Real-time and Right-time evaluation report
Healthcare Improvement Scotland’s Person-Centred Health and Care Programme has worked with four NHS boards in Scotland since October 2015 to prototype, test and evaluate two improvement models. These models attempt to create the process, environment and culture for care teams to effectively identify and make meaningful improvements directly related to feedback from the people who use their services in a reliable and person-centred way.

Both models ask care teams to take a conversational approach to gathering narrative (or qualitative) experience feedback from people receiving care or support, one in real time, i.e. close to or during an episode of care and in the second model this is gathered two to three weeks following the episode of care (or following discharge). Both of these models require care teams to review the feedback routinely within a reflective improvement meeting and take an improvement approach to testing and implementing improvements identified from feedback.

An evaluation report has been compiled and the learning can be found below.

We would be grateful to receive your thoughts and feedback about this evaluation via this online survey

Real-time and Right-time care experience models

Evaluation learning points include:

  1. Both Real-time and Right-time care experience improvement models provide a framework that empowers care teams to effectively identify and implement meaningful improvements directly attributable to service user feedback.
  2. A conversational approach and gathering narrative feedback provides the context and depth to effectively support care team reflection and identification of improvement opportunities.
  3. A good level of conversational skills and training in how to collect and record narrative feedback data is required to provide the depth and context to support improvement.
  4. Embedding the reflective improvement meeting as a routine activity is vital to maintain the engagement of the care team and regular improvement activity.
  5. Providing facilitation and coaching support for care teams initially supports them to embed and take ownership of their approach to the care experience improvement model.
  6. There was no evidence of more gratitude or social desirability bias in the Real-time model (at the point of care) than in the Right-time model (following episode of care).
  7. The Real-time care experience improvement model was quicker to set-up and easier to sustain than the Right-time care experience improvement model.
  8. The Real-time care experience improvement model generates a marked sense of urgency in care teams to make improvements that is not noted as visibly in Right-time.
  9. Care teams working with the Right-time care experience improvement model were less likely to use the recommended improvement approach to testing and developing improvements (PDSA cycles) prior to implementing them.

Two case studies have been developed to demonstrate how improvements were achieved using the Real-time care experience improvement model. You can view these below.

NHS Greater Glasgow and Clyde case study

NHS Lanarkshire case study

If you would like to get in touch with the team, please contact us at: hcis.personcentredscot@nhs.net.