PPP

Developing listening systems and approaches to enhance our understanding of

people’s experience of care.

• My name is Joe Hands• My name is Rick Edwards

Gathering Feedback

Public feedback is used to measure patient outcomes, monitor services, measure performance, systems and processes.

The importance of listening and responding to feedback was identified in the Healthcare Improvement Scotland (HIS) report of December 2013 following its rapid review of the safety and quality of care for acute adult inpatients in NHS Lanarkshire.

Recommendation 4: “NHS Lanarkshire should review its processes for collecting patient and carer experience data, to ensure that patients and carers feel able to provide honest feedback that is reflective of both the positive and negative aspects of care.”

Next Steps blended approach

Fce-to-face Face-to- face In the Mid-Staffs report, Robert

Francis QC called for fast-track reporting of patient experience:

“Results and analysis of patient feedback including qualitative information need to be made available to all stakeholders in as near ‘real time’ as possible, even if later adjustments have to be made.”

Patient Stories Digital Electronic Online

Telephone

Paper based

Feedback MechanismsWe are listening

- how did we do? Your feedback is important as it helps us evaluate the services we provide. It allows us to identify areas where we are doing well but also areas that we can try and improve.

If you would like to tell us about your healthcare experience you can:

v speak to a m em ber of staff

v com plete the reverse of th is form and hand it to a m em ber of staff

v contact us via our website www.nhslanarkshire.org.uk

v call us on Tel No: 01698 858321 M onday - Friday from 1pm - 4pm

v share your story at www.patientopinion.org.uk or call Tel No: 0800 122 31 35

M PR .FEED BK.04321.M

“We are listening” campaign – postcard developed for dissemination throughout the Board area advising the public of the multiple mechanisms available to provide feedback, supported by a media communications campaign.

Increase in amount of unsolicited feedback received by all mechanisms.

Feedback welcome – but some associated challenges – resources / systems.

Revision of Inpatient Experience Programme with Public Partners:ApproachQuestion set – 5 Must do’s

Communications Team developing library of digital “Patient Stories” for learning. Used regularly for reflection and learning at management meetings and learning events.

Local Better Together Questionnaires

• National Better Together results published• Patient Questionnaires developed with 70

questions, 3 different sets asked over quarter• Results showed variable differences from

national to local results• Reviewed question set with patient

partnership (reduced to 26 questions bi-monthly)

Local Better Together Results

Jun-13Jul-1

3

Aug-13

Sep-13

Oct-13

Nov-13

Dec-13

Jan-14

Feb-14

Mar-14

Apr-14

May-14

Jun-14Jul-1

4

Aug-14

Sep-14

Oct-14

Nov-14

Dec-14

Jan-150

20

40

60

80

100

Did you find the ward welcoming?

Value Goal

Month / Year

Perc

enta

ge

Jan-13

Feb-13

Mar-13

Apr-13

May-13

Jun-13Jul-1

3

Aug-13

Sep-13

Oct-13

Nov-13

Dec-13

Jan-14

Feb-14

Mar-14

Apr-14

May-14

Jun-14Jul-1

4

Aug-14

Sep-14

Oct-14

Nov-14

Dec-14

Jan-150

102030405060708090

100

Are you able to eat your meal free from interruptions?

Value Goal

Month / Year

Perc

enta

ge

Local Better Together Results Cont.

Feb-12

Mar-12

Apr-12

May-12

Jun-12Jul-1

2

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12

Jan-13

Feb-13

Mar-13

Apr-13

May-13

Jun-13Jul-1

3

Aug-13

Sep-13

Oct-13

Nov-13

Dec-13

Jan-14

Feb-14

Mar-14

Apr-14

May-14

Jun-14Jul-1

4

Aug-14

Sep-14

Oct-14

Nov-14

Dec-14

Jan-150

102030405060708090

100

Are you happy with the amount of information about your care/condition that staff give to you and your relatives?

Value Goal

Month / Year

Perc

enta

ge

NHS Lanarkshire Person-Centred Care Strategic Prioritised Plan

Collaborative Aims July 2014 - December 2015

AIMS DEFINITION

Person-centred care1 90% of people report a positive experience of the service

2 90% people say they got the outcome (or care/support) that they

expected

3 90% of people who say that we took account of the things that were important to them

4 90% of people who say we took account of the people who were important to them and how much they wanted them involved in care or treatment

5 90% of people who say that they had all the information they needed to help them make decisions about their care or treatment

6 90% of people who say that staff took account of my personal needs and preferences

7 90% of people who say they were involved as much as they wanted to be in communication/transitions/handovers about them

8 Develop and implement a rolling plan for Leadership walk-rounds in tandem with the patient safety collaborative

What did we change?

