Step 2.1 – Match your rollout strategy to your circumstances

Things to consider

This page lists the items that need to be considered in Step 2.1 to match your rollout strategy to your circumstances.

Variables affecting your rollout strategy

There are many variables to consider that may affect your rollout strategy:

• The time you have available will affect the number of stages and amount of formative evaluation you can carry out before full implementation is expected
• If you intend to amend AHPEQS, or to administer it differently or with patient populations that are different to the Commission’s field testing, this will affect the scale and analysis of your pilot testing; you may first need to establish the validity and reliability of the redesigned survey
• If you are adding the AHPEQS to an existing survey, you may first need to establish the validity and reliability of the redesigned survey as there is potential for interference between AHPEQS and existing questions
• The type and features of existing patient experience survey programs will affect the level of technological change and staff training required
• The type and data elements within your patient administration system will affect the level of technological change and your ability to automate survey administration and analysis
• Existing familiarity across the organisation with the purpose and benefits of patient experience measurement will affect the level of initial ‘marketing’ required
• Existing familiarity with integrating patient perspectives and safety and quality data into the quality improvement cycle will affect the level of process change and training required
• The financial and human resources available for the implementation will affect your ability to conduct pilots and analyse these thoroughly (but not conducting a pilot may be a false economy if problems emerge)
• Level of in-house capacity and available skills will affect whether contractors need to be engaged.

Staged implementation and piloting

Deciding how to take AHPEQS into your organisation is a strategic decision and could have important implications for stakeholder engagement and for how the results are used. Rather than implementation across your whole organisation or patient population all at once, you might consider a staged implementation which includes pilot sites. The advantages of this are that:

• Lessons from pilot projects can be applied to improve the implementation process across other settings
• Value can be demonstrated to sceptics early on, to increase overall engagement 
• Overall costs of implementation may be less because the need to correct problems on a large scale is lessened if they are identified during pilots
• The pilot surveys can be used to ask patients what they thought of the survey – such as its length, relevance and layout – and to make appropriate adjustments.

Prioritisation of pilots

If you decide on a staged rollout, you will need to consider how you prioritise your pilot samples and analyse your pilot data. You will need to develop a rationale for your staging and choice of pilot populations or sites. Some ways to prioritise samples for piloting include:

• By ward or department (this may be a good choice if you already have clinical buy-in)
• By reason for admission 
• By type of admission (day stay or overnight).

Evaluation of pilots

Consider how you will evaluate the pilots and feed these findings into the full implementation. You could consider:

• The implementation process itself
• Stakeholder engagement
• Survey response and completion rates.

Parallel surveying

If you have an existing patient experience survey and are planning to replace it with AHPEQS or add AHPEQS into it, you might consider a parallel survey process. This is where you continue to administer your old survey to some patients and at the same time administer the new survey to other patients. The advantages of this are that:

• It gives you more time for pilot testing without a break in patient surveying
• Comparative analysis of the results of the two surveys can yield very useful data to guide your implementation and presentation of results, including
  • how response rates and completion rates compare – if they are higher for AHPEQS, this helps prove value; if lower, this can inform adjustments to the mode of administration or format of the survey
  • how overall scores compare between the two surveys – this will help to set appropriate levels of expectation for scores on the new survey.

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