Paul Jebb Experience of Care Professional Lead Its all an Experience

Experience of Care improving patient experience on your ward: practical steps Always Events: setting out the events that should happen on your ward for every patient developing a responsive ward culture

Where we want to be! Where we are! How do you bridge the gap?

What is patient experience?

What makes a good experience?

The skills that every clinician needs How to connect with other human beings How to listen without controlling the conversation How to recognise, identify and respond to emotion How to respond constructively to difference, disagreement and conflict How to communicate in such a way that the listener understands and

Service excellence ‘Put emotional experience at heart of the healing process, not as an add-on’ Fred Lee ‘If Disney Ran Your Hospital’ (2005)

What is FFT? FFT is a real-time local feedback tool It has different characteristics from national surveys FFT Real-time Ward-level Effective for service improvement Can be used as early-warning system Not representative, not comparable National surveys Robust, comparable data at Trust level Data on a range of issues Suitable for performance management Not meaningful to front-line staff Has not historically changed behaviours FFT and National surveys are complementary sources of Insight FFT is a formative measure: it provides data to improve services National surveys are summative measures: they provide an accurate picture of relative performance

The Friends and Family Test Positive findings: FFT is making an impact 78% of Trusts reported that FFT had increased the emphasis placed on patient experience at their Trust FFT is being used mainly as a service improvement tool Provides feedback to frontline staff, often boosting morale Feedback is real-time and granular: it tells staff about what is happening in their ward Identifies problems and encourages action to be taken Not used widely for performance management Concerns over robustness of data, including comparability between trusts

Means nothing if nothing is done

Friend and Family Test - outcomes Soft closing bins have been purchased for inpatient areas as a response to patients feeding back that noisy bins kept them awake at night Comments regarding disturbed nights led to Introducing the ‘Quiet Protocol’ to help patients sleep well at night Environmental issues Mid Staffs NHS Foundation Trust Sandwell and West Birmingham Hospitals NHS Trust

After negative feedback, the Trust has introduced medication cards for patients who are off the ward during drug rounds to alert them that their medication is waiting to be dispensed "Was in pain on previous admission, felt ignored by staff" – comment led to self- medication programme - patients manage their own analgesic medication when they are in pain Medication issues The Royal Wolverhampton NHS Trust Friend and Family Test - outcomes

Improvement priorities

Priorities 16

Making sure everyone has a voice…

Through the Patients’ Eyes “Patient-centered care focuses on the patient’s needs and concerns as the patient define them.” Picker/Commonwealth Patient-Centered Care Program

Always Events ® Always Events ® are defined as “those aspects of the patient and family experience that should always occur when patients interact with healthcare professionals and the delivery system.” Institute of Health Care Improvement

The Five Aims of Always Events ® 1.Raise the bar on both provider and patient expectations 2.Introduce a new organizing principle to help galvanize action and accountability 3.Demonstrate how the Always Events ® concepts can be implemented in practice 4.Widely disseminate Always Events ® strategies for national replication 5.Energize and expand the movement toward a more patient- and family-centered health care system

Criteria for Always Events ® Important: Patients and families have identified the event as fundamental to their care Evidence-based: The event is known to be related to the optimal care of and respect for patients and families Measurable: The event is specific enough that it is possible to accurately and reliably determine whether or not it occurs Affordable: The event can be achieved without substantial capital expense

How might Always Events work in the NHS? Goal: “a consistent culture of compassionate care with patients’ interests at its very heart” Sir Robert Francis In a NATIONAL Health Service, what can patients expect always and everywhere in interactions with staff? And also staff with each other!

National core set + local Recognition (local decision) - transparent local feedback/ measurement National tools– with patients & professionals Local always events – with patients & professionals

What you said “Is there anything else I can do for you, or get for you, while I’m here?” and “Do you have everything you want to hand?” “Is there anything else I can do for you, or get for you, while I’m here?” and “Do you have everything you want to hand?” “Always gain better understanding of the person as the individual that they were before they became the ‘patient.’ “ “I will always explain my role in a way that is understandable to the person and take steps to be sure they understand” “Always use the person’s preferred name”

What will we be doing nationally? Identify tools to support you developing a core set of Always Events - with patients & professionals Identify pilot sites to test implementation and impact on improved experience of care Develop a strategy for spread and scale-up

17 April 2013 Derbyshire Healthcare NHS Foundation Trust Opening

Its in our gift…..

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