Liverpool Heart and Chest NHS Foundation Trust

The Development of a Nursing Model of Care for Patient and Family Centred Care

Liverpool Heart and Chest NHS Foundation Trust

Liverpool Heart and Chest Hospital became a NHS Foundation Trust in December 2009 and provides heart and chest services for the North West of England, including North Wales and the Isle of Man. Each year they perform 60,000 Outpatient appointments and 12,000 inpatient procedures covering: Cardiology, Heart Surgery, Thoracic Surgery, Upper Gastrointestinal Surgery, Respiratory Medicine (including Adult Cystic Fibrosis) and Cancer Services. This case study was the overall winner in the PEN National Award 2013

Aim – The aim of the initiative was to improve the care experience of patients and families, testing out a number of work-streams:

Care partners: optimise the involvement of families in delivering and supporting patient care. Involvement includes communication and education, providing emotional and spiritual support, physical care e.g. giving drinks or hygiene needs and safety advocate.

Patient & Family Centred Care (PFCC) handovers: to involve the patient and family as communication partners at the handover, on transfer, from the critical environment to a surgical ward.

Care Contract: empowering and engaging patients and families to work in partnership with healthcare staff. This is a tool to engage patients, families and staff to discuss patient preferences and choices and for healthcare staff to deliver key information to support patients in decision making about their care.

Ward rounds: an agreed structure to the scheduling and format of patient and family centred ward rounds to promote effective communication and involvement of the patients and families with the clinical staff.

Healing environment
A new 20-bedded surgical ward designed with patients and families, incorporating a family room, 12 single rooms and two four- bedded bays. It was designed to “feel like a hotel” and comments from patients and their families reflect this. Seven of the twelve individual rooms have a pull down bed for family members to stay with their loved one during what is a most anxious time for them. Other rooms have reclining chairs to maximise comfort for family members.

The outcomes for the project were summarised as follows:
Families are consistently involved in the care of their family member with the support and guidance of the nursing team. Family members are enjoying the new facilities and being able to stay overnight in the patients’ room has resulted in a reduction in anxiety levels of the families.

Easy access for families has created a calm and welcome environment on the ward with families seen as integral to the care team. Families work consistently with staff to support safe and effective care, providing encouragement with mobilisation, hydration and nutrition, education advocate, listening to and supporting the advice of health care team, providing emotional and spiritual care, reading and also as safety advocate ensuring patients have their buzzer and personal possessions at hand.

Staff report how the flow of delivering care is improved throughout the day as the peak visiting times are no longer apparent. Patients are less disturbed by ward activity and are better rested. Patient and family shadowing has demonstrated how reassured they are, that they know how their care is progressing and actively participate in bedside handovers and ward rounds.

For more information contact Louise Blunt at PEN: