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Annie Laverty on improving processes of care and staff-patient interactions in Northumbria
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Transcript of Annie Laverty on improving processes of care and staff-patient interactions in Northumbria
Improving processes of care and staff-patient interactions.
Annie Laverty
The King’s Fund Conference6 December 2010.
Contents
1. Our approach
2. Patient perspective programme
3. Understanding what matters most – in real time
4. Driving improvements at team level
5. The King’s Fund Hospital Pathways Programme
6. Summary
Northumbria Healthcare NHS Foundation Trust :
•large provider
•vast geography
•10 hospitals sites
•6500 staff caring for over 355,000 people each year
•history of diverse and complex delivery needs
Our approachReal-time data collection
Two minutes of your time
Patient perspective
National survey programme
Individual
+
Wards
+
Business units
+
Trust Board
Ward by Ward performance to date
Patient and family free text comments
Outpatient data
• views of 11,500 outpatients
• same approach at individual consultant level
• 8 domains that matter most to outpatients
• generating single score for appraisal
Ward-based real-time surveys
• consistency and co-ordination of care
• treatment with respect and dignity
• involvement
• doctors
• nurses
• cleanliness
• pain control
What matters most to inpatients?
Monitoring performance month-on-month
Driving improvements at team level
Working assumptions
• The bottom line is the bottom line
• Patient experience isn’t just an end point of care, it should be the start of improving care
• We work with different types of people these days
• Patient experience and staff experience are more similar than different
• Best care demands the best ways of improving care
21/06/2010 29/06/2010
09/07/2010 25/08/2010
The likelihood of recommendation based on the care on this ward 8.71The likelihood of recommendation based on the care on this ward 7.88
The likelihood of recommendation based on the care on this ward 7.87The likelihood of recommendation based on the care on this ward 7.23
Resultsby visit
Ward 16Wansbeck
Reported in real time & accessible to staff
Ward 3 Hexham Haltwhistle
Exit surveys : 2 minutes of your time
From ward to board
• Metrics based on what matters most to patients
• Measurement for improvement: tracking + reporting monthly performance
• Appreciative enquiry: sharing best practice + celebrating success
Our share point
Our gains
• Results are transparent and owned
• Individual teams delivering front-line led solutions
• Improved performance and reputation for all pilot teams
• Improved communication and collaboration
• Patients and families engaged at every level of service delivery, planning and improvement
• Important person-centred and staff-focused changes
Some things we’ve learnt• The benefits of real-time reporting at team level
• Focusing on things that matter most has made sense
• Investing in improvement rather than measurement has helped
• Qualitative feedback appears particularly important to our teams
• The transparency of reporting is important
• Executive management team support is crucial
• Ensure patients and families are part of your improvement team
• Collaborative 18 month project designed to transform patient
experience• Part of The Point of Care
Programme• 5 participating hospitals• 2 selected pathways each –
elective and emergency
Hospital PathwaysProgramme
Participating hospitalsGeorge Elliot Respiratory Support and Abdominal Pain Pathway
Royal FreeLiver Surgery and Elderly Care
SalisburyCardiology and Trauma Pathway with Focus on Elderly Care
Taunton and SomersetStroke and Elective Hip and Knee Replacements
Northumbria Dementia and Hip Fracture Care
Programme aims
• Improve patients’ experiences of care in hospital so that all patients receive a consistent and reliable quality of care.
• Improve relatives’ experiences so they can have confidence in the quality of care their loved ones’ receive.
• Demonstrate that the well-being of staff is important, not just for its own sake but for the sake of patients.
• Keep patient experience of care as high on the quality agenda as safety, clinical effectiveness and finance.
Themes
1) Leadership and values
2) Staff effectiveness and well-being
3) Patient and family-centred care
4) Reliable care processes (and environment)
5) Co-ordinated, collaborative, evidence-based care
All ways of knowing
• Process maps• Emotion mapping• Shadowing/patient walkthroughs• Patient surveys• Focus groups• Discovery interviews• Stories• Executive safety walk-rounds
Many opportunities
• Faculty support − special thanks to Annette Bartley
• Understanding the integration between staff engagement and patient involvement processes
• Ensuring continued investment in the internal family
• Creating structured processes for quality improvement• Developing involvement tools that focus on co-production
• Celebrating achievements and acknowledging contributions
• Focus and challenge
• Sharing the learning
In summary
‘People must always come before numbers. Individual patients and their treatment are what really matters. Statistics, benchmarks and action plans are tools not ends in themselves. They should not come before patients and their experiences.’
Robert Francis QC, The Mid Staffordshire NHSFoundation Trust Inquiry
Thanks for listening
Any Questions ?