Patient Client Experience Standards Monitoring Report Quarter Ending Sept 2010 Phase 4: Elective Admissions Ward, Craigavon Area Hospital 3 South, Craigavon Area Hospital Male Surgical, Daisy Hill Hospital
1. Background. In April 2009, the DHSSPS published the Improving the Patient & Client Experience document. The document set out the following five core standards: Respect Attitude Behaviour Communication Privacy and Dignity All Trust adopted these standards during 2009/10 and arrangements were put in to develop methodologies through a regional working group to allow the standards to be monitored. Priorities for Action 2010/11 includes the following target: Following the adoption of the Patient and Client Experience Standards in 2009, Trusts should extend the clinical care areas monitored and increase the range of monitoring tools, and ensure appropriate reporting and follow up consistent with direction from the Public Health Agency 2. Development of monitoring tools and extension of monitoring to additional clinical areas. The use of patient satisfaction surveys was tested during the third and fourth quarters of 2009/10. The surveys were tested in acute medical wards, non acute rehabilitation wards and acute mental health inpatient wards. Questionnaires have been revised to reflect the learning from the surveys undertaken. During 2010/11, the survey was rolled out to three medical wards and this current phase has been extended to three acute surgical wards: Male Surgical Ward, Daisy Hill Hospital, the Elective Admission Ward and Ward 3 South, Craigavon Area Hospital. The Regional Patient Client Experience Working Group has developed a work plan for 2010/11 in agreement with the Public Health Agency and HSC Board to further develop the methodologies for monitoring the compliance against the five core standards. The additional monitoring tools to be developed and tested will include the following: Patient/Client stories Review of compliments and complaints Observations of practice Staff Feedback Audit of organisational arrangements Trusts will provide a monitoring report to the HSC Board on the activities undertaken each quarter. In the current quarter a further three medical wards have been surveyed and the reports for each ward are attached. A summary of the compliments and complaints received in these ward areas is also attached.
Patient Satisfaction Survey - Report Trust: Southern Health & Social Care Trust Ward: Elective Admissions, Craigavon Area Hospital Quarter Ending: Sept 2010 Sample Size: 80 Return of Questionnaire: 43 Response Rate: 53.75% The following table outlines the patient experience on: a) Pre-operative Pre-assessment Clinic b) Arrival on the hospital ward c) Each of five Patient and Client Standards d) Satisfaction with discharge arrangements e) Overall experience during their stay in hospital f) The most positive aspects of their stay on the ward g) Suggestions for improvement h) Completing the Patient & Client Experience Standards questionnaire i) Compliments and complaints for the ward j) Action Plan (a) Journey to hospital using the NI Ambulance Service This section does not apply for the Elective Admissions Ward. (b) Pre-operative Pre-assessment Clinic 33 patients (77%) had attended the Pre-operative Preassessment Clinic and responded as follows: Comment Pre-operative Health Screening questionnaire was (n=30) Were you happy with the amount of information given to you regarding your procedure and what to expect after the procedure / surgery? (n=33) Easy to complete 87% Yes 88% Difficult to complete 13% No 12% I was not informed about what happened during the procedure or aftercare I had to ask Was not informed I would be off work for 2-3 weeks. No response on other questionnaire Did you feel adequately prepared for your admission to hospital? (n=31) Yes 97% No 3% Information was very limited
(c) Arrival on the hospital ward This section relates to all patients who completed a questionnaire (n=43). On arrival to the hospital ward, patients reported staff were: Welcoming Expecting you and prepared for your arrival Q6b (n=40) Fully understanding of your condition / presenting problems Q6c (n=40) Fully understanding of your personal circumstances Q6d (n=40) Q6a (n=40) 100% 100% 98% 98% ( d) The five Patient & Client Experience Standards: red, amber, green classification Respect Considered and respected your wishes Respected your religious / spiritual needs Treated you as an individual Were you interrupted when or care was being delivering to you Q8d (n=5 ) Frequency of those interruptions Was the reason for the interruption explained Q8f (n=2) Q8a Q8b Q8c Q8e (n= 39 ) (n= 34 ) (n=39 ) (n= 2 ) 100% 97% 100% 5 Occasional/rare 100% Attitude Were welcoming Approachable at all times Showed a willingness to help Took time to listen to your questions or concerns Q9c (n=39) Were caring & compassionate towards you Noticed when you were upset / distressed Q9e (n=34 ) Provided assistance when you needed it Q9f (n= 38) Q9a Q9b Q9d (n=40) (n=38) (n=38) (n=37) 100% 100% 100% 100% 97% 100% 