Improving Patient Care & Experience (IPCE) in NHS Forth Valley Angela Wallace, Nurse Director Amy Joss, Patient Public Panel Member and Project Office for Action for sick Children
Overview Improving Patient Care and Experience in Forth Valley What it means to NHS Forth Valley The journey so far What Patients & Carers have been telling us Why we need both safe, effective and caring care What s next
Improving Patient Care & Experience in Forth Valley Improving Care Better Experience Best Practice Patient Treated as Individuals Safe, Clean, Comfortable Environment Engage & Involve Patients
What it means to NHS Forth Valley Top priority for NHS Forth Valley Commitment from: Board Level Across all services IPCE Framework to support & champion frontline staff to always put patients first Active engagement, challenge and leadership from Patient Public Panel Embedded within Clinical Governance
The journey so far Development Forth Valley Healthcare Strategy 2003 Refocus nursing & midwifery profession modern traditionalist Fundamental & essential patient care Public Consultation Building Patient Public Involvement Leadership, training & development Respect, dignity & positive behaviours New models of Patient Care Designing new acute community hospitals Ward Sister positioning & championing Develop, implement new model of care (TA) Measure patient experience Implement Liverpool Care Pathway Spiritual care development Patient stories Patient experience training events Patients & Public & Staff working together to reduce infection Patients & Public & Staff, food, fluid & nutrition Re-measure patient experience Develop other ways of capturing patient experience Communication, training & possible communication approaches 2007
The journey of involvement Public Consultation Building Patient Public Involvement Develop, implement new model of care (TA) Patient stories Re-measure patient experience Develop other ways of capturing patient experience: * equality and diversity* 2003 Designing new acute community hospitals New build committee Measure patient experience Patients & Public & Staff working together to reduce infection: Involving schoolchildren, visiting wards, reporting and re-visiting. Success Award: Consulting with service users in the stroke service. Next steps of Patient Panel. How to measure effectiveness? Changing and refreshing groups. Self leadership! 2007
Patients and the Public Experience of the NHS tends to occur at times when they are at their most vulnerable and emotional this heightens the intensity of their emotions and particularly their negative feels Strong feeling that these emotional needs were not always met by the NHS Patients describe feelings of isolation, overwhelmed by the experience, treated like a number, feelings of being afraid, anxious, lost in the system Source Department of Health November 2003
The Clinician cannot know the patient, the illness or the circumstances without true awareness of the patient experience (Cassell 1991)
What we looked at Safe, Clean comfortable environment Disturbed by noise Cleanliness Eating and Drinking Help with eating and drinking Better Care Staffing hand washing Immediate response to call buttons Staff go away and forget what patients have asked of them Staff working as a team Enough visibility of staff
What we looked at Informing and Involving Patients feel involved about decisions about their care Given answers they feel they can understand Feel if there is a variance in information from staff Opportunity to speak to medical staff Treated Individually Treated with respect, dignity maintained Privacy of environment Requiring spiritual care support Shared accommodation opposite sex
What Patients & Carers have been telling us Safe, clean comfortable environment Satisfaction rating with tidiness of room or ward areas 2006 90 2007 89 Satisfaction rating with cleanliness of toilets and bathrooms 85 86 Satisfaction rating with cleanliness of room or ward areas 88 90 Satisfaction rating with quality of food 62 67 Not disturbed by noise at night 52.9% 56%
What Patients & Carers have been telling us Best practice Satisfaction rating that staff worked well as a team 2006 92 2007 93 Satisfaction rating with overall care 82 83 Patients seen within 2 minutes of using a call button 79% 72.1% Observed that staff always or sometimes washed hands between patients 82.5% 87.2% Staff go away and forget what patients have asked of them 47.5% 46.5% Patients perception that there is rarely or never enough staff 12.9% 17%
What Patients & Carers have been telling us Informing and Involving Fully or partially involved in decisions about their care 2006 78.9% 2007 86.5% Feel they are always given answers they understand 67.1% 70.6% Often or sometimes given a variance in information 34.6% 34.4% Felt given the right amount of information 67.5% 75.5% Felt no opportunity for family to speak with a Doctor 4.2% 7.4%
What Patients & Carers have been telling us Treated individually Respect, Dignity and Diversity 2006 2007 Always treated with respect and dignity 76.7% 80.9% Curtains always provide adequate privacy when being examined or treated Always enough privacy when discussing condition and treatment Never require pastoral services 79.6% 67.9% 50.0% 79.8% 70.6% 49.6% Of those who wish pastoral services had opportunity to access these Felt staff had no time to their discuss worries or fears 49.5% 6.3% 47.5% 11.7% If Shared room/bay with opposite sex - assessment/itu area due to Initial - 69.2% Received help if need to eat meals 91.7% 95.2%
What s next Remains a top priority IPCE Framework unite staff groups Forth Valley committed to systematically gathering Patient & Carer Experience Developing other methods of gathering experiences Continue the Patient & Public involvement activity Using this information to drive service improvement Service improvement in areas that matter to the patients and public of Forth Valley Actively contribute to national approach
You will cope better because you know what to expect", someone once said to me.. I did not know what to expect I had never been a cancer patient before (Wesley Finegan 2004)