVICES 15

SECTION 3.0: CLIENT CONCERNS WITH PERSONAL CARE SERVICES

Introduction Clients were asked to provide comments on the following question:

Question 46: Do you have any concerns about your Personal Care services?

Summary of client comments No comments were provided for Question 46 by Christenson clients.

APPENDICES

APPENDIX I 17

APPENDIX I: CLIENT CHARACTERISTICS

Table 1: Client characteristics by comparators

Cognitive Performance Scale (CPS)

Christenson (N = 27)

Edmonton Zone (N = 2,486)

Alberta (N = 7,171)

% % %

CPS 0 81.5 75.2 75.1

CPS 1 18.5 24.8 24.9

Gender



Alberta (N = 7,171)

% % %

Male 25.9 27.3 27.9

Female 74.1 72.7 72.1

Age



Alberta (N = 7,171)

Average Age 88.6 83.8 83.7

18 APPENDIX I

Your Health and Wellbeing Two questions were asked regarding client’s overall health as well as overall emotional health.

Table 2: Complete responses for Q52 and Q53 across comparators

Q52: In general, would you say your overall health is…

Christenson

(N = 25) Edmonton Zone

(N = 2,352) Alberta

(N = 6,812)

Response % % %

Poor 0.0 11.6 9.6

Fair 44.0 40.6 38.6

Good 44.0 37.9 40.2

Very Good 12.0 8.6 10.1

Excellent 0.0 1.3 1.5

Total 100.0 100.0 100.0

Q53: In general, would you say your emotional health is…

Christenson


(N = 2,379) Alberta

(N = 6,864)

Response % % %

Poor 0.0 3.4 2.6

Fair 11.1 22.4 19.2

Good 48.1 44.6 45.9

Very Good 22.2 22.5 24.8

Excellent 18.5 7.1 7.5

Total 100.0 100.0 100.0

APPENDIX I 19

Help with the survey Questions 54 and 55 of the questionnaire were used to determine whether a client received help in completing the survey and the type of help that was provided.

Table 3: Complete responses for Q54 across comparators

Q54: Did someone help you complete this survey?

Christenson


(N = 2,421) Alberta

(N = 6,982)

Response % % %

No 57.7 53.2 55.6

Yes, my spouse 19.2 7.4 7.7

Yes, another family member 11.5 28.5 26.0

Yes, Home Care staff 0.0 0.7 1.0

Yes, someone else/unspecified 11.5 10.2 9.7

Total 100.0 100.0 100.0

Figure 9: Responses for Q55 across comparators

Read thequestions to

me

Wrote downthe answers

I gave

Answeredthe

questions forme

Talked withme aboutwhat myanswers

should be

Translatedthe

questionsinto my

language

Helped inanother way

Christenson 4 5 1 5 0 0Edmonton Zone 634 636 203 191 123 43Alberta 1,872 1,771 501 493 312 125

0

500

1,000

1,500

2,000

Num

ber o

f res

pond

ents

20 APPENDIX II

APPENDIX II: ADDITIONAL METHODOLOGICAL DETAILS

Survey protocol and sampling

While home care supports Albertans of all ages, the AHCCES focused on the senior population (65+ years of age) who were long term supportive and maintenance clients for the following reasons:

The majority of home care clients were among the senior population (70.8%).

The majority of home care clients were long term supportive and maintenance clients (54.9%).

Younger populations, such as the pediatric population, typically have different needs and access different resources relative to the majority of home care clients.

Cognitively able seniors in long term / maintenance were sufficiently homogenous as to permit a single questionnaire tool and methodology.

Based on the cognitive and field testing, clients with lower cognitive performance (CPS score over 1) – could not independently complete the survey in sufficient numbers to be reliably included in a self-administered survey process.

Eligible clients were identified using a list obtained from Alberta Health Services of all long term supportive and maintenance home care clients in Alberta. Current clients (defined as receiving services any time during the period of January to February 2015) were identified and included, with data collection beginning March 2015. Administrative variables included in this database, such as service frequency criteria, were from the time periods January to December 2014. Clients were included according to the following criteria:

Cognitive Performance Scale score 0 and 1 (intact to borderline intact cognition)

Age 65 or older as of March 2015

Weekly service; defined as either:

o At least one visit per week or more of AHS services in calendar year 2014

o At least 30 minutes per week or more of contracted services in calendar year 2014