100% Behaviour Were polite & courteous Q10a (n=39) Behaved in a professional manner Q10b (n=38) Made you feel safe & supported Q10c (n=37) Called you by preferred name Q10d (n=37) Provided enough information Q10e (n=37) Asked for consent before Q10f (n=38) 97% 97% 97% 97% 97% 97% Of note: one patient responded Never to all of the questions in the above section on behaviour, however did not elaborate on this. That patient was very satisified with their overall experience in hospital. Communication Spoke in a way which you could easily understand Q11a (n=40) Checked if you understood what they were telling you Q11b (n=39) Listened to you Q11c (n=39) Explained what was happening in relation to your Q11d (n=38) Involved you in decisions which needed to be made Q11e (n=38) Introduced themselves when you first met Q12 (n=41) Information leaflet was easy to understand Q13a (n=23) Info leaflet told you what you needed to know Q13b (n=24) 95% 97% 100% 100% 100% 98% 100% 100% Section: Involved you in the development of your care plan was not included in the questionnaire
Privacy & Dignity Provided enough privacy when discussing / care and personal matters Q14a (n=41) Maintained your privacy & dignity when examining you or providing care / Q14b (n=41) Took steps to prevent you feeling embarrassed Q14c (n=41) Was your bed in an area of the ward where male and female patients were being cared for beside each other (relates to sleeping accommodation only) No responses Q14a (n=35) If yes, did staff give you the option to move to another part of the ward where male and female sleeping accommodation was not mixed Yes responses Q14b (n=3) 98% 98% 98% 91% 67% Took action to relieve your pain Q15a (n=28) Helped with toileting when you needed it Q15b (n=23) Helped with eating & drinking when you needed it Q15c (n=21) Helped with washing & dressing when you needed it Q15d (n=19) Had enough time to spend with you Q15e (n=29) 93% 96% 100% 100% 97% (e) Satisfaction with discharge arrangements Satisfaction with various aspect of discharge arrangements was reported as: Information provided regarding your discharge Q17a (n=32) Time given for you to plan for going home Q17b (n=32) Information provided regarding your medication before going home Q17c (n=29) Information regarding who to contact if you were worried about your condition / after you went home Q17d (n=31) Were you given an expected date of discharge Q17e (n=30) 97% 100% 100% 97% 93% Overall how satisfied were you regarding your discharge arrangements: Very Satisfied Satisfied Dissatisfied Very dissatisfied 79% 18% 3% 0% The one patient who was dissatisfied regarding discharge arrangements did not elaborate on this. (f) Overall experience during their stay in hospital Patients reported their overall satisfaction with their experience in hospital as: Excellent (n=1) Very Satisfied (n=31) Satisfied Dissatisfied Very dissatisfied 84% 16% 0% 0%
(g) The most positive aspects of their stay on the ward Patients reported the most positive aspects of their stay on the ward as: The service provided: Level of care I was well looked after. I think the service was A1! All aspects of my stay on the ward were very positive. I was treated very well and I have no complaints at all and I wish to thank all members of staff for a very satisfactory stay. I found the staff very helpful and friendly. Most positive aspect was everything going to plan. Very well looked after thanks. The staff Doctor's and nurses were very approachable and they were able to answer my questions and I am very satisfied with the answers and able also to discuss the procedures very well. Never was in as friendly a ward until this one. Sister McClenaghan and her team of angels were marvelous. It was a treat, really enjoyed myself. Sisters and staff very caring and professional, even many well educated staff on ward. The friendly staff and atmosphere. You couldn't improve it, it was 110%. Friendliness. Very satisfied on this Elective Admission Ward. Staff are excellent! Hope this can be said on other wards. The professional nursing shown. I was very nervous but always reassured. The staff were most dedicated and lovely. Every blessing in your work. How prepared they were on my arrival. All the staff were very good. That the nurses are very professional and pleasant at their job. Very friendly staff, made to feel at ease and very well looked after. Excellent! The nursing staff very friendly and made me at ease. Staff were very friendly and helpful. The staff were very helpful and friendly and they could not have done enough for me. I always found the staff very friendly. Most positive aspect was very peaceful and personal, staff very nice. How nice and friendly the nurses are. Pleasant and helpful staff. Friendliness of staff. (h) Suggestions for improvement State where location of Elective Admissions is on sheet. Say patients should not have false nails. Only small point was I was not asked at any stage if I could be pregnant. Faster to surgery. I hope you get more staff so you all won't be run off your feet.
