Improving Patient, Service User and Carer Experiences

Improving Patient, Service User Improving Patient, Service User and Carer Experiencesand Carer Experiences

Teaching Materials to accompany the DVD

IntroductionIntroduction

• The following slides are in three sections – one for each patient or service user featured. The hyperlinks on the ‘menu’ slide will take you to the start of each of the sections.

• The patient, service user, and carer stories are real and represent selected perspectives on aspects of their healthcare.

• The video extracts on this DVD have been selected to trigger discussion and we have provided some trigger questions and hyperlinks to resources in this PowerPoint. These are not exhaustive and viewers may develop these further.

• We appreciate that hyperlinks can become out of date with time and we encourage users to update these as necessary.

Look, Listen, & Learn!

MenuMenu

• Antonina’s Experience

• Koki’s Experience

• Sheila’s Experience


• This story has extracts from a patient and her family’s experience of an episode of healthcare.

• The materials are designed to trigger your thinking about strategies to improve NHS care experiences.

• In the following scenes, try to find ways through which you yourself might improve a person’s experiences from a service provider point of view.

• Downloads

Information on Marinesco-Sjogren Syndrome (MSS)

Antonina’s experienceAntonina’s experienceIntroductionIntroduction


Antonina’s experienceAntonina’s experienceChapter 1 – The Hospital ExperienceChapter 1 – The Hospital Experience

• Key phrases

– “The evening sister said “stay”; the following day sister insisted on me going..”

• Activities– Discuss what impression the family would gain from

this experience.– How would you improve this situation in a clinical

setting?

• Downloads– High Impact Changes– NMC Record Keeping Advice


Antonina’s experienceAntonina’s experienceChapter 2 – Communication and Complaint SystemsChapter 2 – Communication and Complaint Systems

• Key phrases – “He wrote “mother to stay”… she crossed it out.” – “Matron – no one could find her.”

• Activities– Discuss who should ‘control’ patient notes?– What are the proper procedures for dealing with

complaints?– How would you improve on Antonina and family’s

experience?• Downloads

– RCN Complaints & Clinical Governance– Trust Complaint Procedures– Health Service Ombudsman


Antonina’s experienceAntonina’s experienceChapter 3 – Calling for AssistanceChapter 3 – Calling for Assistance

• Key phrases – “... I bought telephone cards.”– “(buzzer) they didn’t want to come.”

• Activities:– Discuss effective family communication.– Who should help when a buzzer is sounded?– How would you improve this situation in a clinical

setting?

• Downloads– NMC Dignity Ward Document– Confidence in Caring– Essence of Care 2010


Antonina’s experienceAntonina’s experienceChapter 4 – Collaborative HelpChapter 4 – Collaborative Help

• Key phrases

– “you had to fight for it”

– “they won”

• Activities:– How might collaborative care have made a difference

in Antonina’s situation.– How might carers facilitate families who want to help?

• Downloads– Open Visiting Comment– Learning Disability Patient Toolkit


Antonina’s experienceAntonina’s experienceChapter 5 - DignityChapter 5 - Dignity

• Key phrases

– “All naked and a bowl of water in front of her…”

– “…told to ‘get on with it…’”

• Activities:– Discuss how you yourself would like to receive help

with daily living activities and how these can be supported with dignity.

– Discuss various degrees of help that will be needed by clients in your care setting.

• Downloads– Self Care Debate– NHS Institute "Dignity"


Antonina’s experienceAntonina’s experienceChapter 6 – Levels of DisabilityChapter 6 – Levels of Disability

• Key phrases – “... another plaster because of her diabetes.” – “She’s disabled.”

• Activities– Discuss ways of sharing specialist care with families

patients, and care users.– Some disabilities are more visible than others.

Discuss what is meant by invisible disability.

• Downloads– RADAR The Disability Network


Antonina’s experienceAntonina’s experienceChapter 7 – Information SharingChapter 7 – Information Sharing

• Key phrases – “...one says one thing, one says another thing.”

• Activities– Discuss what the place is of written and verbal reports

to colleagues, patients, and service users.– How would you improve information sharing in a

clinical setting?

• Downloads– Adult Safeguarding


Antonina’s experienceAntonina’s experienceChapter 8 Conclusions and SummaryChapter 8 Conclusions and Summary

• Commentary– Should relatives stay or not?– Communication between workers– Attitude to and treatment of users– Inclusive care– Patient notes – correct usage– Additional needs and limitations

• Downloads – NHS Constitution Interactive


Koki’s experienceKoki’s experienceIntroductionIntroduction

• This story has extracts from a patient’s experience of the care she has received for her long-term condition.

• The materials are designed to trigger your thinking about strategies to improve care experiences.

• In the following scenes, try to find ways through which you yourself might improve a person’s experiences from a service provider point of view.

• Additional resource

– Parkinson’s UK


Koki’s experienceKoki’s experienceChapter 1 – The DiagnosisChapter 1 – The Diagnosis

• Key phrase

– “Sorry to say, my dear, you have Parkinson’s.”