Valid mailing address

o Existing postal code

o No “care of” in address line

o Address in Alberta

Did not participate in pilot sample

Data collection results 13,756 clients met the above criteria and were sent a survey. An additional 2,606 clients were excluded from eligibility based on the following criteria (n, %):

Deceased (169, 6.5%)

Client reported she/he applied for services but had not yet received services (21, 0.8%)

APPENDIX II 21

Client reported no longer receiving home care services (552, 21.2%)

Client reported they received services less frequently than weekly (674, 25.9%)

Invalid mailing address and phone number (494, 19.0%)

Client reported she/he had not received home care services (690, 26.5%)

Clients in 2014 only receiving Adult Day Support Program services and in a congregate setting (6, 0.2%)

There are several reasons for inconsistencies between what clients reported and the administrative database:

Data quality issues in the administrative database due to inconsistent data capture, coding, and complex consolidation from multiple independent data systems

Clients may not know that they were receiving services from home care staff12

Memory recall

The survey utilized a modified Dillman Protocol with an initial mailing of the full survey package on March 27, 2015, followed by a post card reminder, and mailing of a second full survey package. Non-respondents and survey packages with invalid addresses were followed-up by phone, up to eight times, in an attempt to obtain a valid address, reasons for non-response, or in a few cases as per request to conduct the survey over the phone. The entire data collection process was completed on July 31, 2015.

The provincial response rate for the survey was 64.3 per cent; 7,171 clients out of a possible 11,150 eligible clients responded to the survey.

Quantitative methods

Treatment by Personal Care Services Staff

There were nine questions relating to personal care services that were examined through factor analysis to construct a single composite measure reflecting client’s perception of: Treatment by Personal Care Services Staff. The summary measure was calculated by taking the sum of individual weighted items and dividing by the total number of items creating an average score on a 0 to 100 scale, where 0 was the least positive response and 100 was the most positive response.

Met Needs-Personal Care Services

Another measure was produced to summarize the extent to which clients felt their personal care service needs were met. The percentage of Met Needs-Personal Care Services was made up of a set of five questions related to various personal care service needs. Each measure was calculated by counting the number of times a client said needs were met (“Yes” responses) divided by the total number of needs asked in the survey that the client reported having.

12 Common for clients residing in non-designated supportive living receiving home care services.

22 APPENDIX II

Additional details for provider results

Provider, organization, zone, and provincial results are presented in graphs which include 99 per cent confidence intervals (99% CI). These intervals can aid the reader in gauging statistically significant differences in results: as a general rule, intervals that overlap each other, in most but not all cases, reflect non-statistically significant differences between results. In contrast, intervals that do not overlap tend to reflect statistically significant differences between results.13

Lower limits of the 99 per cent CI that range below the minimum value of a scale will be reported as the minimum value. Upper limits of the 99 per cent CI that range above the maximum value of the scale will be reported as the maximum. These changes will be marked with a †. For example, an upper limit of 11.0 on a 0 to 10 scale will be reported as 10.0†.

Individual proportions (%) may not sum to 100 per cent due to rounding of decimals.

Qualitative methods Two open-ended questions relevant to personal care services were asked in the AHCCES. Questions were designed to understand the experience of cognitively intact clients (CPS rating 0-1) and their perception of home care service quality. These questions were:

1. Question 46: Do you have any concerns about your Personal Care services?

2. Question 48: In the last year, was there any service of any kind that you felt you needed but didn’t get?

The comments in response to these questions were analyzed for themes independently by two analysts. Steps were taken to ensure coding agreement.

13 In the article Interval estimates for statistical communication: Problems and possible solutions (2005), by Cumming and Fidler, the authors developed a “rule of eye” for judging significance for two independent means with confidence intervals.

APPENDIX II 23

LIMITATIONS In interpreting results, there are important limitations to consider:

1. Scope: Alberta’s home care program supports Albertans of all ages; however the present survey focused on the senior population (65+ years of age) who are long term supportive or maintenance clients with no cognitive impairment.

2. Provider-level reporting. Some clients received services from multiple providers over the time frame asked about in this survey. Therefore, steps were taken to ensure that the client feedback in this report was limited to your organization. While this refinement process made provider-level reporting possible, the following should be considered when interpreting results:

Providers typically deliver services to a client base that goes beyond the scope of the survey. The target sample of this survey must be considered when interpreting provider-level results.

3. Sample size: Readers should be mindful that results become increasingly unreliable as the number of clients decrease in relation to the total population. Throughout the report, sample sizes are reported with results.

