Patient and Carer Experience Strategy

Transcription

1 Patient and Carer Experience Strategy Hertford County I Lister I Mount Vernon Cancer Centre I New QEII

2 What is patient experience? The Department of Health define a positive patient experience as: Getting good treatment in a comfortable, caring and safe environment, delivered in a calm and reassuring way; having information to make choices, to feel confident and feel in control; being talked to and listened to as an equal and being treated with honesty, respect and dignity. DH Building on the best: Choice, responsiveness and equity in the NHS (2009)

3 Patient and Carer Experience Strategy Contents Foreword 1 Introduction 2-4 Ambitions: 1: We want to improve the experience of our patients and carers from their first contact with the Trust, through to their safe discharge from our care : We want to improve the information we provide to enhance communication between our staff, patients and carers : We want to meet our patients physical, emotional and spiritual needs while they are using our services, recognising that every patient is unique Monitoring patient and carer experience Key milestones Patient experience reporting structure 17 National policy and guidance 18 Acknowledgements 19 Abbreviations: Patients the Trust Carers = = = adults, children, inpatients, day case, outpatients and maternity East and North Hertfordshire NHS Trust relatives and friends (not paid carers)

4 Ian Ian Morfett Chairman Foreword Our vision is to be amongst the best NHS Trusts in the country. Ensuring excellent patient and carer experience is fundamental to achieving this vision. We believe that every member of staff is responsible for ensuring that our patients, relatives and carers have an excellent experience and we aim to ensure that all our staff are equipped with the essential skills, knowledge, compassion and caring attitude to deliver a truly excellent service. The Trust s Nursing and Midwifery Strategy and People Strategy set out our aims to create a culture where staff feel valued, developed and supported to provide a truly customer-focussed service. This strategy, with its focus on patient experience, sets out how our staff will deliver the excellent experiences for patients that are essential to achieving our vision. The Trust s values underpin everything we do and we expect our staff to work to these values in the delivery of safe, consistent and high quality patient care: We put our patients first We strive for excellence & continuous improvement We value everybody We are open and honest We work as a team Implementation of this Strategy will ensure that the Trust has a co-ordinated approach to listening to, and learning from, patient feedback and working together with our patients and carers to continually review and improve our services. 1

5 Angela Angela Thompson Director of Nursing and Patient Experience Introduction This Strategy builds on the successes and learning gained from our Patient and Carer Experience Strategy and sets out how our staff, patients, families, carers and stakeholder groups can all work together to ensure that our patients have the best possible experience whilst using our services. The main aims of the Strategy are to: Actively engage with patients and carers encouraging all feedback and demonstrating genuine learning from listening Identify our key ambitions to improve patient and carer experience throughout the Trust Ensure that patients and carers are provided with the best possible experience whilst using our services Providing the best possible experience means getting the basics right, making sure our patients feel safe and well-cared for, that they have trust and confidence in the staff caring for them and that they receive excellent quality care in a clean and pleasant environment. This Strategy was developed with the involvement of patients, families and carers, public Trust members and staff during February-April It has also been influenced by national policy and publications aimed at improving patient experience. Our patient focus groups were asked to consider: What makes a good experience for you as a patient or carer of hospital services? What could hospitals do better to improve the patient or carer experience? What do you think a hospital should include when developing a patient experience strategy? 2

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7 Key Themes From Our Focus Groups: Improve information about care, treatment and discharge Improve outpatients administration Better communication between staff Shared decisions Smooth transition between services Reduce cancellation of outpatient appointments Value, respect and involve carers Easy access to hospital and parking Learn from comments and complaints Extend pharmacy opening times Kind and caring staff Basic care needs - nutrition, cleanliness Clean environment Treated with respect and compassion Happy and welcoming environment Support patient to make decisions Enough staff available Better food for patients and visitors Review care pathways from PATIENTS point of view Ensure timely pain control Make it easy for patients to provide feedback Involve patients / carers in service changes Our Ambitions Improve the whole journey Ambition 1: We want to improve the experience of our patients and carers from their first contact with the Trust, through to their safe discharge from our care. Improve communication Ambition 2: We want to improve the information we provide to enhance communication between our staff, patients and carers. Meet care needs Ambition 3: We want to meet our patients physical, emotional and spiritual needs while they are using our services, recognising that every patient is unique. This strategy will underpin our efforts to achieve our ambitions with our staff, patients and the public, commissioners and partner organisations. An annual evaluation of progress towards our ambitions will be undertaken and published on the Trust s website. 4

