Improving Patient & Client Experience Measuring the Impact Mary Hinds Director Nursing, Allied...
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Transcript of Improving Patient & Client Experience Measuring the Impact Mary Hinds Director Nursing, Allied...
Improving Patient & Client Experience
Measuring the Impact
Mary HindsDirector Nursing, AlliedHealth Professions
Why? Negative reports in the press and inquiries Feedback from patients, carers and nurses Targets which focused to date on numbers Pace and complexity of change The need to put humanity back in the health
service.
Quality Issues There are serious problems in quality
– Between the health care we have and the care we could have, lies not just a gap but a chasm.
The problems come from poor systems…not bad people– The question is why have we not sorted it to date?– What is each of our responsibilities?
What difference have we made since last year?
Patient Client Experience Standards Respect – Being valued as a unique individual
Attitude - Feeling cared for as an individual
Behaviour – Feeling valued and safe
Communication - Understanding and feeling understood
Privacy & Dignity - Protected and treated with due respect and consideration
Measurement Approach Obtaining User Feedback Patient Survey
Patient Stories Review of compliments & complaints
Observing the Impact Observations of practice
Staff Feedback Staff survey Focus Groups
Organisations Organisational audit
Priorities for Action Target “By September 2009 Trusts should adopt
Patient and Client Experience Standards in relation to Respect, Attitude, Behaviour, Communication, and Privacy and Dignity, and have put in place arrangements to monitor and report performance against these standards on a quarterly basis”
Process Approach
Survey tool – Acute Medicine
Survey Tool - Acute and non medicine, acute psychiatry, learning disability
Organisational Audit Trust Wide
Observations of Practice
Patient Stories Staff feedback
Observations of Practice
Patient Stories Staff feedback
Observations of Practice
Patient Stories Staff feedback
Observations of Practice
Patient Stories Staff feedback
Observations of Practice
Patient Stories Staff feedback
Engagement Approach Standard Development Membership of
development group
Consultation
Focus Groups
Pilot Tool Development PCC membership
HSC Trust PPI structures
Targeting specific groups
Progress to date Design of satisfaction survey for pilot Completion of pilot testing December quarter Evaluation, reshaping and rolling programme
Pilot Standard 30 questions Acute medical wards Quarter ending Dec
Pilot What worked well
Regionally agreed questions to measure standards with some flexibility for local targeting Positive feedback from patientsEasy to complete Engagement from all 6 Trusts
What we needed to change? Response rate 19% to 52%Improved involvement of carers Better options for return of survey
Pilot Messages Communications Information Mixed sex wards
Pilot Actions Trust action plans Performance Monitoring
What Next Comprehensive Action Plan with key
milestones– Roll out revised pilot to acute mental health and non
acute medicine – Working group for learning disability clients– Organisational audits – Observations of practice – protocol, training – Compliments & Complaints
Five Forces for Change Respect Attitude Behaviour Communication Privacy & Dignity
The Sixth Force.. You
The Gap What we came in to achieve? What patients and their families tell us we
deliver? Value Gap
What we do? What we do about it? Empowerment Gap
Why is it important? Powerless nurses are:
– Ineffective nurses – Less satisfied with their jobs – More susceptible to burn out– More likely to depersonalization – More likely to contribute to poor patient outcomes.
Independent inquiry into care provided
by Mid Staffordshire NHS Foundation Trust – Attitudes of patients and staff – Bullying – Target driven priorities – Disengagement from management – Low staff morale – Isolation – Lack of openness – Acceptance of poor standards of care – Reliance on external assessment– Denial
Independent inquiry into care provided
by Mid Staffordshire NHS Foundation Trust Privacy and Dignity
– Incontinent patients left in degrading conditions – Patients left inadequately dressed in full view of
passers by– Patients moved and handled in unsympathetic and
unskilled ways, causing pain and distress – Failures to refer to patients by name or their preferred
name– Rudeness and hostility
Myths The perfection myth – if we all try hard enough
we will not make any mistakes
The punishment myth – if we punish people when they make mistakes they will make fewer.
Reality It is in your hands…