With respect to provider-level reporting, reporting of results was limited to providers with reliable sample sizes. The criteria used to determine reliability was: (1) a provider with a margin of error of equal to or less than 10 per cent, (2) a response rate of greater than 50 per cent, and (3) five or more respondents for reported measures.14

4. Questionnaire: Although survey questions were meant to capture the client’s overall experience of home care services, there may be other important aspects of home care services that were not included in the survey or identified through client comments. All survey instruments have limitations and cannot cover all possible content of relevance to clients.

5. Other: Clients were not always able to complete the survey on their own due to cognitive or physical limitations and may have required family involvement. Therefore the results may be both client and family reported experience.

Another limitation is that because home care may be delivered in continuing care facilities, clients may not have been able to differentiate between the services provided by home care versus services provided by the facility. This may have impacted how clients responded.

14 The reporting of a minimum sample size also functions to prevent identifiability of clients.

24 APPENDIX III

APPENDIX III: QUESTION-LEVEL RESPONSES

Global Overall Care rating

Table 4: Complete responses for Global Overall Care rating (Q51) across comparators

Q51: OVERALL, how would you rate the quality of your Home Care Services?

Christenson Edmonton Zone Alberta

% N % N % N

0 - Worst 0.0 0 0.4 10 0.4 24

1 0.0 0 0.4 10 0.4 27

2 0.0 0 0.5 12 0.5 30

3 0.0 0 1.6 36 1.1 75

4 0.0 0 2.2 50 1.6 107

5 3.8 1 9.2 210 7.3 486

6 0.0 0 7.6 174 6.2 412

7 3.8 1 13.9 319 11.6 774

8 23.1 6 25.0 574 24.4 1,623

9 23.1 6 16.8 385 17.8 1,185

10 - Best 46.2 12 22.3 512 28.6 1,904

Total 100.0 26 100.0 2,292 100.0 6,647

Overall rating of personal care services

Table 5: Complete responses for overall rating of personal care services (Q47) across comparators

Q47: OVERALL, how would you rate your Personal Care Services?

Christenson Edmonton Zone Alberta

% N % N % N

Poor 0.0 0 1.6 32 1.1 64

Fair 0.0 0 8.1 161 6.5 372

Good 12.5 3 32.0 637 29.7 1,691

Very Good 41.7 10 37.7 751 37.9 2,158

Excellent 45.8 11 20.7 412 24.7 1,404

Total 100.0 24 100.0 1,993 100.0 5,689

APPENDIX III 25

Treatment by Personal Care Services Staff To accurately capture how a client perceived they were treated by personal care services staff, responses of “I don’t know” were excluded from the calculation of percentages (Table 6).

Table 6: Number of valid responses for questions that comprise Treatment by Personal Care Services Staff Q37 to Q45

Response Christenson Edmonton Zone Alberta

N valid N non-valid N valid N non-valid N valid N non-valid

Q40: In the last year, Personal Care staff listened carefully to my wishes and needs 20 2 1,910 64 5,449 171

Q43: In the last year, Personal Care staff explained things in a way that was easy to understand 19 1 1,834 77 5,283 169

Q39: In the last year, Personal Care staff treated me with kindness even during difficult or embarrassing tasks 20 0 1,925 41 5,502 114

Q38: In the last year, Personal Care staff knew what kind of care I needed and how to provide it 21 1 1,946 53 5,516 174

Q44: In the last year, Personal Care staff treated me as gently as possible when providing care 21 0 1,959 23 5,560 68

Q45: In the last year, Personal Care staff made me feel safe and that my belongings were safe 20 1 1,925 54 5,412 146

Q42: In the last year, Personal Care staff kept me informed about when they could arrive 19 0 1,954 34 5,568 94

Q37: In the last year, Personal Care staff let me know when they could not come 19 1 1,841 103 5,260 257

Q41: In the last year, Personal Care staff encouraged me to do things for myself if I could 19 0 1,812 87 5,240 222

26 APPENDIX III

Table 7: Complete responses for questions that comprise Treatment by Personal Care Services Staff Q37 to Q45


% N % N % N

Q40: In the last year, Personal Care staff listened carefully to my wishes and needs

Yes 100.0 20 77.4 1,479 80.9 4,409

Partly 0.0 0 19.3 368 16.3 891

No 0.0 0 3.3 63 2.7 149

Total 100.0 20 100.0 1,910 100.0 5,449

Q43: In the last year, Personal Care staff explained things in a way that was easy to understand