8 Improve the whole journey Ambition 1: We want to improve the experience of our patients and carers from their first contact with the Trust, through to their safe discharge from our care. To do this we will: Further develop and maintain the information on the Trust website about the services provided along with contact details for wards and departments. Engage with patients and carers when developing and reviewing services to ensure that their needs are taken into consideration. Provide clear information and directions on how to get to our hospitals including public transport and alternatives, e.g. Health Shuttle. Review and continually monitor hospital signage to ensure patients and visitors are directed to the right ward/department in a clear and easy way. Share patient feedback relating to signage and car parking with partner organisations where appropriate. Ensure our staff and volunteer helpers provide a friendly and efficient welcome to patients, carers and visitors. 5

9 Minimise waiting times in clinics and departments ensuring that staff keep patients and carers informed of the reasons for any delays. Improve the administration process for outpatients including the booking of appointments, reducing cancellations and proactively contacting patients to avoid delays and unnecessary journeys to hospital. Ensure that patients wishing to cancel or reschedule outpatient appointments are able to do so efficiently and they are consulted about future clinic appointments. Develop clear points of contact for outpatients and improve the outpatient telephone appointment service reducing the length of time patients have to wait for their call to be answered. Ensure that all inpatients have a written welcome card including information about what will happen next and their likely discharge date. Keep patients and carers informed about what is likely to happen to them throughout their time in hospital. Work closely with health and social care teams to ensure safe and co-ordinated discharge from hospital with all the necessary support in place. This may include the patient seeing a doctor, physiotherapist or social worker before leaving hospital and ensuring medication to take home is ready in a timely manner. Ensure that family carers are fully involved in the discharge process and are able to provide care and support for their relative at home. Ensure our patients receive high quality care at the end of their life in line with the Trust s End of Life Care Strategic Plan. Wherever possible we will follow the patient wishes as set out in the Advanced Care Plan, Advance Decision to Refuse Treatment and/or Do Not Attempt Cardiopulmonary Resuscitation form. Continue to improve the patients stay by working with the community encouraging individuals and groups to participate in a programme of activities which benefit both the community and the hospital, e.g. gardening groups, student beauticians/hairdressers providing free treatments to patients, singers/musicians entertaining patients, Pets as Therapy dogs visiting patients etc. Pilot new and innovative ways of providing healthcare to patients including tele-health clinics. Continue to develop seven-day working across all services. We ll measure our success by: Measuring our national inpatient survey responses about: Admission date to hospital not changed 2014 = 9.2/ target = 9.4/10 Patients knowing when their discharge will be 2014 = 6.9/ target = 7.5/10 Delayed discharge from hospital 2014 = 5.0/ target = 6.5/10 Measuring the proportion of patients who would recommend our outpatient services to their friends and family: = 92.75% 2019 target = 94.00% Measuring the number of complaints received regarding delays in treatment/appointment: = target = 300 Measuring the number of complaints received regarding cancellation of appointments/clinics: = target = 20 6

10 Improve communication Ambition 2: We want to improve the information we provide to enhance communication between our staff, patients and carers. To do this we will: 7 Actively promote the #hello my name is. campaign ensuring all staff are aware of the importance of introducing themselves to patients and asking how each patient would like to be addressed. Ensuring that all patients know the name of the healthcare professional looking after them. Publicise our customer care pledges. Provide customer care training for our staff and ensure that patients are involved in the development of the training. Aim to answer patients and carers questions straight away and, if there is likely to be a delay in responding, keep them informed of the reason for the delay. Ensure that patients are provided with well-written information leaflets on their care and treatment to enable them to prepare for their outpatient appointment or inpatient stay. Advise patients where they might find reliable high quality information and support from sources such as national and local support groups, networks and information services. Ask patients how they would like to be communicated with and the type of information they want. Based on their views, provide clear, consistent and accurate information throughout all stages of their care and treatment, recognising each patient s individual needs. Encourage patients to express their personal needs and preferences when making decisions about their care and treatment, encouraging patients to ask questions so they understand the benefits and risks. Support wards to provide an information booklet to all inpatients including information about the ward routines, mealtimes, visiting hours, staff etc.

