Dorset County Hospital

Title of Project
The Side Rooms Project – Dorset County Hospital uses crowd sourcing to engage frontline staff in improving the patient experience of hospital side rooms.

Organisation
Dorset County Hospital

1.Introduction
Dorset County Hospital (DCH) is a modern, 333-bed hospital, with 7 main theatres and 2 day theatres and 50 side rooms. It provides the full range of general, acute hospital services including an emergency department and links with satellite units in five community hospitals and has 3,114 members of staff. The hospital serves a population of approximately 215,000 people.
Dorset is a medium-sized county with a smaller than average, sparsely distributed and mainly rural population. Over a quarter of the population is of retirement age (in the whole of England, this figure is less than a fifth). The population of Dorset has been growing faster than the national average, particularly in the older age groups in which long-term illness is more common.

2.Aims of the Initiative
This project used the experience based design approach (NHS Institute for Innovation & Improvement, 2009) to understand the experience of healthcare in side rooms from the patients’, carers’ and staff perspective in a deeper way. Working in partnership with the Local Involvement Network (LINks) in Dorset, DCH discovered that patients in side rooms often felt isolated, at times disorientated and didn’t always understand why they were in the rooms. DCH wanted to address these issues and make significant improvements by engaging the frontline staff who service the side-rooms in making improvements to the patient experience.

3.What was done?
DCH used a ground-breaking way of collecting and using ideas from their staff to improve how patients experience their services and is now implementing the ideas put forward.

Using innovative ‘crowdsourcing’ methods, the project empowered staff of all levels to act as patient ambassadors. Using a private social-media style website called ‘Patient & Family Echo’ they anonymously submitted ideas for improvement, and voted the best to the top.

The campaign asked cleaners, porters, doctors and nurses to submit their ideas on how to improve the patient experience in the side rooms. All ideas were treated equally, which can be a problem for more traditional engagement technique such as focus groups.

The campaign was promoted to 175 doctors, nurses and support staff who work with patients in side-rooms, who were asked:
What can we do to improve communication with our patients about their stay in the side-rooms?
What can we do to make our patients feel less lonely and isolated during their stay in the side-rooms?

The campaign ran for three weeks and during this time:
17 representatives from all clinical groups came together to suggest improvements based on their interactions with patients,
They collectively made over 150 contributions, around 19 specific, actionable ideas.
This campaign was delivered without any meetings or workshops, allowing the whole consultation process to be completed in a little over a month.

Having implemented the improvements, DCH has engaged a volunteer to monitor them and the patient experience. The campaign enabled the Patient and Public Experience Team together with the Infection Control Team and Dorset LINks to work with their colleagues across the hospital to make improvements.

4.What impact has the initiative made?
The ebd approach enables healthcare providers to ensure that what might have been seen as ‘little things’ in the past are an important part of the delivery of high quality care, and involves understanding the experience from the staff, patient and carers perspective.

During the project, all contributions were mapped against the QIPP objectives of Quality, Productivity and Prevention, showing how these objectives are being met. Specific improvements include:

Clocks with day, date and time are being put in every room.
The League of Friends deliver a free newspaper for every side room patient.
Estates and Facilities plan more imaginative colour schemes when they next redecorate.
In partnership with Hospedia, a communication was sent to staff on how to request free television for patients, based on clinical need.
The Infection Control Team reassessed and restructured the communications given to patients and carers to help them understand the reasons for their stay in the side rooms.
Piloted Intentional Ward Rounding
Engaged a volunteer to monitor the changes and impact upon patient experience.

The campaign also saw the submission of a number of smaller ideas which constitute best practice in daily activities (e.g. ways of speaking with patients). These ideas were not made into formal action plans, as we used the website to encourage participants to put them into action themselves.

5.What next and where can we find more information?
We are systematically using this process to engage staff in service improvement and decision making. Our second campaign engaged staff to share ideas for patient experience improvement around themes from the National Inpatient Survey. The Patient & Family Echo team worked closely with us during the first project to help us build a capability we can use on our own. As we continue we will seek to identify groups of staff that have not engaged, understand the reasons why and try to encourage them to do so.
This campaign was widely publicized through CEO and Trust briefings, Sisters and Matrons meetings and the local press. The project was written up in full and available on the Trust intranet site. Reports were made to the Learning from Patients Committee, Trust Board, PEAT Committee and Infection Control Team meetings. Individual frontline staff were invited to participate in the campaign via their Trust email addresses. The campaign was publicized through the Dorset Echo, HSJ, Patient Feedback Challenge Website and Patient & Family Echo/Clever Together Website.

http://www.dorsetecho.co.uk/news/10456669.Hospital_staff_share_knowledge_to_improve_patient_experience/

http://clevertogether.com/public/case-studies/dorset-case-study/

http://www.hsj.co.uk/dorset-county-hospital-crowdsources-improvements/5060040.article

6.How might the initiative be relevant to other groups
Service improvement:
improve the experience of patients and their families in healthcare
drive efficiencies and increase quality
create more integrated and motivated workforce
more joined-up working with partners and suppliers

Robust, transparent strategies with buy-in from the off-set:
capture the collective wisdom of staff and stakeholders to inform strategic choices
use staff and stakeholders as a test bed for tactical ideas to drive action, fast

Patient & Family Echo was part of The Patient Feedback Challenge, and supported several NHS Trusts in running campaigns. The NHS Patient Feedback Challenge, created and managed by the NHS Institute and funded by the Department of Health, was a one year programme designed to find and spread great approaches which use feedback from patients to improve services.

http://pfchallenge.clearvale.com/pg/groups/27985/patient-and-family-echo/

http://pfchallenge.clearvale.com/

7.What do you feel makes this initiative special?
Service Quality: Turns patient feedback into service improvement, quickly and transparently.
 
Staff Motivation: Helps staff feel engaged and valued, by giving them a voice in service improvement.
 
Compliance: Embeds a systematic approach that empowers staff to share insight & concern with leadership, anonymously.

8.Learning points
Go for it! Until you try something out you don’t know how it’s going to work in your organisation. Some of our campaigns have been more successful than others. It is important to communicate and publicize the project, throughout the campaign, so when you start one be prepared to set aside time for this aspect.

9.Materials for Sharing
Tools and resources about the ebd approach are available at www.institute.nhs.uk

http://www.institute.nhs.uk/quality_and_value/experienced_based_design/the_ebd_approach_(experience_based_design).html

Tools and resources for the Patient & Family Echo are available at www.clevertogether.com

http://clevertogether.com/public/patient-family-echo/