(i) Ease of completing the Patient & Client Experience Standards questionnaire Very easy Easy Not easy 71% 26% 3% Suggestions for improving the questionnaire: Make the questionnaire shorter to rate your stay on a 1-10 scale and write any complaints. A lot of unnecessary questions. Do not repeat the same question over and over again. It was repetitive (j) Compliments and Complaints Compliments received for Elective Admissions, CAH: June Sept 2010: 10 cards 15 boxes of Chocolates Complaints received April June 2010 No Complaints (k) Action Plan Action Plan Issue Identified Action Planned Responsibility and timescales Pre/Op Pregnancy Testing To be completed by ward in detail Communication of Procedures
Patient Satisfaction Survey - Report Trust: Southern Health & Social Care Trust Ward: 3 South, Craigavon Area Hospital Quarter Ending: Sept 2010 Sample Size: 80 Return of Questionnaire: 27 Response Rate: 33.75% The following table outlines the patient experience on: a) Journey to hospital using the NI Ambulance Service (results to NIAS) b) Arrival on the hospital ward c) Each of five Patient and Client Standards d) Satisfaction with discharge arrangements e) Overall experience during their stay in hospital f) The most positive aspects of their stay on the ward g) Suggestions for improvement h) Completing the Patient & Client Experience Standards questionnaire i) Compliments and complaints for the ward j) Action Plan (b) Arrival on the hospital ward This section relates to all patients who completed a questionnaire. On arrival to the hospital ward, patients reported staff were: Welcoming Expecting you and prepared for your arrival Q6b (n=26) Fully understanding of your condition / presenting problems Q6c Fully understanding of your personal circumstances Q6d (n=23) Q6a 100% 96% 100% 91% ( c) The five Patient & Client Experience Standards: red, amber, green classification Respect Attitude Considered and respected your wishes Respected your religious / spiritual needs Treated you as an individual Were you interrupted when or care was being delivering to you Q7d (n=3 ) Frequency of those interruptions Was the reason for the interruption explained Q7a (n= 27 ) Q7b (n= 21 ) Q7c (n=27 ) Q7e (n=3 ) Q7f (n=3 ) 96% 95% 96% 3 Frequent x 3 100% Were Approachable welcoming at all times Showed a willingness to help Took time to listen to your questions or concerns Q8c Were caring & compassionate towards you Noticed when you were upset / distressed Provided assistance when you needed it Q6a Q8a Q8b Q8d Q8e Q8f (n=27 ) (n= 27 ) (n=24 ) (n= 26) 100% 93% 100% 93% 100% 100% 96%
Behaviour Communication Were polite & courteous Q9a Behaved in a professional manner Q9b Made you feel safe & supported Q9c Called you by preferred name Q9d Provided enough information Q9e Asked for consent before Q9f 100% 100% 100% 93% 96% 100% Spoke in a way which you could easily understand Q10a Checked if you understood what they were telling you Q10b Listened to you Q10c Explained what was happening in relation to your Q10d Involved you in decisions which needed to be made Q10e Introduced themselves when you first met Q11 Information leaflet was easy to understand Q12a (n= 20) Info leaflet told you what you needed to know Q12b (n=20) 96% 100% 100% 100% 100% 81% 100% 100% Section: Involved you in the development of your care plan was not included in the questionnaire Privacy & Dignity Provided enough privacy when discussing / care and personal matters Q13a (n=26) Maintained your privacy & dignity when examining you or providing care / Took steps to prevent you feeling embarrassed Was your bed in an area of the ward where male and female patients were