 Friends and Family Test (FFT) -single question ‘would you recommend…’  The Adult National Inpatient Survey (AIPS) - AIPS uses validated questions based on the Picker survey carried out annually by every hospital and results published by CQC - Survey is posted to the patient after discharge - retrospective - Potential bias of respondents - provides no feedback to teams or wards  Local schemes – may not be validated

 Bell et al Good patient experience can independently improve clinical outcomes and safety  Sullivan et al Identified the relevant questions from AIPS applying to AMUs -Established the national average (NA) for each question and compared AMU scores to other wards and specialties  RCP Future hospital Commission recommendations

 Series of recommendations considered to be best practice  ‘Embed patient experience in service design and delivery’  ‘Develop mechanisms for measuring patient experience on an ongoing, structured and real-time basis, and publish the results in the public domain’  ‘Patient experience: The patient should be the definitive focus of healthcare delivery’

 Measure the patient experience on an Acute Medical Ward using a validated questionnaire  Assess it’s ease of use and ability to identify areas for improvement  To assess the advantages and limitations of this questionnaire on an Acute Medical ward  Comply with RCP recommendations  Compare results with national data QI project

 Conducted on Grantham and District’s 28 bedded AMU (~15 admissions/day)  Used the AIPS validated questions from the Sullivan paper 22 validated questions in 4 domains: - Doctors - Nurses - Medication and discharge - Overall impression and comments section  PALs department volunteer  ‘Fresh’ data obtained at the point of discharge  Compared with local and national data

Included  Medical patients  Admitted AND discharged from unit Excluded  Cognitive impairment  Severe psychiatric disorder  Patients transferred from another hospital or transferred to a ward

 3 week period in May 2015  32 responses – 100% return rate  M=F ratio  Age range  Median length of stay 2-3 days  Included weekday and weekend discharges

 100% of patient felt treated with respect and dignity (NA* 76%)  100% had trust in the doctors and nurses (NA* 74%)  95% rated the unit good or excellent  18 questions scored equal to or higher than NA *NA refers to national average scores published by Sullivan et al 2013.

 63% given sufficient information about their treatment (*NA 74%)  56% of patients felt they were given clear printed information about their medications (*NA 62%)  19% of patients felt the nurses spoke over them (*NA 19%) *NA refers to national average scores published by Sullivan et al 2013.

 Validated questionnaire  Results directly relate to the care individuals and teams deliver  Individual consultants and senior nurses can directly monitor their own and teams performance  Allows direct targeting to improve areas of concern  Easy to use on any AMU  Tool which could explore other aspects of care (eg. Measure weekday vs weekend experience )

 Small survey  Volunteers may have administered survey prior to ‘completed discharge’ which can affect results  Comparison data was done by post after hospital discharge and there may have been a selection bias

 We used a validated questionnaire to measure the patient experience on an Acute Medical ward  The questionnaire was easy to implement and analyse with minimal resources  The questionnaire identified areas of good practice and areas of concern  It allowed results to be compared to local and national data

 Royal college of physicians future hospital commission – March 2012, published January 2013  Care quality commission national inpatient survey 2014/15 ULHT data published online  Sullivan, p; patient experience: what does it mean for an acute medicine consultant?, J R coll physicians edinb, 2013; 43(suppl 20):12-15  Sullivan et al the quality of patient experience of short stay acute medicial admissions: finidings of the adult inpatient survey in England. Clinical medicine 2013; vol 13 no 6:  Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013;3:e  Reeves R, Coulter A, Jenkinson C et al. Development and pilot testing of questionnaires for use in the acute NHS trust inpatient survey programme. Oxford: NHS Surveys, DevelopmentInpatientQuestionnaire.pdf [Accessed 7 June 2013].  Cleary PD, Edgman-Levitan S, Roberts M et al. Patients evaluate their hospital care: a national survey. Health Aff (Millwood) 1991;10:254–67.

 Presentations to medical and nursing staff with follow up presentations to reaffirm message  Poster Campaign ‘GrEAT Wardround’  Tried to introduce a new discharge summary checklist that encompassed a lot of the information patient stated they didn’t get on discharge