Patient Experience Feedback Renal Medicine - Dialysis Overall there was a very positive experience from all those surveyed Some very strong common themes ran throughout all respondents (see below), with some interesting suggestions for quick wins and quality service improvements Whilst there were some differentials between the purple and orange units, they were not significant or consistent throughout all respondents. But there was an overwhelming sense of us and them resulting in one patient suggesting that the units need to be mixed up more and integrated (presumably this will be addressed within the new unit) There were a few minor differentials between the time slots in that the afternoon session seemed to have to wait much longer than either the morning or evening sessions, due to machines not being cleaned and ready for the allocated appointment times. This needs addressing as a priority. 1. Did you arrive by pre-booked hospital transport today? 13 (65%) Yes 7 (35%) No 2. If Yes please tell us how this was (including how long the journey took, was it on time, was it comfortable etc?) The majority of patients surveyed (65%) had arrived to the unit via pre-booked hospital transport. Of those that did arrive by this method ALL (100%) had had a somewhat negative experience of lengthy waits for transport to bring them to and take them home from the unit. All agreed that patient transport made a huge contribution to their overall experience of visiting the unit. Instead of coming straight here, goes round Monton, even though all patients are in Would sooner walk than wait on transport it would be quicker!!! Waiting around for 90 minutes for them to turn up Have used transport in the past but kept waiting sometimes into the middle of the night would rather pay 100 pr week in taxis than put up with the messing about The timings are always so different usually takes 90 minutes for what is just a 20 minute journey Sometimes waiting around 2 3 hours after coming off dialysis Terrible takes far too long to get here. Driver goes the long way round to increase his mileage claim!!!!! Arrive 2 hours before appointment time Always here nearly an hour before the unit opens have to wait in the corridor It s alright getting here it s getting home that is the problem usually still in unit 2 hours after I ve finished dialysis 3. Were you asked by what name you would like to be known by? 19 (95%) Yes 1 (5%) No 4 How long after arriving at the unit did you wait to start your dialysis?
All patients surveyed had to wait after their allocated appointment time before they were put on the dialysis machines. Of those that specified a wait the average wait was more than 60 minutes, with those on afternoon sessions waiting longer than any others due to machines having not been cleaned and made ready in time. All of these patients found this unacceptable 50 minutes Today just 20 minutes but have waited upwards of an hour, depends on the staffing levels Had a 1pm appt but didn t get on until 2.25 as the machine wasn t ready but then they never ever are why have appt times when they know machines aren t going to be ready Over an hour (but sometimes 2) 5. If you had to wait did anyone tell you why you were waiting, or how long you might have to wait? (please include whether or not you minded waiting) Patients were not informed of how long they might have to wait or indeed why they were waiting. All would have liked to have been kept informed. Ongoing problems with staffing levels was often given as an excuse, resulting in some patients believing that the unit is permanently understaffed due to a costcutting exercise. Many patients suggested that the waiting room facilities are not adequate (very hot, over-crowded), whilst other were left to wait in the corridor due to the waiting room not being open at appropriate times for transport arrivals. Waiting room should be made available for patients arriving by hospital transport to use. Many patients felt that the wait made them anxious, frustrated and sometimes depressed. No, but don t mind the waiting as unit is short staffed Always short staffed, so always have to wait around not good Because I drive myself, I can time it just right so rarely have to wait Always the same excuse that they are short staffed and there is a backlog hate waiting around Would be good if the machines were actually ready for the allocated appointment times Hate having to wait around in the corridor they should at least let us in the waiting room No one ever explains why we are waiting or how long just have to wait and wait wouldn t be so bad if someone had the decency to explain Never told always given excuses that they are short staffed or changing shifts Waiting room so small and stuffy if you re allowed in it! Seem to be different priority systems between the two units Orange unit is better as I get on quicker No and it s very frustrating when you are just left waiting 6. Did the staff who cared for you explain what would happen during your dialysis in a way that you could understand? 12 (60%) Yes, completely 6 (30%) Yes, to some extent 2 (10%) No explanation was needed Don t always understand but it depends on the member of staff Don t have time to tell you anything, because always short staffed Explain but not in a way that makes sense to me I m not a nurse so don t
