Using Technology to Improve Patient Feedback and Patient Experience

Using Technology to Improve Patient Feedback and Patient Experience

Nottinghamshire Healthcare provides integrated healthcare services, including mental health, learning disability and community health services. It employs over 8800 staff from over 100 sites. It has an income of £435 million.

The Trust aimed to be the most open and responsive organisation in the NHS and to help do this they wanted to develop their own publicly accessible patient experience website. They wanted to be the first NHS organisation to make all their feedback visible to the public and Trust staff whilst making it easier for staff to respond.

They successfully applied for funding from the £1m NHS Patient Feedback Challenge. They used some of the funding received from the Challenge to develop their own feedback website where people could leave and view feedback from the variety of sources they use.

With the enthusiastic support of the Board the Involvement Team launched their Feedback Challenge project in September 2012. The team led a transformational and ambitious programme to:

  1. Develop ten teams across the Trust’s three Divisions to become beacons of good practice for all aspects of patient feedback and to spread this to other teams.
  2. Create a patient experience website that is public, accessible, improves accountability and drives change

To develop the website two design workshops were run in November 2012 one for service users, carers and frontline staff and the other for managers. These were to gather what people wanted from a Patient Experience Website and to seek advice on its design.

The website was developed over five months, during which they tested versions with service users, carers and staff. It was refined into a site that meets the needs of both staff and the public, with five distinct sections:

  1. Home page – with the most recent survey results, latest Patient Opinion postings and changes teams have made in response to feedback
  2. Leave Feedback – where people complete the survey, tell their story via Patient Opinion or find contact details to speak to the organisation directly via PALS
  3. View Feedback – see reports with survey results and all the comments received for each team. A custom search with the ability to interrogate the data in many ways including looking at the experience of different communities.
  4. What we’ve done – where Nottinghamshire Healthcare teams post changes they have made in response to feedback
  5. Learn More – where people can see patient experience case studies, videos, resources and how to get involved.

It can be seen at: http://feedback.nottinghamshirehealthcare.nhs.uk and can be viewed on PC, iPAD, Smartphones and there is a QR code for the site.

The Feedback Matters website has already had a significant impact and made a difference to how people use and respond to feedback. The usage of the website is increasingly rapidly from 17 unique visitors in April to 601 in October 2013 and now 1608 unique visitors to the site with over 13,000 page views.

The site has already made a difference to staff enabling them to see all the feedback about their team or service at any time online. They can see graphs and trends from the survey, all the comments received (analysed by theme) and all Patient Opinion stories about the Trust. This has opened up feedback to all staff through the ‘View Reports’ section.
http://feedback.nottinghamshirehealthcare.nhs.uk/reports

The initiative has had a wider impact, increasing the number of survey responses by 43% to 13 671 in the last year. Over 14 500 comments have been received, analysed by theme, and are visible to staff and public on the website.

The number of Patient Opinion postings has increased by 48% to 401 stories in the last year, as well as increasing the number of service changes from 20 to 31 on the site. In addition, the Trust’s Service Quality Rating has increased from 88% over the year to September 2012 to 90% in the year to September 2013.

The increased focus on responding to feedback has meant teams have taken action on a whole range of issues. Over 35 changes are recorded on the site these can be seen on the ‘What we’ve Done’ Section of the Nottinghamshire Healthcare website: (http://feedback.nottinghamshirehealthcare.nhs.uk/service/what-weve-done) Many more changes can be seen in the Annual Involvement Report 2012/13 (http://feedback.nottinghamshirehealthcare.nhs.uk/learn-more/resources/annual-involvement-report-2012-13).

New online seminar: The Power of Co-Production

I’m writing to invite you to a new online seminar we are holding on Friday 7 March at 10.30am. The one hour seminar reflects on how Hywel Dda University Health Board involved service users in a quality improvement project and the real difference it made.

The Power of Co-Production’ focuses on the NHS Wales award-winning project which involved improving way finding and signage at Withybush Hospital.
During the seminar, you will:

  • Find out how you can apply a citizen-centred approach to your work and develop wider partnership working.
  • Discover how service users and staff worked together to develop a solution to a problem.
  • Understand the importance of continued engagement to test and improve the solution.

Members of the team will share their whole hospital approach. The work was shaped and delivered by a group of adults with learning disabilities, Siarad Iechyd/Talking Health members, the Community Health Council, outpatients’ user group, hospital staff and the hospital estates department.

Martin Semple, a member of the judging panel, said: “The project put citizens at the very centre of redesigning signage to ensure when they visit the hospital they can get to the department and service they need. It shows that citizens can make a huge contribution in designing services in the NHS.”

I hope you’re able to attend and perhaps encourage other members of your organisation to join you on Friday 7 March, from 10.30 to 11.30am.

And because it’s a free online seminar, there’s no need to travel – you just need a phone and a computer.

Further details can be found in the attached leaflet and you can book your place on the seminar at www.1000livesplus.wales.nhs.uk/co-production.

Should you have any queries, please don’t hesitate to contact me.

Regards

Karen

 

P.S. You may also want to arrange for a ‘hub’ in your organisation so a group of colleagues can attend the seminar together.

 

*You may receive this email more than once if you are a member of more than one of the networks supported by 1000 Lives Improvement service.

Karen Field

Rheolwr Labordy Dysgu a Rheolwr Gwobrau GIG Cymru, 1000 o Fywydau – Gwasanaeth Gwella, Iechyd Cyhoeddus Cymru, Ty Arloesi, Ffordd Pen-y-bont, Llanharan CF72 9RP

Learning Laboratory Manager & NHS Wales Awards Manager, 1000 Lives Improvement Service, Public Health Wales, Innovation House, Bridgend Road, Llanharan CF72 9RP

 

Ffôn/Tel:01443 233347   WHTN: 1754 4847

Ebost/Email:karen.field@wales.nhs.uk

Gwasanaeth llyfrgell am ddim i’r GIG/y sector Cyhoeddus/y sector Gwirfoddol / Free library service for NHS/Public/Voluntary sector staff

Dilynwch @gwobraugigcymru ar Twitter i gael y newyddion a’r wybodaeth ddiweddaraf

Follow @nhswalesawards on Twitter for the latest news and updates

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: l.blunt@patientexperiencenetwork.org

Central Manchester University Hospitals NHS Foundation Trust

Promoting High Quality Care and Dignity For All Deceased Persons (Adults) And Their Families

case-study-januar

Central Manchester University Hospitals is a large teaching hospital located in Manchester city centre comprising five specialist hospitals providing health care to a diverse population. It treats more than one million people per year. On average, there are 1200 adult deaths per annum. The Trust adult mortuary also provides a City mortuary service to care for a further 1200 deceased persons who have died in the community.

The death of a person causes distress to the deceased person’s family and loved ones so it is essential to manage all aspects of their care sensitively. Review of local practice highlighted the lack of formal guidelines and policy to support best practice for deceased persons and their families. Standards of care after death were found to differ not only between but also within clinical areas, and the need for change was identified.

The purpose of the initiative was to promote high quality, dignified and standardised care for the deceased person and their family following deaths occurring both within hospital and community settings. During their journey to the adult mortuary with the porters, care within the adult mortuary concluding when the care of the deceased person is transferred to the funeral director.

Current practice within the organisation, including incidents and complaints to capture family/carer and professional feedback was scrutinised together with relevant local and national guidance. Consultation within and beyond the organisation was key to understanding the entire care in a variety of settings as well as to recruit support, and for promotion. A Macmillan Palliative Care Nurse Specialist led a multi-professional policy development group.

A comprehensive new policy with organisational ratification was developed. Supporting documentation was developed incorporating new requirements in addition to those of pre-existing policies. Standardisation of care and the processes to follow was a key driver. The new policy was embedded into organisational practice through a three-month multi-disciplinary education programme delivered by the lead and the End of Life care facilitator.

The initiative has enabled current practice to be challenged and has resulted in a huge organizational change in practice and culture. Clinical practice is now evidence-based with a huge focus on high quality and dignity. Trust staff started to question their own individual practice but also their team’s approach to this aspect of care, having previously delivered care embedded in a ritualistic approach.
As a result of this work, both clinical and non-clinical staff have received training with specific feedback from bereaved families and evidence from national guidance to gain a clearer understanding of the importance and rationale to deliver dignified care. This incorporates the promotion of personal, religious, and cultural wishes in care after death; considering family involvement; and the improvement of communication ensuring consistency in language to maintain quality and dignity. Staff fed back that they had never received formal training in this aspect of care and this has enabled them to reflect on their practice.

The initiative is special as it has given an aspect of care that is so important the opportunity to be high on the Trust agenda. It has challenged opinion and aspects of care that were grounded in tradition and ritual, and has striven to ensure that regardless of which area a person has died in that they will receive high quality and dignified care.

The initiative also provided all Trust staff who care for the deceased person with clear guidance of the process and procedures to follow after a death, and formal, standardised training including staff groups who do not routinely receive such training including porters and administration/clerical staff. Over 600 Trust staff received formal training delivered in small groups to allow interactive teaching in a protected environment.

Professional and carer feedback has been extremely positive, with many staff wishing to support the initiative in the future by becoming champions and contributing in the audit process.

Learning Points

  • Identifying an appropriate lead that is dedicated, passionate, and determined is paramount.
  • Key attributes of members of the working party included commitment and compassion. Collaborative working and elicitation of family and professional views, as well as the incorporation of national guidance is essential.
  • Employment of a variety of promotional activities as well as ensuring compatibility with the organisation’s ethos/principles is necessary to secure commitment of both clinical and strategic levels within the Trust.
  • The use of real examples from practice within training helped staff understand the real needs of deceased persons and their families and the rationale behind the required care.
  • An awareness of the enormity of such a project is vital; one must be prepared to uncover more areas for consideration than initially anticipated.

Patient and Public Engagement Conference

Friday 7th February 2014, London

The Tavistock and Portman NHS Foundation Trust is hosting a Patient and Public Engagement Conference on Friday 7th February 2014 on behalf of the Mental Health Patient and Public Involvement Forum. The Forum is a network of PPI representatives from all the mental health trusts of Greater London and the Home Counties who meet regularly to learn from each other, share examples of user engagement and speak as a united voice to policymakers to influence change.

The conference is for service users, carers and other professionals who are interested in learning, understanding and developing their thinking and practical skills around providing good practice in mental health settings in relation to service user involvement. Angela Greatley, Chair of the Tavistock and Portman NHS Foundation Trust, will be opening the conference and the day will begin with a talk from Baroness Molly Meacher of Spitalfields on the subject of ‘No Health Without Mental Health’. As well as some stimulating and lively talks throughout the day, there will be some practical workshops available for delegates to attend and to gain some further insight into providing good practice in patient and public involvement. Each workshop will be interactive and encourage delegates to share and discuss their personal experience of service user involvement. The day promises to ensure that service users can genuinely engage with staff in order to properly influence service delivery.

For more information about this conference, please click here to view the conference programme. The conference is free for service users and carers to attend, and £50 for staff and other professionals. Professionals are encouraged to attend with a user.

You can also learn more about the conference and what the day offers by clicking here.