#3720 “Measuring for improvement: changes in the perception of care in haemodialysis patients over four years”

Abstract Background and Aims Perception of care is a key indicator for assessing the quality of health services, especially in patients with chronic conditions such as those on haemodialysis (HD), who face physical, emotional and social challenges due to their disease burden and prolonged treatment. Assessing this perception through tools such as the Patient Perception of Care (PPC) Survey allows us to understand what is really important to patients and to identify areas of direct impact on their quality of life. This approach generates valuable data to humanise care, optimise resources, guiding strategies towards a holistic and patient-centred approach Method A multicentre retrospective observational study was performed in HD patients, by analysing the responses of the annual, voluntary and anonymous PPC Survey. It consists of 39 specific questions organised in 12 domains involving the care of HD patients: “Access”, “Communication”, “Fluid intake and diet”, “Information”, “Needling”, “Privacy and dignity”, “Scheduling and appointment planning”, “Shared decisions about treatment”, “Support about your care”, “Tests and investigations”, “Environment” and “Transport”. Responses were analysed considering two main scales: Global Score (GS), which measures patient perception by domain on a scale of 0 to 7, and Patient Global Experience (PGE), which assesses overall patient experience on a scale of 0 to 10. In addition, Net Promoter Score (NPS) and participation rate were collected and analysed from survey implementation in 2021 to 2024. Trends in overall patient experience were identified and domain-specific conclusions were drawn to highlight improvements and challenges. Results Of the 49 outpatient dialysis centers analysed, the average participation rate was 94.45% over the study period. Of the total 16,187 surveys analysed, 3,703 (93%) were completed in 2021, 4,154 (97%) in 2022; 4,201 (98.71%) in 2023 and 4,129 (96.7%) in 2024, reflecting significant patient engagement. The GS showed continued improvement from 6.30 in 2021 to 6.48 in 2024, reflecting overall progress in the perception of quality of care. Meanwhile, the PGE increased from 8.67 in 2021 to 8.81 in 2024, highlighting an overall positive and growing experience. The NPS, a key indicator of satisfaction and loyalty, remained consistently above the threshold of excellence (>50), with an upward trend, reaching 61.98% in 2024, the highest point of the period analysed. In terms of specific domains, notable improvements were observed in key areas such as ‘Communication’ (from 6.26 in 2021 to 6.47 in 2024) and ‘Fluid Intake and Diet’ (from 6.40 in 2021 to 6.53 in 2024), reflecting significant progress in these essential dimensions for patients. Detailed analysis at question level showed steady progress in patients' reported comfort and access to additional assistance, consolidating the positive perception of the care received. However, areas such as ‘Support’ presented opportunities for improvement in some of the periods studied, suggesting the need for a continued focus on strengthening this dimension. Conclusion The PPC survey has proven to be an effective tool for monitoring trends in patient experience. The sustained growth of these indicators reaffirms the importance of continuing to apply and refine these measurement instruments, consolidating a patient-centred model of care and promoting a positive impact on both the quality of life of haemodialysis patients and standards of clinical practice.