being cared for beside each other (relates to sleeping accommodation only) No responses If yes, did staff give you the option to move to another part of the ward where male and female sleeping accommodation was not mixed Yes responses Q13b (n=26) Q13c (n=25) Q14a (n= 23) Q14b (n=3) 96% 96% 100% 83% 33% Took action to relieve your pain Q15a (n=25) Helped with toileting when you needed it Helped with eating & drinking when you needed it Helped with washing & dressing when you needed it Had enough time to spend with you Q15b (n=14) Q15c (n=13) Q15d (n=12) Q15e (n=20) 100% 93% 100% 92% 80% (d) Satisfaction with discharge arrangements Satisfaction with various aspects of discharge arrangements was reported as: Information provided regarding your discharge Q16a (n=26) Time given for you to plan for going home Q16b (n=26) Information provided regarding your medication before going home Q16c (n=26) Information regarding who to contact if you were worried about your condition / after you went home Q16d (n=26) Were you given an expected date of discharge Q16e (n=25) 96% 96% 100% 96% 100% Overall how satisfied were you regarding your discharge arrangements: Very Satisfied Satisfied Dissatisfied Very dissatisfied 73% 19% 8% 0%
The reason for dissatisfaction regarding discharge arrangements was recorded on one of the two questionnaires as follows: Before taking the bed from patients leaving that day, ensure that the paperwork and medications are at hand. Having relinquished my bed and called for transport, I then spent 2 hours sitting in a chair in the ward waiting for medication to be delivered from Pharmacy. I became tired and sore. (e) Overall experience during their stay in hospital Patients reported the overall satisfaction with their experience in hospital as: Very Satisfied Satisfied Dissatisfied Very dissatisfied 81% 19% (f) The most positive aspects of their stay on the ward Patients reported the most positive aspects of their stay on the ward as: Good staff, fun. Comfortable beds, food on demand. Clean wards and toilets. Very happy, was much better than expected. Staff were very helpful and patient. Rachel (1st year placement student) was very good considering her position. Operation quick, after care very good. Given my pain relief and staff being friendly. Staff and consultants were very efficient. Staff were polite and attentive. Staff always at hand and very informative. Very caring approach. Staff couldn't have done any more for me. A very comfortable stay. I have to say that everything was positive. I was very satisfied with my stay in hospital. The nurses, doctors and staff were very helpful and understanding. Appropriate and care of all staff. Staff were caring, professional and good humored. The friendliness and helpfulness of the nurses. All members of staff were extremely friendly and helpful which made me feel very comfortable during my stay. Staff friendliness. The staff were very helpful, even though they were always busy. Very professional in their approach. The ward was very clean. The I received for pain when required. I found all staff from admittance at A&E, Triage, on wards, both medical, auxiliaries and hygienists to be friendly and approachable, particularly the student nurses, very professional. The help I got from all the staff. The service was excellent. Staff. How clean the ward was kept at all times. Food, nice menu, food hot and enjoyable. Improvement not applicable. Staff were lovely at all times. I felt very welcome and comfortable. Friendly caring staff, very clean. Staff on admission ward super friendly and informative, made me feel at ease. All the staff were very kind and caring.