always understand the words they use 7. Did the staff who cared for you treat you with dignity and respect? 19 (95%) Yes, completely 1 (5%) Yes, to some extent explanation was needed 8. Did you have confidence and trust in the staff who cared for you? 13 (65%) Yes, completely 7 (35%) Yes, to some extent explanation was needed Overall there was a great deal of confidence and trust placed in the clinical staff. Depends on the member of staff some of the younger, less-experienced staff have no idea what they are doing 9. Please tell us how you were made to feel on the unit (please include your perceptions of the atmosphere, how staff treat you, safety, other patients, privacy etc) Overall patients found the units very welcoming and comfortable. However there were some comments about the overall noise levels (ie TVs, radios etc) and a lack of respect from some individuals. Many patients felt that the surroundings could be made a little more comfortable (ie chairs, soft furnishings, daylight etc), but all hoped these things had been taken into account when developing the new unit in the Hope Building. Some patients felt that the long waits to get on the machines often had a negative impact on the atmosphere in the unit. And some patients felt the staff could play a bigger part in improving the atmosphere on the unit, particularly amongst the patients. Very good Feels comfortable Very welcoming and relaxing Sometimes quite noisy Can feel quite isolated The waiting gets everyone down and affects atmosphere on unit It s ok but sometimes the staff can be unsympathetic and impatient sometimes even insulting and rude! Sometimes made to feel second-rate when patients turn up late and are fast tracked onto their machine and you re just sat there waiting without explanation Tv s could be a bit lower, can t really relax have to shout Not enough privacy Prefer to sit in a chair than a bed it s more relaxed and comfortable Mostly welcome but some of the nurses just talk over you and chitter-chatter amongst themselves and ignore you 10. Does this change from day to day, week to week? If Yes, how? Overall patients felt that the atmosphere remained consistent from week to week with occasional differentials based on staffing levels and stress on the unit. There was a differential between the Orange and Purple Units, with those that have experienced both stating that the Orange Unit doesn t seem as friendly. Both units need to be providing consistent and comparable care and to this end, staff should be mixed around to ensure consistency. Somebody different puts you on machine each day would be good to have continuity Changes dependent on which nurses are on
Depends on the staff Atmosphere is much worse when the nurses are stressed, and they make you aware of this Can very from day to day sometimes too noisy with tv and radio from other patients who have no respect for anyone Staff always seem under pressure Some staff are more patient-focused than others Staff on orange unit aren t as friendly and don t seem as happy Seems to be a them and us atmosphere between staff on the different units even to the point they bicker with each other 11. What one thing would you change about the department to improve your experience? Most patients were happy with the care they received and wouldn t change anything, other than having more staff to decrease the often lengthy waiting times. Transport was a major factor here, for all those that arrived this way transport can have a negative impact on the overall experience and therefore becomes the overriding factor. Noise levels were a common theme, with suggestions of more private spaces and use of headphones for TVs and radios. Some suggestions around staff training to ensure that patients are not waiting round for just one single member of staff that is able to use complex equipment. Staggering of appointment times could reduce waiting times, especially for afternoon sessions where it is unfeasible that all machines are cleaned and ready for the same time following lunch. This was a major bugbear for most respondents in the afternoon cohort. Transport waiting is always a pain No privacy curtains are not enough The waiting for 4 hours dialysis, always here about 5 ½ hours should be off and on in a more timely way would be much better for everyone Waiting around causes anxiety and depression Would like to be in a private room on my own because it gets far too noisy so can t sleep or relax Very happy would change nothing More relaxed atmosphere can seem quite hectic Need more staff so can get on, on time, or at least stagger the appt times That the staff were more patient with patients! More staff More single cubicles, thus more privacy Too noisy Wouldn t change a thing Staff more approachable don t like to ask for simple things like going to the toilet Privacy Ward management needs to be more robust at dealing with noise Free Wi-Fi Speed up the time here (ie no waiting, smoother transport etc) Newer machines All staff should be trained on all machines sometimes I have to wait for a particular member of staff that knows how to use the Sonsonite Make sure the staff know where to put the needle need more training Better transport to reduce waiting times Staff having the time to talk to you Sick of waiting around in corridors why don t they open the waiting room? Mix the units up so everyone gets the same quality of care Have used dialysis in other countries whilst on holiday and they get you on
within 5 minutes of your allocated appointment time why can t they do that here? 12. Are you 9 (45%) Male 11 (55%) Female No differential identified 13. Age Cross section no differentials between age groups 14. Ethnicity Cross section no differentials between age groups