11 Encourage patients to talk to staff if they have any questions or concerns and support patients to seek advice from the Patient Advice and Liaison Service (PALS) or to make a complaint. Improve communication between our staff to avoid the need for patients to keep answering the same questions. Listen to patients and carers and answer their questions in a way that they can understand. Provide patients and carers with information, verbal and in writing, about their care and treatment that is clear and understandable. Ensure that patients and carers are given the opportunity to complete a This is Me booklet (dementia) or Purple Folder (learning disabilities) to share important information about the patient with staff. Ensure that staff are able to access interpreter and other services for patients who require information in alternative formats. Clarify with the patient whether and how they would like family members/carers to be involved in key decisions about the management of their condition. Share information and involve carers in accordance with the patients wishes. Recognise the valuable status of carers who are often the expert on the patient. With the patients permission, involve carers in discussions and decisions about care, treatment and discharge. Liaise with carers about on-going care needs and direct carers to additional support if needed, e.g. carers assessment, Carers in Hertfordshire/Bedfordshire. Support carers to be with their relative or friend on the ward outside of published visiting hours if they wish to help at mealtimes or with providing care. Share the benefits of our carers agreement which sets out how hospital staff and carers can work in partnership. Provide information for carers on our Trust website with useful information about the Trust s services, carers rights and links to local and national support and information for carers. Encourage all patients, relatives and carers to provide feedback about their hospital experience by completing one of our surveys which includes the national Friends and Family Test question. Ensure that all services are supported to collect patient experience feedback and this is shared within the team. Display results of patient feedback in public areas and on the Trust website including our You Said We Did posters to share actions taken as a result of feedback. We ll measure our success by: Measuring our national inpatient survey responses about: Patients understanding answers to questions from doctors 2014 = 7.8/ target = 8.5/10 Patients understanding answers to questions from nurses 2014 = 8.3/ target = 8.8/10 Patients being involved as much as they wanted to be in decisions about their care and treatment 2014 = 7.3/ target = 7.8/10 Measuring the number of responses to the Friends and Family Test survey: = 53, target = 65,000 8

12 Meet care needs Ambition 3: We want to meet our patients physical, emotional and spiritual needs while they are using our services, recognising that every patient is unique. To do this we will: Be kind, courteous and help patients, carers and visitors making them feel welcome in our hospital. Provide care and treatment for patients which minimises the risk of harm and respects their privacy and dignity. Provide a clean, safe and comfortable environment, accessible to patients with a disability. Ensure that our staff have access to the equipment they need to meet patient needs. 9

13 Do all we can to help control pain, reduce the risk of infection, harm from falls and pressure ulcers. Give our patients access to nutritious meals, snacks and drinks which meet their dietary, religious and cultural needs. Maintain protected mealtimes where staff, volunteers and carers can focus on helping patients to enjoy their meal in a calm environment. Ensure that regular checks are made on all inpatients (minimum hourly during the day and two hourly at night). This is called intentional rounding and includes checking that patients are comfortable, whether they are experiencing any pain or need help with food/drink or to use the bathroom. Nursing staff will ask each patient whether there is anything else they need and check the call bell is within easy reach. Display information on our wards about staffing levels, numbers of infections, falls, pressure ulcers, cleanliness scores so you know How we re doing. Ensure our patients and carers have access to all the practical, emotional and spiritual support they need and provide contact information for organisations and support groups. Make sure that patients and carers have an opportunity to speak to a doctor, nurse, member of the chaplaincy team or other healthcare professional if they wish to. Recognise that the patient and/or carer are the expert on their condition and respect their knowledge, skills and expertise. Provide support, advice and information for carers via our Carers Lead. Ensure that all patients are treated as individuals and their cultural and/or religious needs, values and preferences respected. Develop an understanding of the patient as an individual taking into account factors such as physical or learning disabilities, speech or hearing problems and difficulties with understanding English. Ensure that any reasonable adjustments are made to meet the patients needs. We ll measure our success by: Measuring our national inpatient survey responses about: Patients having enough emotional support from staff: 2014 = 6.7/ target = 7.2/10 Patients having enough help from staff to eat their meals: 2014 = 6.0/ target = 8.0/10 Patients overall rating of their experience: 2014 = 7.8/ target = 8.3/10 Patients feeling well looked after by hospital staff: 2014 = 8.5/ target = 9.0/10 Measuring the number of complaints received about medical care: 2014 = target = 125 Measuring the number of complaints received about nursing care: 2014 = target = 55 10

