Inpatient Survey 2009/10 Improvement Plan NHS Lanarkshire Result Action(s) By Whom / Timescale Priority Area 1: Food and Drink I was happy with the food and drink I received (52%) and I got help with eating and drinking when I needed it (60%) Task and finish group established led by Chair of Area Clinical Forum and involving Employee Director and external advice. Five workstreams: Patient Information Menu choice Patients Own Food Presentation and serving Staff approach To report to Board in March 2011 Priority Area 2: Communication Issues (linked to bottom 5 scores) In the ED/A&E I was told how long I would have to wait (54%) External advice being recruited through Scottish Government Industry department. Patient experience is being gathered by volunteers and selected senior staff using the ward based NHS Lanarkshire patient experience indicator. Patient experience is also being gathered via the patient catering opinion survey with the results considered by the Patient Catering Opinion Survey Group which has patient/public representation. More accurate display signs within the A&E departments Providing arriving patients with written information about what to expect when waiting to be seen Nurse to be assigned to the waiting area whose remit will include updating patients on their waiting time Each ward to display results along with other quality indicators Operational General Manager by Property & Support Services Implement improvements by 31 March 2011 Divisional Nurse Director and Nurse Consultant for Emergency Medicine 1
Local monitoring of patient experience using volunteers on a quarterly basis with local action plans Operational Associate Director of Nursing for Emergency Care I knew who was in charge of the ward (61%) Complete Priority Area 3: Personal care, particularly by nursing staff Nurses gave me clear explanations about any operations and procedures (72%) National uniform introduced which clearly differentiates the Senior Charge Nurse from other nursing staff Information about the different staff uniforms contained within the inpatient booklet Name of the Senior Charge Nurse contained within the wardspecific information sheet Nurse in charge required to introduce themselves at the start of each shift to each patient. To be monitored through the patient experience indicator Audit by Patient Information Manager to monitor whether patients received the inpatient booklet and ward specific information sheet; and whether these publications give them the information they need Local monitoring of patient experience using volunteers Programme of Acute Services Division updates on communications skills, particularly relating to information-giving and documentation. Top tips for nursing staff in good communication Complete Complete Operational. Audit of compliance underway Divisional Nurse Director Operational. Audit of compliance underway Head of Patient Affairs Wards to display results along with other quality indicators from 31 March 2011 Deputy Director of Practice Operational. Divisional Nurse Director to monitor compliance each month Under development. Expected to be available from April 2011 Deputy Director of Practice Local monitoring of patient experience using volunteers Underway. Wards to display results along with other quality indicators 2
I got help with washing and dressing when I needed it (76%) Improve assessment of patient needs such that where patients should have assistance this is agreed with them and documented in the care plan and nursing record as having been provided. Complete Releasing Time to Care initiative which is freeing up nursing time. The patient experience indicator has a section dedicated to asking the patient about their experience of help with their personal hygiene. From April 2011 Deputy Director of Practice and Senior Nurses Monitoring of patient s care to be undertaken by Senior Nurses undertaking ward rounds each day By end of March 2011. Review by Underway. Data collection and feedback to Senior Charge Nurses 3
There was enough time to talk to the nurses (76%) Releasing Time to Care, will enable more time to be available although pressures abound for the time and attention of nursing staff. By end of March 2011. Review by Nurses talked in a way that helped me understand my condition and treatment (78%) Nurses knew enough about my condition and treatment (80%) Nurses listened to me if I had any questions or concerns (81%) As far as I was aware nurses washed/cleaned their hands at appropriate times (86%) Local monitoring of patient experience using volunteers. Rolling programme of updates for nursing staff that include communications skills, particularly relating to information-giving and documentation. Each patient to have personal conversation before any surgical or investigative procedure Staff compliance with the hand hygiene policy is regularly audited and is consistently higher than patient-reported experience. Patients are to be encouraged to ask staff if they have washed their hands. Review meet and greet at ward visiting times to encourage visitors to adopt good hand hygiene. Underway. Wards to display results along with other quality indicators Operational From march 2011, to be monitored by Senior Nurse Operational - data collection and feedback to Senior Charge Nurses and individual practitioners by Infection Control staff From April 2011 - Nurse in Charge of ward to include when introducing themselves to patients at start of span of duty By April 2011 - Divisional Nurse Director with Associate Nurse 4
Directors Priority Area 4: Arrangements for discharge planning and services following discharge I was happy with how long I had to wait around when I was told I could go home (68%) I was told about any danger signals to watch out for when I got home (70%) Discharge Planning Policy to be reviewed. Surgical patients receive written information about their procedure (which includes information about danger signals). By May 2011 Divisional Nurse Director Operational - Patient Information Manager to continue to feed the results of audits back to the authors of the information leaflets in order to deliver improvements. The publications are consistently highly rated I was confident that any help I needed had been arranged for when I got home (72%) I was given advice on how to look after myself (73%) I understood who to contact if I had any questions after leaving hospital (79%) Priority Area 5: Communication about the Nurse in charge of ward to ensure every patient has personal explanation at least once before discharge. Discharge Planning Policy to be reviewed. New carers receive Home from Hospital pack. New discharge letter being developed as part of introduction of new electronic Patient Management System. Nurse in charge of ward to ensure every patient has personal explanation at least once before discharge. From March 2011 to be monitored by Senior Nurses By May 2011 - Divisional Nurse Director Operational - Carers co-ordinators to report on uptake From May 2011 - Divisional Nurse Director to ensure roll out once available From March 2011 to be monitored by Senior Nurses 5
arrangements for discharge I was given help with arranging transport (60%) Brief information is contained within the inpatient booklet. This will be reviewed to set out what patients might expect By April 2011 - Patient Information Manager I understood the possible side effects (of my medicines) and what to do if I had any concerns (80%) Patient experience is being gathered by volunteers and selected senior staff on an ongoing basis through the NHS Lanarkshire patient experience indicator. The results are being fed back to Senior Charge Nurses in order to deliver improvements. Operational: Drug information sheet given to every patient Clinical pharmacist briefs selected patients From April 2011 all patients not briefed by clinical pharmacist to be briefed by nurse in charge of their care or medical staff: Senior Nurses to monitor 6