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Improving System Wide Governance and Leadership in Patient Experience Utilising an Integrated, Evidence-Based Evaluation and Decision-Support Tool


Avnesh Ratnanesan ,

Metro North Health, Australia, AU
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Christine Petrie

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Metro North Health Service underwent a Patient Experience Maturity Evaluation (PXme) to identify specific needs and capability gaps to make more strategic decisions and targeted improvements in their ability to provide person-centered care.


Metro North Hospital and Health Service enables people to deliver excellent person-centred care and high-quality health services. Being the largest Hospital and Health Service in Australia, Metro North aspires to being the ‘nicest’, with numerous strategies and initiatives to add rigour to this aspiration. At a system level, Metro North has invested many years developing and refining systems and processes for staff, consumer and community engagement. 

However, it’s difficult to assess how this translates into practice at an operational level within each of Metro North’s hospitals, community and ambulatory health services.  Metro North did not have any tools or processes to measure how these systems and processes were enabling improvements to person-centred care.

Targeted Population

The PXme is aimed at the core clinical and executive leadership staff directly involved in patient experience, quality, and safety activities in two facilities at Metro North health Service.


The evaluation component consists of 132 questions aimed at comprehensively understanding maturity on a variety of patient experience domains utilising Energesse’s proprietary 6e methodology.  Each of the 6e is further divided by a comprehensive range of sub-domains. The domains are derived from a range of evidence based resources such as the Australian Safety and quality Framework for Health care (NSQHS) standards

Comments on transfer-ability

Designing actions to improve person-centered care can be challenging. There’s no one-size fits all approach and organisations draw upon various frameworks to support staff, consumer, and community engagement. However, many struggle to translate the principles within these frameworks into actions that suit the unique setting and context of each health service. A health service’s ability to make progress is dependent on multiple factors including leadership commitment, systems and processes for staff, and consumer engagement as well as the knowledge and skills of personnel who implement the actions.

The PXme provides a structured approach to support the development and implementation of actions to advance person-centered care. It is based on an organisation’s maturity via a self-assessment by key internal stakeholders and triangulation with objective patient experience data. This process is transferable to any state government, health system, hospitals, aged care and primary care providers. 


Through the use of the tool, hospital A was identified to be in Stage 3 ‘Organised’ and Hospital B to be in stage 4 ‘Managed’. Following the results of the maturity evaluation, 32 capability gaps across 6 domains were identified from Hospital A and B highlighting the need to further improve.

The tool identified 61 unique actions with corresponding ‘Academy’ and ‘Provider Digital-Matrix’ which provide evidence based ‘how-to’ guides, local providers and digital solutions that address specific capability gaps making the process seamless and effective.

The PXme process provided valuable point-in-time assessment of progress, guidance on evidence-based actions and priorities for the best utilisation of our finite resources towards continuous quality improvement. 


How to Cite: Ratnanesan A, Petrie C. Improving System Wide Governance and Leadership in Patient Experience Utilising an Integrated, Evidence-Based Evaluation and Decision-Support Tool. International Journal of Integrated Care. 2022;22(S1):29. DOI:
Published on 08 Apr 2022.


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