14 Monitoring patient and carer experience We actively encourage feedback from patients in a variety of ways, including:- National surveys The Trust participates in the national patient experience survey programme including the annual inpatient survey and ad hoc surveys of outpatients, cancer, maternity, accident and emergency, children and young people etc. The Friends and Family Test (FFT) We aim to offer all patients the opportunity to respond to the FFT question and to have the opportunity to tell us about anything else we could have done to improve their experience. Responses to the FFT for inpatients/day cases, accident and emergency, maternity and outpatients will be reported monthly to the Department of Health and published on the NHS England and NHS Choices website. We continually monitor the proportion of patients who would recommend our services and identify key themes from the comments made to continually improve our services. 11

15 Local patient experience surveys The Trust uses the Meridian system to capture real-time feedback from patients. A variety of patient experience surveys are available for patients to complete, either using an i-pad on the ward, by completing a paper survey or from home via the Trust s website or using our unique survey link www. tellusmore.org.uk Surveys include inpatients, outpatients, accident and emergency, maternity, critical care, neonatal and renal dialysis. Results from these surveys are available for all wards and departments to see real-time via the Trust s intranet. NHS Choices, Patient Opinion and Social Media The NHS Choices and Patient Opinion websites and Facebook and Twitter provide the Trust with valuable feedback from patients and their relatives/ carers. We always respond promptly to any feedback provided and encourage people to get in touch with the Trust directly if there are any issues or concerns that we can help to resolve. All feedback, whether positive or negative, is shared with the clinical teams. Complaints/Patient Advice and Liaison Service (PALS) Complaints and concerns provide valuable feedback to the Trust about patient and carer experiences. We encourage patients to share any concerns with staff as soon as possible so that we can help. We analyse the themes from complaints and compare this with other patient experience feedback to identify areas where additional support may be required. Patient and carer focus groups We arrange patient and carer focus groups on an ad-hoc basis when reviewing, or developing new services. The Trust s patient/public members are invited to participate as patient/public representatives on Trust committees, participate in service reviews and ward environment/cleanliness inspections etc. Comments Compliments Concerns Complaints Patient information leaflet = = = = = = = 12

16 Monitoring patient and carer experience Patient/Carer Stories The Trust regularly listens to patient stories and shares learning from these with the clinical teams. The monthly Trust Board meetings start with a patient story. This can be told by the patient or carer attending the meeting in person or by sharing the story in writing or listening to a recording. The Board welcome hearing about both positive and negative experiences and the clinical teams share the learning from the experience and agree actions to be taken. Patient Experience Committee (PEC) The PEC is chaired by a Non-Executive Director and the Director of Nursing and Patient Experience is the Vice-Chair. The committee is supported by the Project Manager Nursing and Patient Experience and includes six patient representatives along with representatives from all Clinical Divisions, heads of departments e.g. Facilities, Safeguarding, Health Liaison Team and Chaplaincy. Divisional Patient Experience Action Plans There are five Clinical Divisions within the Trust:- Medicine: General/Elderly Care, Specialist Medicine, Emergency Medicine Surgery Cancer Women s & Children s: Women s Services and Children s Services Clinical Support Services (outpatients, radiology, pharmacy) The Nursing Services Managers within each Division are responsible for producing and updating their Divisional patient experience action plan. This includes key issues that need to be addressed to improve patient experience the actions required, timescale, responsibility and a regular update on progress. A representative from the Clinical Division attends the Trust s Patient Experience Committee on a regular basis to update on key actions and progress to improving patient and carer experience. You Said We Did All wards have a patient experience notice board where they display their latest survey results, Friends and Family Test results and any actions they have taken as a result of patient feedback this is called You Said We Did. Examples of You Said We Did actions and quotes from patients are displayed and regularly updated in public areas of the Trust and on the Trust website along with our FFT results. 13

