Improving Patient Care

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Improving Patient Care Experience (IPCE)in NHS
Forth Valley

• Angela Wallace
• November 2007

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Overview

• Improving Patient Care and Experience in Forth
  Valley
• What it means to NHS Forth Valley
• The journey so far
• What Patients have been telling us
• Delivering on what the patients have asked of us
• Why we need both safe, effective caring care
• Whats next

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NHS Forth Valley Patient Experience Framework
 
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What it means to Forth Valley

• A strategy framework for patient focus
  Improving Patient Care Experience
• Patient care and experience NHS Forth Valley
  top corporate priority
• Executive Director leadership
• Focus on action across areas important to
  patients, carers and public
• Respect, dignity and individuality
• Safe, clean comfortable hospital environment
• Food, fluid and nutrition
• Communication

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The journey so far
Building Patient Public Involvement
Patient experience training events
Re-measure patient experience
Develop other ways of capturing patient experience
Public Consultation
Development Forth Valley Healthcare Strategy
Patient stories
New models of Patient Care
Measure patient experience
Designing new acute community hospitals
Patients Public Staff, food, fluid nutrition
Develop, implement new model of care (TA)
Leadership, training development
2003
2007
Refocus nursing midwifery profession modern
traditionalist Fundamental essential patient
care
Communication, training possible communication
approaches
Respect, dignity positive behaviours
Patients Public Staff working together to
reduce infection
Ward Sister positioning championing
Implement Liverpool Care Pathway Spiritual care
development
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• Patients and the Public Experience of the NHS
  tends to occur at times when they are at their
  most vulnerable and emotional this heightens the
  intensity of their emotions and particularly
  their negative feels

Strong feeling that these emotional needs were
not always met by the NHS
Patients describe feelings of isolation,
overwhelmed by the experience, treated like a
number, feelings of being afraid, anxious, lost
in the system
Source Department of Health November 2003
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Systematically understand act on our patients
experiences

• Acute Hospitals 2006
• Patients Stories
• Acute Hospitals 2007
• Maternity Services 2007
• Acute Hospitals Out Patient Services 2007
• Community Hospitals in planning 2007/08

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What we looked at

• Safe, Clean comfortable environment
• Disturbed by noise
• Staffing hand washing
• Cleanliness
• Eating and Drinking
• Better Care
• Help with eating and drinking
• Immediate response to call buttons
• Staff go away and forget what patients have asked
  of them
• Staff working as a team
• Enough visibility of staff

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What we looked at

• Informing and Involving
• Patients feel involved about decisions about
  their care
• Given answers they feel they can understand
• Feel if there is a variance in information from
  staff
• Opportunity to speak to medical staff
• Treated Individually
• Treated with respect, dignity maintained
• Privacy of environment
• Requiring spiritual care support
• Shared accommodation opposite sex

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Measuring Patient Experience

• Initial focus acute hospitals
• 1st experience measurement winter 2006
• Patient public staff led improvement plan
• Food, fluid nutrition in hospitals
• Cleanliness of wards and rooms
• Staff washing hands between patients
• Respect dignity
• Communication

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What Patients Carers have been telling us

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What Patients Carers have been telling us

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What Patients Carers have been telling us

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What Patients Carers have been telling us

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Taking action on things thatmatter to patients

• Patient Public Panel and staff created action
  plan
• In key staff objectives
• Boardroom Bedside
• Targeted actions and changing practice across
  Forth Valley
• Protected patient mealtimes
• Patient public panel cleanliness monitoring
• Performance monitored PFPI Steering Group

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Areas of Improvement

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Key messages from womens experience of maternity
services

• 91 indicated that overall experience of care
  during pregnancy was good
• 94.9 indicated that they were either satisfied
  or very satisfied with midwives involved in their
  care
• 94 were always or sometimes spoken to in a way
  they could understand, treated with respect
  dignity and given explanations they required

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Outpatients Experience Survey September 2007

• Stirling Falkirk Royal Infirmaries
• Leadership support by Patient Public Panel
• Information from 1353 patients
• 768 56.8 Stirling Patients
• 583 43.1 Falkirk
• (2) 0.1 not recorded

• Experience Journey
• Before attendance
• Length of wait
• Getting to the clinic
• Convenient time
• How did you travel
• Parking space
• Wheelchair support
• Welcome at clinic
• On time delay
• Informed if delays
• Communication
• Respect
• Privacy
• Cleanliness
• Involved in decisions

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• The Clinician cannot know the patient, the
  illness or the circumstances without true
  awareness of the patient experience
• (Cassell 1991)

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Whats next

• Remains a top priority
• IPCE Framework unite staff groups
• Forth Valley committed to systematically
  gathering Patient Carer Experience
• Developing other methods of gathering experiences
  
• Using this information to drive service
  improvement
• Service improvement in areas that matter to the
  patients and public of Forth Valley