Friendly and helpful staff. Friendly staff, made you feel welcome. Care and attention by all staff. (g) Suggestions for improvement Before taking the bed from patients leaving that day, ensure that the paperwork and medications are at hand. Having relinquished my bed and called for transport, I then spent 2 hours sitting in a chair in the ward waiting for medication to be delivered from Pharmacy. I became tired and sore. More beds. The only thing I wish to state I was advised by Doctor I would need to stay until lunchtime but because of shortage of beds, I was out of bed at 11.30 and had to sit in TV room. Although 6/7 days later I was in extreme pain and went back to the ward (3 South), and was very disappointed, I could have collapsed and it would have been no-one's problem. I was sent here, there, everywhere until eventually I went back to GP Out of Hours Clean toilets more often. Staff on ENT ward not as friendly especially with family members who are only concerned. Extra staff. Staff were under staffed, no time, always rushing. More funding from Health Minister to promote and supply nurses, doctors etc. Ulster fry for breakfast - no more rubberised toast, apart from that, the service is excellent. (h) Ease of completing the Patient & Client Experience Standards questionnaire Very easy Easy Not easy 84% 16% (i) Compliments and Complaints Compliments received for 3 South: June Sept 2010 30 boxes of chocolates 20 cards Complaints received April June 2010 No complaints
(j) Action Plan Action Plan Issue Identified Action Planned Responsibility and timescales Staff Introduction & Explanation. A common theme is re mixed sex wards. Although wards are mixed, bays are not. Patients complaining re being discharged too early (ie asked to vacate their bed) An explanation was given for this (PFA Targets).
Patient Satisfaction Survey - Report Trust: Southern Health & Social Care Trust Ward: Male Surgical, Daisy Hill Hospital Quarter Ending: Sept 2010 Sample Size: 80 Return of Questionnaire: 15 Response Rate: 18.75% The following table outlines the patient experience on: a) Journey to hospital using the NI Ambulance Service (results to NIAS) b) Arrival on the hospital ward c) Each of five Patient and Client Standards d) Satisfaction with discharge arrangements e) Overall experience during their stay in hospital f) The most positive aspects of their stay on the ward g) Suggestions for improvement h) Completing the Patient & Client Experience Standards questionnaire i) Compliments and complaints for the ward j) Action Plan (b) Arrival on the hospital ward This section relates to all patients who completed a questionnaire. On arrival to the hospital ward, patients reported staff were: Welcoming Expecting you and prepared for your arrival Q6b Fully understanding of your condition / presenting problems Q6c Fully understanding of your personal circumstances Q6d Q6a 100% 93% 93% 87% ( c) The five Patient & Client Experience Standards : red, amber, green classification Respect Considered and respected your wishes Q7a (n= 15 ) Respected your religious / spiritual needs Q7b (n= 13 ) Treated you as an individual Q7c (n=15 ) Were you interrupted when or care was being delivering to you Q7d (n=2 ) 100% 100% 100% 2 Frequency of those interruptions Q7e (n= ) Occasional x 1 Frequent x 1 Was the reason for the interruption explained Q7f (n=2 ) 50%
Attitude Were welcoming Approachable at all times Showed a willingness to help Took time to listen to your questions or concerns Q8c (n= 15) Were caring & compassionate towards you Noticed when you were upset / distressed Q8e (n=15 ) Provided assistance when you needed it Q8f (n= 15) Q6a Q8a Q8b Q8d (n=15 ) 100% 93% 100% 93% 100% 93% 100% Behaviour Were polite & courteous Q9a Behaved in a professional manner Q9b Made you feel safe & supported Q9c (n=14) Called you by preferred name Q9d Provided enough information Q9e (n=14) Asked for consent before Q9f 100% 100% 100% 93% 93% 100% Communication Spoke in a way which you could easily understand Q10a Checked if you understood what they were telling you Q10b Listened to you Q10c Explained what was happening in relation to your Q10d (n=14) Involved you in decisions which needed to be made Q10e (n=14) Introduced themselves when you first met Q11 Information leaflet was easy to understand Q12a (n= 6) Info leaflet told you what you needed to know Q12b (n=6) 100% 93% 93% 100% 93% 80% 100% 100% Section: Involved you in the