17 Nursing and Midwifery Quality Indicators These indicators provide key performance data at ward level and are updated monthly. Information includes bed occupancy, staffing levels, sickness absence, incidents, numbers of falls/pressure ulcers, key nursing audit results, complaints and responses from our inpatient experience survey to the following eight questions:- Did you get enough help from staff to eat your meals? In your opinion, were there enough nurses on duty to care for you in hospital? After you used the call button, how long did it usually take before you got help? Do you think the hospital staff did everything they could to help control your pain? When you had important questions to ask a nurse, did you get answers that you could understand? Did you find someone on the hospital staff to talk to about your worries and fears? Do you feel you got enough emotional support from hospital staff during your stay? Do you know who your named nurse is? We benchmark our performance with other NHS Trusts and aim to be amongst the best. We endeavour to learn from other organisations to provide excellent care for our patients. 14

18 Key Milestones Ambition 1: We want to improve the experience of our patient s and carers from Engage with users to review the appointment system. Business case for administrative support for outpatient team. Actively engage with patients and carers when developing Trust Services via the Engagement Team. Establish Voluntary Services Steering Group and further develop links with the local community to provide services and entertainment for patients. Develop and implement End of life Strategy for the Trust. Support on-going education and training regarding end of life. Implementation of individualised end of life care documentation. Launch Trust-wide values-based customer care training programme building on the work already undertaken. Launch monthly staff recognition scheme. Information available on Trust web-site to reflect changes in department locations and new signage. Ambition 2: We want to improve the information we provide to e Review patient information leaflets and develop new information as required. Expand on the information available in alternative formats, eg easy read. #hello my name is included in Divisional patient experience action plans. Improvements in communication categories in patient experience survey responses Begin to develop ward information booklets. This is Me booklet available for patients with dementia and purple folder for people with a learning disability. Carers Lead in post providing support for carers and promoting Carers Policy and carers agreement. Ward staff recognise importance of role of carer. Ambition 3: We want to meet our patients physical, emotional and spiritual nee Patient safety elements monitored and information displayed at ward level. Reduce number of hospital acquired pressure ulcers and new Catheter Associated Urinary Tract Infections reported in the safety thermometer audit. Protected mealtime in place on all wards and patients receiving assistance at mealtimes. Introduce new menus on inpatient wards. Maintain improvements in cleanliness of hospital. Clinical areas display information for patients on support groups and advice available. 15

19 their first contact with the Trust, through to their safe discharge from our care. Continue to make improvements in appointments system and review patient feedback. Increase in the number of patients, carers and Trust members involved in Trust activities (service reviews, inspections, committees etc) Voluntary Services Strategy in place. Audit implementation of End of Life Strategy. Increased levels of recognition at external awards. Monthly staff recognition scheme in place. Information maintained and regularly reviewed regarding Trust services. nhance communication between our staff, patients and carers. Patient information leaflets regularly reviewed and available for patients on Trust web-site and within departments. Increased amount of information available for patients in alternative formats. #hello my name is embedded within the Trust. Significant improvement in patient experience feedback regarding communication evidenced in national inpatient survey. All wards have information booklets available. Use of This is Me and purple folder embedded in the organisation. Improvements in number of carers agreements in place. Carers report improved support provided. ds while they are using our services, recognising that every patient is unique. Reduction in number of harms caused to patients. New (hospital acquired) harms reported in safety thermometer audit continues to fall. Patient feedback improved in relation to rating of food and receiving assistance at mealtimes. Improved feedback from patients reflected in national inpatient survey score. PEAT score reflects high level of cleanliness. Clinical areas display information for patients on support groups and advice available. 16