• Activities– Why might Koki feel so negatively about the way in

which the doctor broke the bad news?– How would you express bad news or express

compassion in a similar situation?– List the environmental, infection control, and safety

risks that might arise from a multi-use trolley.

• Downloads– Breaking Bad News– Journal of Infection Prevention


Koki’s experienceKoki’s experienceChapter 2 – Sharing the NewsChapter 2 – Sharing the News

• Key phrases: – “..he went through medication..”– “..my mind was.. in a daze.”– “..my culture could have shunned...”

• Activities– Discuss the effects of routine in care.– How would you minimise the shock effect?– Discuss the effect of cultural embarrassment.

• Downloads– Specialist Care– Cultural Awareness Conference


Koki’s experienceKoki’s experienceChapter 3 – Treated like a NumberChapter 3 – Treated like a Number

• Key phrases: • - “…always anxious before appointments.”

– “…doesn’t look at you.”– “I’m just like a number.”

• Activities:– Discuss how it might be possible to minimise the

anxiety of waiting.– How does one develop meaningful eye contact?

• Downloads– Anxiety Reduction


Koki’s experienceKoki’s experienceChapter 4 – The Consultant OfficeChapter 4 – The Consultant Office

• Key phrase– “You’re too young...”

• Activities:– Discuss how room set-up affects interviews. – What types of behaviour block patients & service

users from being able to express their needs?– How should one provide space for other’s feelings and

needs to be expressed?

• Downloads– Just Listening– Listening Harder


Koki’s experienceKoki’s experienceChapter 5 - Who believes whom?Chapter 5 - Who believes whom?

• Key phrase: – “You’re looking fine... I wasn’t feeling fine.”– “Did it have to come to this?”

• Activities:– Discuss how it might be possible to improve the ability

to listen to others effectively.– What leads to properly managed care?

• Downloads– Evidence Based Practice– King's Fund "The Point of Care"


Koki’s experienceKoki’s experienceChapter 6 Conclusions and SummaryChapter 6 Conclusions and Summary

• Key phrase– “See the person behind the patient.”

• Commentary: – Listening needs practice– Observation and eye contact help – Depersonalisation should be avoided– Culture affects everyone– Quality of care is paramount

• Downloads– NHS Constitution Interactive


Sheila’s experienceSheila’s experienceIntroductionIntroduction

• This story has extracts from a patient and her carer’s experience of an episode of healthcare.

• The materials are designed to trigger your thinking about strategies to improve patient, service user and carer experiences.

• In the following scenes, try to find ways through which you yourself might improve a patient, service user and carer’s experiences from a care provider point of view

• Downloads– Informal Carers


Sheila’s experienceSheila’s experienceChapter 1 – Admittance to HospitalChapter 1 – Admittance to Hospital

• Key phrase: – “Learning difficulties... Can someone explain to her..”

• Activities– Identify ways in which learning difficulties or disability

might affect a person’s admission to hospital.– What measures might be needed in order to ensure

that the patient or service user with learning disabilities understands this experience?

• Downloads– Learning Disability Definition– Learning Disability Patient Toolkit


Sheila’s experienceSheila’s experienceChapter 2 – Diet and MedicationChapter 2 – Diet and Medication

• Key phrases– “Can you take care of these medicines?”– “She is on a strict diet.”

• Activities– Discuss who is responsible for the care of medicines in

a clinical situation.– What might have been the consequences of not

keeping to a strict diet?– Whose responsibility is it to meet the patient’s or

service user’s dietary needs?

• Downloads– Medicines Management– Directions on Discipline 2005


Sheila’s experienceSheila’s experienceChapter 3 – The stress of requesting helpChapter 3 – The stress of requesting help

• Key phrase– “It took it’s toll on me too.”– “I couldn’t get to the buzzer.”

• Activities:– Discuss how significant others and friends might have

the worry of care minimised.– What might assist requests for help in any form?

• Downloads– Seven Steps To Patient Safety


Sheila’s experienceSheila’s experienceChapter 4 – Gifts and CleanlinessChapter 4 – Gifts and Cleanliness

• Key phrases– “They weren’t taking her to the toilet..” – “Dirty nighties on top of smelly fruit..”

• Activities– Discuss how it might be possible to improve the basic

needs of patients and clients more effectively.– What alleviates poor hygiene and uncleanliness?

• Downloads– NHS Investigation


Sheila’s experienceSheila’s experienceChapter 5 – Discharge to HomeChapter 5 – Discharge to Home

• Key phrase

– “She needs transport”

• Activities– List some general requirements for discharge to home

to be managed effectively.– Discuss how transport home for clients is properly

arranged in your area of work.

• Downloads– Discharge Planning– Support to Live and Die Well


Sheila’s experienceSheila’s experienceChapter 6 Conclusions and SummaryChapter 6 Conclusions and Summary

• Key phrase– “See the person behind the patient.”

• Commentary• Quality of care • Awareness of conditions• Intercommunication

• Downloads– NHS Constitution Interactive


Index of Web LinksIndex of Web Links


Improving Patients, Service User Improving Patients, Service User and Carer Experiencesand Carer Experiences

Improving Patient, Service User and Carer Experiences

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