development of your care plan was not included in the questionnaire Privacy & Dignity Provided enough privacy when discussing / care and personal matters Q13a Maintained your privacy & dignity when examining you or providing care / Q13b Took steps to prevent you feeling embarrassed Q13c (n= 15) Was your bed in an area of the ward where male and female patients were being cared for beside each other (relates to sleeping accommodation only) No responses Q14a (n= 12) If yes, did staff give you the option to move to another part of the ward where male and female sleeping accommodation was not mixed Yes responses Q14b (n=2) 93% 100% 100% 75% 50% Took action to relieve your pain Q15a (n=14) Helped with toileting when you needed it Q15b (n=9) Helped with eating & drinking when you needed it Q15c (n=7) Helped with washing & dressing when you needed it Q15d (n=9) Had enough time to spend with you Q15e (n=14) 93% 89% 71% 100% 93% (d) Satisfaction with discharge arrangements Satisfaction with various aspect of discharge arrangements was reported as: Information provided regarding your discharge Q16a (n=14) Time given for you to plan for going home Q16b Information provided regarding your medication before going home Q16c (n=14) Information regarding who to contact if you were worried about your condition / after you went home Q16d (n=12) Were you given an expected date of discharge Q16e (n=13) 100% 93% 100% 100% 92%
Overall how satisfied were you regarding your discharge arrangements: Very Satisfied Satisfied Dissatisfied Very dissatisfied 86% 14% % % (e) Overall experience during their stay in hospital Patients reported the overall satisfaction with their experience in hospital as: Excellent (n=1) / Satisfied Dissatisfied Very dissatisfied Very Satisfied (n=12) 87% 13% % % The most positive aspects of their stay on the ward Patients reported the most positive aspects of their stay on the ward as: Nothing was a bother to all staff. Treated with the greatest respect. If it's not broke, don't fix it, perfect. Very homely environment, very clean, treated like a VIP, excellent. Treatment received, kindness and care of staff. Staff were excellent, worked very hard. Only the best and felt very comfortable throughout my stay. As I had never stayed in hospital, the way I was made to feel at ease by staff and the manner in which they dealt with my problem. With nothing to compare it to, the service seemed great. Friendly caring and approachable staff who cared for us the relatives as well as the patient. Answering our questions clearly in our language and taking time with us. We couldn't praise them enough. Friendly caring staff throughout. You couldn't possibly improve it. Very satisfied with my stay on the ward, everyone was fantastic towards me. Staff were friendly and helpful and always did their best to make sure I was comfortable. I have no suggestions for improvement. Very friendly and helpful staff. Cannot see any area it can be improved on! Very pleasant stay. Was very well looked after Nurses are always nearby. You couldn't improve, everything was perfect. Looked after me very well. Staff very pleasant, helpful and professional. The Nurses
(g) Suggestions for improvement Length of time waiting on the discharge letters needs a serious review - I personally waited over 7 hours on a letter! Discharge letters etc could be done quicker. Wasn't satisfied with after x-ray and scan, blood tests on day of arrival at A&E On second day of time in Male Surgical, 24 hours later finally was sorted, and there is a lack of communication from the doctors who was on duty in A&E. Be more aware of blood test results. Better communication from Senior Doctors. Talk with one, not at one. Wasted time on day of admission when they should have been operating. Televisions Personnel may need more money for their services and commitments. More staff on ward. (h) Ease of completing the Patient & Client Experience Standards questionnaire Very easy Easy Not easy 93% 7% How could we improve the questionnaire: HDU needs separate questions, staff in this unit were very. (i) Compliments and Complaints Compliments received for Male Surgical : June Sept 2010: 12 boxes of chocolates 18 cards Complaints received April June 2010 No complaints (j) Action Plan Action Plan Issue Identified Action Planned Responsibility and timescales Assistance with meals A common theme is re mixed sex wards. Although wards are mixed, bays are not.