20 Patient experience reporting structure: Reporting Structure - Patient Experience Committee Trust Board Risk and Quality Committee Quality Review meetings with Clinical Commissioning Group Patient Experience Committee Medicine Division Patient Experience / Complaints / PALS Update Surgical Division Noise at Night / Tele Clinics Care Environment Committee / PLACE Cancer Division Staff Survey / Customer Care Training Women & Children Division Volunteers Clinical Support Services Equality & Diversity Learning Disabilities Community Engagement Patient experience surveys, friends and family, patient stories, complaints, PALS etc. 17

21 National policy and guidance Recommendations and guidance from national policy and guidance have been considered in the development of this Strategy: Equity and Excellence: Liberating the NHS (2010) Putting patients at the heart of the NHS. Services to be more responsive and designed around the patient with shared decision-making the norm no decision about me, without me. DoH Framework for patient experience (2012) The NHS National Quality Board agreed a working definition of patient experience to guide the measurement of patient experience across the NHS. Compassion in Practice the Six C s (2012) Aim to deliver high quality, compassionate care and to achieve excellent health and wellbeing outcomes. The values and behaviours are at the heart of the vision and are set out as the 6 C s which are Care, Compassion, Competence, Communication, Courage and Commitment. NHS Constitution (2013) Describes the purpose, principles and values of the NHS and illustrates what staff, patients and the public can expect from the service. Francis Report recommendations (2013) Two inquiries into the events at Mid Staffordshire Hospital identified a number of themes and recommendations. A key action is to listen to the patient and public voice about the quality of care provided. NHS England Commitment to Carers (2014) Commitments that NHS England will do to support carers. NICE quality standard for patient experience in adult NHS services (2012 & 2014) Sets out how a high-quality service should be organised so that the best care can be offered to people using NHS services. It is made up of 14 statements that describe high quality care for patients. Putting Patients First: The NHS England Business Plan for 2014/ /17 (2014) NHS England plans to deliver high quality care for all now, for the future and developing the organisation. Patient experience is a key objective within the plan. NHS Outcomes Framework 2015/16 A driver for quality improvement and outcome measurement throughout the NHS. Structured around five domains; Domain 4 ensuring that people have a positive experience of care. National Quality Board Improving experiences of care: our shared understanding and ambition (2015) Sets out what is meant by national statutory organisations across the health and care system about people s experiences and the NQB role in improving experiences of care. 18

22 Acknowledgements We would like to thank everyone who participated in the patient and carer experience focus group sessions and all the staff and patients who completed our survey and shared their views about improving patient experience. Your contribution has been key to developing this Patient and Carer Experience Strategy thank you. Patients and Carers: Patient Experience Committee members: Staff: Janet Altham Pamela Ball Barry Brant Heather Brant Denice Gately Jackie Hacker Barbara Haws Dorothy Hayward Liz Johnson Carol Pillinger John Mobbs Christine Palmer Norman Phillips Sandy Robertson Michael Taylor Fiona Thomson Lesley Williams Peter Wilson Ronald Woodward Helen Altringham David Brewer Carol Pillinger Pat Cotton Caroline Dilks Jean Eldridge Maurice Eldridge Jacqui Evans Carolyn Fowler John Gilham Jane Hatton Bernadette Herbert Louise Jenkins Jenny Kilminster Liz Lees Sali Lovett Rosemary Lucey David Martin Jackie Martin Karen Mead Jenny Pennell Carol Pillinger Mary Tattan Angela Thompson Jane Unwin Peter Wilson Zoe Anstead Abby Barcinal Shahina Begum Michael Chilvers Jessica Clay Jane Dhokotera Natalie Galvam Kimberley Harvey Joanne Hay Nikisha Lynch Kirstie Matthews Claire McClean Joana Oppong Blair Robertson Rebecca Roydhouse Aislie Sand Abigail Tilley Siobhan Walshe Produced in-house by the Department of Clinical Photography & Illustration

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24 Delivering excellence in patient and carer experience East and North Hertfordshire NHS Trust Coreys Mill Lane Stevenage Hertfordshire SG1 4AB Tel: