Objectives of the Future Health and Social Services Centre programme 3/5: Improving the quality and effectiveness of services

Aki Pykälistö from Karjalohja and his family feel that the local maternity and child health services have provided them with high-quality service. “We’ve always had quick access to care, but I don’t remember anyone asking for feedback,” Pykälistö remarks. The development of quality involves conducting feedback surveys for clients, but Pykälistö’s experiences with services have felt so intimate that he has been able to provide feedback during appointments.  

When the Pykälistö family moved on from maternity and child health services to school health services, they faced the resource challenges that are common in the industry at the national level. “Recently, it has been almost impossible to make an appointment with school health services,” Pykälistö says. The monitoring of children’s health may deteriorate due to personnel changes and a lack of resources, making it impossible to fully monitor the effectiveness of services. Basic dental services are also extremely busy, forcing people to turn to private sector services. 

All in all, the Pykälistö family are very satisfied with their local health services, and they hope that all of the services that they are used to will continue to be available locally after the transition to a wellbeing services county. 

Anu Rautiainen from Ingå considers local services to be important, as they facilitate daily life. She has been satisfied with Ingå’s services. As an example of a high-quality service, she mentions the local health centre’s call-back system: “If they’re too busy to answer the phone, they’ll call back soon.” Rautiainen says that, at best, you can receive a referral to treatment with one phone call.  

On the other hand, Rautiainen also understands the operational differences between large and small municipalities – a municipality with a population of less than 6,000 is able to organise services in a slightly different way than a city as large as Espoo, which has a population of almost 300,000.  

Rautiainen says that the experience of quality is also affected by staff turnover, such as a change in doctors, for example. “When your doctor changes, you always have to start over from the beginning,” Rautiainen remarks. One solution to this problem would be to unify the information systems and keep them up to date, which would allow the new doctor to find the client’s complete medical records in one place.  

Rautiainen does not have experience of feedback surveys or other similar things in Ingå, but she has regarded service situations as encounters during which feedback may be given freely. She has also taken the opportunity to do just that. For example, she found the process of receiving a referral to a laboratory to be slightly lacking, so she immediately gave feedback about it. The feedback was accepted well and in a friendly manner, which increases trust in the development of operations. 

Aila Thurin from Espoo also has experience from Kauniainen, where her children grew up. While living in Kauniainen, the family used maternity and child health services and school health services, which Thurin describes as good: “Being a young mother, it was important to me that the services were provided at the scheduled time – the staff were never busy, and I was served by the same person for years,” Thurin sums up. Although she was never asked to provide separate feedback, she felt that she was able to influence the quality of services to a sufficient degree.  

While living in Espoo, Thurin has not used public healthcare services much because she is covered by occupational healthcare services – Thurin mentions dental care as an example of the public services that she does use. “I immediately selected the Kauniainen Dental Care Clinic as my service provider, and I’ve been very satisfied with this arrangement,” Thurin says. She believes that the option to select your healthcare service provider is something that should be retained, and she hopes that the option will also remain available after the transition to a wellbeing services county. 

“With regard to the preparation of the wellbeing services county, effectiveness refers to results achieved in functional capacity and health that are relevant to clients,” Project Manager of Knowledge Management for Western Uusimaa Yrjänä Hynninen sums up. “The core element of effectiveness is how the client’s health and functional capacity improve as a result of a particular service.” Client-centred development of care paths is a key part of the development of the Western Uusimaa Wellbeing Services County’s services, and high-quality information supports this development.  

Hynninen says that the effects relevant to the client can be examined from three perspectives: information reported by the client about the effects they have experienced and their client experience; a professional’s assessment of the client’s condition; and clinical indicators. Effectiveness can also be examined from the perspective of preventing the client’s functional capacity from deteriorating and their service needs from increasing.  

A knowledge management tool called a data lake is currently being developed for the Western Uusimaa Wellbeing Services County. It will change knowledge management capabilities and modernise the tools over the course of the following years. In the future, the data lake will facilitate new ways to process data and support practical operations by showing the waiting time at service points in real time, for example.   

The data lake will store the client and patient data of health and social services systems as well as the key data on financial and HR management. “The data can be combined, resulting in more precise information on service needs, costs and human resources. This will make it possible to establish a more comprehensive picture of the operations and their impacts and costs,” Hynninen describes. The data lake will be used as a basis for creating sets of indicators that will support the planning of operations and meet the needs of the wellbeing services county’s management team and professionals – as well as residents. 

A tool for measuring the client experience is currently being developed in the Western Uusimaa Wellbeing Services County under the supervision of Project Director of Shared Services and Integration Jutta Tikkanen. She agrees with Yrjänä’s idea about understanding the client’s subjective experience as part of the assessment of effectiveness. “The idea is to provide us with better, regularly updated data about the client’s experience of the accessibility and quality of care and services,” Tikkanen describes. 

In the future, it will be possible to conduct automated surveys through multiple channels, making the collection of data easy for clients and personnel alike. This means that clients will be able to provide feedback through different channels and with different tools. “The client understands and sees different things than a professional. The only way to find out what the client is thinking is to ask and listen,” Tikkanen muses. Many people have become used to companies sending feedback surveys to their mobile phones. “Once we start sending them from the wellbeing services county, we truly hope to receive many responses,” Tikkanen continues. 

Systematic collection of data on client experiences will help identify operational strengths and problems. “All of this work is for the purpose of being able to develop the operations based on the needs of various client groups. For example, we want to determine what types of operating models and practices will facilitate the use of and access to services,” Jutta describes. Combining survey response data with the other data in the data lake, as mentioned earlier, will help professionals understand the background factors affecting client experience, such as opening hours or resources. “Everyday life also includes a great many good things and encounters. We hope that the tool will also help our clients share these good things with us,” Jutta continues. Another key objective is that not only clients but also every service unit and employee of the wellbeing services county will have access to the client experience data and be able to use it in planning their daily life. The development of the tool is ongoing, and the project will enter the pilot phase next year. 

“If we look at the big picture, there is great potential in highlighting effectiveness data and making use of it to support the development of services,” Hynninen remarks. Effectiveness data provides reliable, comprehensive and up-to-date information on operations. Additionally, a fact-based understanding of clients’ service needs supports decision-making in different situations, which will lead to better allocation of resources in the future. The data collected in the data lake will provide an opportunity to monitor the trends in service needs at the population level, which will support the planning and management of service provision. More efficient data processing will make it possible to act in anticipation and take preventive action. “The data lake will also decide how we can obtain equal data from the Western Uusimaa region,” Hynninen remarks. 

Data protection and security issues play a major role in the system’s development – the data lake will improve the ability to examine the reliability of data. From the point of view of professionals, not much will change at the turn of the year – they will continue to use the same tools but utilise the data accumulated in operations in a wider variety of ways.  

From the staff’s point of view, it is important for the data they record to impact the development of operations and help make sure that the service provision in the Western Uusimaa region is as equal and high-quality as possible. Making data visible provides motivation, inspiration and perspective into the development of operations. Professionals gain new insight into their work when their work is made visible and the impacts and effectiveness of services are given practical expression from the client’s point of view.  

 “Healthcare and social services professionals have a desire to help people and provide health and wellbeing – that’s precisely why we work here,” Hynninen sums up in conclusion. 

More information:  
Project Manager of Knowledge Management Yrjänä Hynninen, yrjana.hynninen@luvn.fi 
 

Read the previous parts of the article series:
1) Improving the equality, accessibility, timeliness and continuity of services
2) Shifting the focus of operations from heavy services to preventative and predictive work