Yes 94.7 18 77.1 1,414 80.7 4,263

Partly 0.0 0 17.3 317 14.7 779

No 5.3 1 5.6 103 4.6 241

Total 100.0 19 100.0 1,834 100.0 5,283

Q39: In the last year, Personal Care staff treated me with kindness even during difficult or embarrassing tasks

Yes 100.0 20 88.4 1,702 90.6 4,983

Partly 0.0 0 9.5 183 7.6 416

No 0.0 0 2.1 40 1.9 103

Total 100.0 20 100.0 1,925 100.0 5,502

Q38: In the last year, Personal Care staff knew what kind of care I needed and how to provide it

Yes 100.0 21 76.8 1,494 80.7 4,448

Partly 0.0 0 19.0 369 16.2 895

No 0.0 0 4.3 83 3.1 173

Total 100.0 21 100.0 1,946 100.0 5,516

Q44: In the last year, Personal Care staff treated me as gently as possible when providing care

Yes 100.0 21 89.1 1,746 91.5 5,087

Partly 0.0 0 9.1 179 7.3 404

No 0.0 0 1.7 34 1.2 69

Total 100.0 21 100.0 1,959 100.0 5,560

Q45: In the last year, Personal Care staff made me feel safe and that my belongings were safe

Yes 100.0 20 89.5 1,723 91.2 4,934

Partly 0.0 0 7.2 138 6.3 343

No 0.0 0 3.3 64 2.5 135

Total 100.0 20 100.0 1,925 100.0 5,412

APPENDIX III 27


% N % N % N

Q42: In the last year, Personal Care staff kept me informed about when they could arrive

Yes 94.7 18 67.5 1,319 69.5 3,871

Partly 0.0 0 23.5 460 21.3 1,186

No 5.3 1 9.0 175 9.2 511

Total 100.0 19 100.0 1,954 100.0 5,568

Q37: In the last year, Personal Care staff let me know when they could not come

Yes 100.0 19 68.3 1,257 71.9 3,781

Partly 0.0 0 18.8 346 15.7 827

No 0.0 0 12.9 238 12.4 652

Total 100.0 19 100.0 1,841 100.0 5,260

Q41: In the last year, Personal Care staff encouraged me to do things for myself if I could

Yes 73.7 14 67.2 1,217 72.5 3,800

Partly 0.0 0 16.7 302 14.0 735

No 26.3 5 16.2 293 13.4 705

Total 100.0 19 100.0 1,812 100.0 5,240

28 APPENDIX III

How clients felt about the number of staff they had

To accurately capture how a client felt about the number of different personal care services staff they had, responses of “I don’t know” were excluded from the calculation of percentages (Table 8).

Table 8: Number of valid responses for Q31


N valid N non-valid N valid N non-valid N valid N non-valid

Q31: In the last year, how do you feel about the number of different Personal Care staff you have had? 17 0 1,920 52 5,485 152

Table 9: Complete responses for Q31


% N % N % N

Q31: In the last year, how do you feel about the number of different Personal Care staff you have had?

I'm very happy 70.6 12 39.1 750 44.4 2,435

I'm Ok 29.4 5 49.9 959 47.2 2,588

I'm not happy at all 0.0 0 11.0 211 8.4 462

Total 100.0 17 100.0 1,920 100.0 5,485

APPENDIX III 29

Clients’ personal care service needs To accurately capture how often a client perceived their needs were met, responses of “I don’t know” and “I did not need this service” were excluded from the calculation of percentages (Table 10).

Table 10: Number of valid responses for questions that comprise Met Needs-Professional Services Q32 to Q36


N valid N non-

valid N valid N non-valid N valid N non-

valid

Q32: In the last year, Personal Care staff met my needs for help with showering or bathing 19 1 1,771 253 5,006 747

Q35: In the last year, Personal Care staff met my needs for help with eating 3 18 586 1,356 1,643 3,920

Q34: In the last year, Personal Care staff met my needs for help with using the bathroom 5 15 704 1,241 1,937 3,649

Q33: In the last year, Personal Care staff met my needs for help with getting dressed 8 11 1,250 714 3,455 2,164

Q36: In the last year, Personal Care staff met my needs for help with taking medications 8 13 912 1,061 2,578 3,052

30 APPENDIX III

Table 11: Complete responses for questions that comprise Met Needs-Professional Services Q32 to Q36


% N % N % N

Q32: In the last year, Personal Care staff met my needs for help with showering or bathing

Yes 94.7 18 81.7 1,447 84.7 4,241

Partly 0.0 0 10.9 193 9.2 462

No 5.3 1 7.4 131 6.1 303

Total 100.0 19 100.0 1,771 100.0 5,006

Q35: In the last year, Personal Care staff met my needs for help with eating

Yes 0.0 0 17.2 101 14.9 245

Partly 0.0 0 13.1 77 11.7 192

No 100.0 3 69.6 408 73.4 1,206

Total 100.0 3 100.0 586 100.0 1,643

Q34: In the last year, Personal Care staff met my needs for help with using the bathroom

Yes 20.0 1 30.5 215 30.2 584

Partly 20.0 1 18.3 129 15.3 297

No 60.0 3 51.1 360 54.5 1,056

Total 100.0 5 100.0 704 100.0 1,937

Q33: In the last year, Personal Care staff met my needs for help with getting dressed

Yes 75.0 6 56.5 706 56.9 1,966

Partly 12.5 1 24.2 302 22.2 767

No 12.5 1 19.4 242 20.9 722

Total 100.0 8 100.0 1,250 100.0 3,455

Q36: In the last year, Personal Care staff met my needs for help with taking medications

Yes 50.0 4 47.5 433 44.1 1,136

Partly 12.5 1 12.1 110 13.7 352

No 37.5 3 40.5 369 42.2 1,090

Total 100.0 8 100.0 912 100.0 2,578

APPENDIX IV 31

APPENDIX IV: CLIENT COMMENTS

Comments have been edited for grammatical purposes, but no changes to the content of the comments were made, with the exception of the removal of identifying information.

Table 12: Client comments in response to Question 4815

Q48 In the last year, was there any service of any kind that you felt you needed but didn’t get?

Sometimes a few groceries.

My [family member] provide transportation to medical appointments and to deliver groceries.

Grocery delivery.

Grocery delivery - once a week.

Sweeping balcony and washing balcony will pay within reason. I think that last year I paid for the service.

Grocery shopping.

15 Comments were broken up if they contained distinct topics to ensure anonymity. As a result, the total number of comments presented in Table 12 may appear higher than the number of comments reported.

32 LIST OF TABLES AND FIGURES

LIST OF TABLES

Table 1: Client characteristics by comparators ............................................................................... 17 Table 2: Complete responses for Q52 and Q53 across comparators ............................................ 18 Table 3: Complete responses for Q54 across comparators ........................................................... 19 Table 4: Complete responses for Global Overall Care rating (Q51) across comparators .............. 24 Table 5: Complete responses for overall rating of personal care services (Q47) across

comparators....................................................................................................................... 24 Table 6: Number of valid responses for questions that comprise Treatment by Personal Care

Services Staff Q37 to Q45 ................................................................................................ 25 Table 7: Complete responses for questions that comprise Treatment by Personal Care

Services Staff Q37 to Q45 ................................................................................................ 26 Table 8: Number of valid responses for Q31 .................................................................................. 28 Table 9: Complete responses for Q31 ............................................................................................ 28 Table 10: Number of valid responses for questions that comprise Met Needs-Professional

Services Q32 to Q36 ......................................................................................................... 29 Table 11: Complete responses for questions that comprise Met Needs-Professional Services

Q32 to Q36 ........................................................................................................................ 30 Table 12: Client comments in response to Question 48 ................................................................... 31

LIST OF FIGURES

Figure 1: Global Overall Care rating (Q51) across comparators ....................................................... 5 Figure 2: Top 2 box responses for overall rating of Personal Care Services (Q47) across

comparators......................................................................................................................... 6 Figure 3: Treatment by Personal Care Services Staff across comparators ...................................... 8 Figure 4: Top box results for questions that comprise Treatment by Personal Care Services

Staff Q37 to Q45 (1of 2) ...................................................................................................... 9 Figure 5: Top box results for questions that comprise Treatment by Personal Care Services

Staff Q37 to Q45 (2of 2) .................................................................................................... 10 Figure 6: How clients felt about the number of staff they had .......................................................... 11 Figure 7: Average percentage of Met Needs-Personal Care Services across comparators ........... 12 Figure 8: Top box results for questions that comprise Met Needs-Professional Services Q32 to

Q36 .................................................................................................................................... 13 Figure 9: Responses for Q55 across comparators .......................................................................... 19

210, 811 – 14 Street NW Calgary, Alberta, Canada T2N 2A4

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alberta home care client experience survey report · health quality council of alberta. alberta...

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