Outcomes of 10,000 Voices: Power of the Patient Voice on Quality Improvement SECOND REGIONAL SAS CONFERENCE 20 April 2016
It all starts with an introduction #hellomynameis Christine Armstrong Regional Lead 10,000 Voices
Introduction to 10,000 Voices Commissioned and funded by HSCB and PHA Patient focused approach to improving experience and shaping future health and social care Implemented across all 6 HSC Trusts 9 work streams to date, blends qualitative and quantitative data Provides evidence of quality, safety and effectiveness of care from patient perspective
Context The patient voice was not heard or listened to, either by the Trust Board or local organisations.. (Sir Robert Francis 2013) The patients voice should be heard and heeded at all levels within the organisation even when that voice is just a whisper (Don Berwick 2013) Safety Patient experience is at the heart of these reforms (John Compton 2012) Quality Experience
Aims of 10,000 Voices Initiative To improve patient experience To influence how services are commissioned Working in Partnership
Regional action plans and commissioning priorities Influencing Listening Person and their experience Stories (SenseMaker) Learning Trust action plans What matters to me Working together to make positive change Improving
Current work streams (all at various stages of information gathering and quality improvement) Unscheduled care including NIAS Experience of Nursing & Midwifery Care Care in Your Own Home Paediatric Autism and CAMHS Direct Access Physiotherapy (SET only) Adult Safeguarding Staff Experience Stories
Key outcomes Improvements in experience for people who use our health and social care services Integration of patient experience information into regional strategies/work Raising the profile of patient experience in NI Enabling staff to drive forward patient experience as an indicator of quality and compliance with standards Embedding the work on patient experience into practice.
Knowing what matters Information Having everything explained helped reduce my anxiety. I've great praise for the doctors approach Attitude and behaviour The doctor had a very nice way about him. Patient, kind to talk too. He didn't make me feel rushed. It was reassuring being kept well informed The doctor advised me when my review would be and what to do if I had any problems in the interim. my own GP is so helpful and kind and he takes time out to talk to me The doctor was patient and explained all to me. He was pleasant and talked calmly
Knowing what matters Feeling safe I felt well cared for and in safe hands. When you feel so ill and in pain that means everything! Being listened to The doctor I thought was easy to talk to and seemed to listen to everything I was saying I feel well looked after and in capable hands. They made me feel cared for and in professional safe hands. I am very confident in the care and treatment I received I thought the doctors taking care of me were lovely and good. They listened to what I had to say. The doctor didn't talk over me, I felt he listened to the answers I was giving. He showed patience and I felt I was in good hands - I trusted his explanations and advice.
Using 10,000 voices in quality improvements in patient experience I was not offered anything to eat or drink not even a glass of water Patient experience in EDs After X-ray I was left for a long time with no pain killers. I was in so much pain!! What doctors tell you sometimes doesn t make sense, sometimes I feel they don t listen Review of pain pathways Providing better information for patients Education, training, learning events, staff induction Your experience is our experience
Showing improvement: Unscheduled care 2016 Did you feel the department was. Well managed 84% stories located here DID YOU FEEL THE DEPARTMENT WAS..(unscheduled (80% in 2014) care 2016 ) 0.5 % stories located here (3% in 2014) Unsafe Haphazard 3 % stories located here (6% in 2014)
10,000 Voices: Working and learning in partnership: Voices of staff It s the simple things that make a difference. Be mindful of how you interact with patients, always introduce yourself. Always keep in mind how patients feel and your attitudes impact their perception Self-awareness, respect for patients. Treat each patient as an individual. Honesty and openness for patients. My own actions will affect the patients experience Communication is a key factor in delivery of good patient care. We need to focus on effectively communicating with patient and relatives, other staff and colleagues.
10,000 Voices informing regional work: Care at home I'm glad the Carers come in every day because they're the only people I see apart from a woman from the church who comes once a fortnight if she can. I do get very lonely but at least I can live in my own house. My health would be better if I had company. My experience of care is good but I am lonely.
10,000 Voices informing regional work: Dementia care..i know my dementia is going to get worse, so I feel safe that other people are around and can keep an eye. I feel there has been difficulties communicating with the medical team some of.the nurses have a poor understanding of how his dementia affects him. Before he passed away he had many trips to A&E. These would often upset his dementia, he was left on a trolley in a corridor for hours on end I believe there needs to be more support at home for carers and managing diseases and conditions such as dementia
10,000 Voices informing regional work: Dementia care Key themes Positive aspects of care supported living, sheltered accommodation, receiving care at home Skills and knowledge of staff Attitude of staff Not enough support/help at home/ inconsistency in care Long waits in unscheduled care areas
10,000 Voices informing regional guidelines: Voices of women (Midwifery Led Units) Felt safe all the time Felt safe didn t feel worried Very well looked after and monitored regularly My partner was kept up to date all times Water birth was a wonderful experience.. The midwives were fantastic I always felt vulnerable and unsafe It depended on who was looking after me
Recognising the power of the patient voice.. A core focus of the DHSSPS Guidance is on gathering people s feedback and viewpoints. This is reflected in related documentation, such as the HSCB/PHA PPI Strategy,148 the Regional and LCG Commissioning Plans, as well as existing consultative mechanisms. On the latter, there is, for example, the 10,000 Voices project, which gathers patient / service user feedback regarding their experiences
Recognising the power of the patient voice...although there is some very good practice, for example the 10,000 Voices initiative, which has so far drawn on the experience of over 6,000 patients and led to new pathways of care in pain management, caring for children in Emergency Departments, and generally focusing on the areas of dignity and respect.
Sharing outcomes: local and national The Florence Nightingale Foundation
In conclusion.. Redesigning approach to measuring patient and client experience and integrating PCE work Partnership working Engaging creatively with people Over 8500 stories to date Recurrent funding 10,000 Voices is a great way to listen to people thank you for listening to my story
Looking forward Build on successes More public awareness National/international links Continue to influence care with compassion and ensure that patient voices are heard and heeded at all levels of HSC organisations even when that voice is just a whisper
Thank you for listening to 10,000 Voices
Contact details Christine Armstrong - Regional Lead 10,000 Voices Email: Christine.Armstrong@setrust.hscni.net