This report provides a snapshot of what patients have to say about the accessibility and quality of ambulatory cancer care in British Columbia (BC). These first-hand experiences matter—to patients, their families and friends, and to those who work in health care. They also provide an essential perspective from which we can continue to inform and target initiatives to improve cancer care in the province.
Patient Experiences with Ambulatory Cancer Care in British Columbia focuses on features of health care that Canadians have indicated are important to them—respect for their values, preferences and needs, coordination and continuity of care, information, communication and education, physical comfort, emotional support, and the involvement of family and friends. The report also pays attention to other facets of quality that have been identified as a priority by those who work in health care in BC—access to care and safety.
In 2005, the BC Ministry of Health and the province’s health authorities commissioned surveys of patients who received ambulatory cancer care in British Columbia. NRC+Picker conducted the survey, which was mailed to 12,215 adults who received chemotherapy or radiation treatment on an outpatient basis between November 2005 and May 2006. More than 6,974 patients completed the survey. Researchers at NRC+Picker analyzed the survey data, and the UBC Centre for Health Services and Policy Research created this report to summarize the results.
Patients in BC gave high ratings to the overall quality of the ambulatory cancer care they received—97% of those surveyed rated the quality of services as excellent, very good or good. However, responses to more detailed questions regarding specific aspects of the quality of their care reveal that patients see room for improvement. They gave relatively high ratings to access to care, physical comfort and provider respect for patient preferences. They gave lower ratings to coordination and continuity of care, to information, communication and education, and to emotional support.
Access and Wait Times
Most patients (78%) felt that they didn't have to wait too long for their first appointment for treatment. After arriving at appointments, 69% waited less than 30 minutes for chemotherapy and 74% waited less than 15 minutes for radiation treatments. When asked how often this wait exceeded expectations, approximately 60% reported 'never' and 35% reported 'sometimes'. The majority (80%) of patients who did have to wait indicated that staff did everything they could to make them feel comfortable.
Physical Comfort and Safety
A majority (80%) of patients reported that providers did everything they could to address the side effects of cancer treatment, but felt providers could have done more. Five per cent believed that they or their families suffered personal injury or harm resulting from a medical error or mistake. Analysis of the survey results by NRC+Picker indicates that these issues are not concentrated in a single health authority or facility.
Respect for Patient Preferences
Patients reported that providers respected their preferences, treated them with dignity and respect, and offered opportunities for family and friends to be involved in their care and treatment. The majority (88%) felt they could trust their care provider with confidential information.
Coordination and Continuity of Care
Most patients reported that they knew who was in charge of their therapies (83%) and that providers knew enough about therapies to treat cancer (79%). But only half said they were always aware of what the next steps in their care would be (53%) or who to ask when they had questions (57%). Half reported that their care providers were not always familiar with their medical history.
Information, Communication and Education
Many patients reported they were given enough information about cancer therapies (66%), felt comfortable discussing new cancer treatments (73%), understood why tests were needed (79%), and understood test results (69%). Half felt they didn’t receive enough information about potential changes in their energy levels, nutritional needs and work or usual activities.
Patients see the area of emotional support as having the most room for improvement. Sixty-nine per cent reported being told of their diagnosis in a sensitive matter, but few were put in touch with other providers who could help them deal with anxieties and fears when they were first told of their illness (35%) or after (24%).
- Diane Watson
- British Columbia Ministry of Health