• Established a sub group from care assurance board

• Patient representatives• Developed a question bank against each must

do with me• Questionnaires completed inpatient and post

discharge with 14 days• What we did well• What could we do better

Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-150

102030405060708090

100

MD03 (Inpatient): Did you have all the information and support you needed to help you make decisions about your care or treatment?

% positiveGoal

Month / Year

Perc

enta

ge

Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-150

10

20

30

40

50

60

70

80

90

100

MD03 (Post Discharge): Did you have all the information and support you needed to help you make decisions about your care or treatment?

% positiveGoal

Month / Year

Perc

enta

ge

Feedback received Care & Treatment Compassion, Kindness, Courtesy“Being treated like a human” Clean EnvironmentFriendly staffAccessible visiting

Please tell us: Where you are

Hospital or Health Centre:

...............................................................................................................

...............................................................................................................

Ward or Department:

...............................................................................................................

...............................................................................................................

Date: ......../......../........

What we did well:

W hat we cou ld have done be tte r:

Staff action: com ple ted fo rm s shou ld be re tu rned to the Patien t A f fa irs D epa rtm ent, N H S Lana rk sh ire H Q K irk lands

Version 1 - April 2014

Feedback shared directly with staff as close to real time as possible. Monthly report provided to Management Teams and Executive.

CommunicationSupportNoise at nightFoodWait for treatment“Not enough staff”

Safety brief / handoverImproved verbal communication and electronic displays (ED)Dietetics in discussion with cateringChange in operating times (audiology)

Postal surveysDistributed

QuestionnairesSurvey MonkeyComment Cards

Cancer Services – Your JourneyLanarkshire Links

Maternity Services Liaison Group

Your Care ExperiencePublic Partnership Forum

Patient Experience IndicatorPatient Opinion

Facebook/TwitterTelephone Interviews

Listening Stations

Mor

More Generalisable

Less descriptive More descriptive

Less Generalisable

SurveysComments CardsKiosk Questions

In-depth InterviewsFocus groups/Panels

Online RatingsPublic Meetings

Patient StoriesPhotovoiceWard rounds/ObservationComplaints & Compliments

Positive Neutral NegativePatient Opinion 88 0 62Comments/Compliments/Suggestions 194 3 31We are Listening 726 3 118TOTAL 1008 6 211

1 2

43

Valuing Feedback

What we did well?• Staff very friendly and helpful.• Staff took time to speak to me and made me feel at ease.• Food is good. I was in hospital five years ago and there is a big

improvement since last time. I am really satisfied with the care from all the staff.

What could we do better?• Just some more information about all the tests they are doing.• Food – it’s not nice – either too much or too little. Visiting time

is too long, it’s very tiring. I can say to my family to go home but other patients have their visitors in for hours and it can be exhausting.

• Disappointed the medical staff did not initially listen to me. I had to be insistent.

What next?• Potentially use free text questions to gather inpatient

information• Continually review data to inform changes to process• Post discharge increased with themed questions specific to

ward• Possible development of an app to capture feedback• MDT real time feedback within ward (currently being

tested)• Link with patient safety harms collaborative• Report data and qualitative themes through ward

dashboard reporting

Aligning ‘Person Centred Care’ with Reduction in Cardiac Arrest Harm – Medical/Gastroenterology Ward 11, Hairmyres Hospital

SCN Tom Imrie

Safe – Measurement of Reliable Observations -

MEWS

Effective - 100% compliance with MEWS Bundle

Person Centred Care – What Information do I need? Nothing about me Without me

Problem highlighted from

patient experiencequestionnaire

Test a communication booklet to inform patients about care/treatment

Adobe Acrobat Document

Learning from first PDSA CYCLE

Microsoft Office Word 97 - 2003 Document

So What?Early Resolution or Celebration is our aim!

Feedback is “owned” by and shared directly with the area(s) identified so that they are empowered to reflect, learn and act.

Director of Hospital Services / Chief of Medicine / Chief of Nursing/ General Managers / Departmental / Ward Managers share or discuss the feedback with their respective colleagues and teams to support learning and actions.

Feedback reports provided and considered routinely at Hospital and Corporate Management Team Meetings.