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Patient Experience and Staff EngagementCathy White Patient Experience Survey Manager December 2013

An Associated University Hospital ofBrighton and Sussex Medical School

System Requirements

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• We needed a better way of understanding Patient Experience:

- Include more patients as systematically as possible- Be more aligned with National Inpatient Survey- Have quick, open access to the results- Recognise good performance- Involve staff more- Listen and respond to patients’ comments

“The thinking behind the new programme came from wanting our

patients to feel that Surrey and Sussex Healthcare NHS Trust is at

the heart of their community and that we welcome their ideas. We

wanted to move past static measures of performance to a more

‘caring’ solution that gauges our patients’ experience and most

importantly, enables us to take actions based upon their views.”

Michael Wilson,

CEO at Surrey and Sussex Healthcare NHS Trust

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Our Solution – Your Care Matters

• Card given to every patient with verbal explanation and request

• Stress that relatives/carers can assist

• Options are:• Online

• Via QR code

• Paper version in Discharge Lounge

• Freephone number (shorter version)

• Sent a text or letter reminder within 48hrs of visit (depending on pathway)

• Opportunity to opt out of text reminders and also arrange to have a translator

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Survey first page

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The Survey

• Generated through discussions with staff at all levels

• Key issues covered:

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Respect & Dignity

Care & Compassion Cleanliness

Emotional Support Pain Control

Privacy

Confidence & trust in

staff

Food

Communication (Doctors, nurses,

medication)

Noise

Free Text Options

• Staff going ‘above and beyond’

• Additional comments

• Started in Inpatient wards and Emergency Department, now rolled out to Outpatients, Day Cases and Maternity

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We are reaching a great range of patients

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48% 50%

2% prefer not to answer

Source: Surrey and Sussex Healthcare Inpatients, April to September 2013

Surrey and Sussex Admissions data

Surrey and Sussex Survey respondents

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How our patients access Your Care Matters

In patients 44% 2% 29% 25%

ED 57% 13% 30%

Out patients 58% 7% 35%

Day Cases 59% 6% 35%

Internet MobileIVR – Free

Phone Paper

Source: Surrey and Sussex Healthcare survey data, April to September 2013

Outputs 1- Monthly Ward Dashboards

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Output 2 – Daily Staff Commendations

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Laura, Zoe and nearly all the staff on Brockham ward were fantastic, but Zoe and Laura made me smile. Were there when I needed a shoulder to cry on and gave me everything I needed. They were

stars

Andrea. Always willing, totally efficient, stayed after the end

of her shift to finish a treatment, just an excellent example of good nursing

100% care and attention ward sister

Kate 5ft bundle of energy

The beverages man on Brook ward, very friendly and kind.

Really helped to see a friendly smiling face.

Made sure I was comfortable, provided seat for my husband. Gave us both a cup of tea and was very kind and considerate. … was very grateful for all

their help and reassurance.My wife has dementia and both Jenny and Anne made a point

of talking to her so she felt included even though she

didn`t necessarily understand what was going on, and both

treated her with kindness

Liz and Laura midwives working birthing pool on 16th October were amazing and stayed with us through the whole experience, couldn't

have done it without there help and support. Truly amazing,

thank you

Output 3 – Monthly Additional Comment Reports

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Overall I have no complaint but I do have this observation, noise at night with particular problems

being noise from the staff rest rooms /false warnings from monitoring equipment that carried

on for ages before being reset or switched off and loud trollies moving through the corridors. I must

admit I was glad to get home for a rest

With all the bad press I was pleasantly surprised and extremely satisfied with

the stay at East Surrey

I have to say that I was a bit apprehensive about treatment at ESH, following bad press,

and also bad personal experiences from other people,

but nothing was further from the truth. I would definitely not

think twice about having treatment there again and would recommend ESH to

friends and family.

The only criticism that I have is that the night nursing staff were noisy, banging

bins, turning lights on and off and generally being noisy, apart from that a

very caring, clean and professional hospital

Some way of notifying you as to how long you would need to

wait before being seen.

The Your Care Matters Patient

Survey

Staff Commendations•Sent to Managers, Matrons and Chiefs daily

Additional Comments reports •Monthly for each Ward/Dept.•Sent to Managers in full•Comments coded and reported to Patient Experience Delivery Committee

Monthly Dashboard •Ward and Directorate level data

•Month on month trends•Available on intranet•Reported at Patient Experience Delivery Committee

Trust Level•Key indicators in Integrated Quality and Performance Report (IQPR) •Linked to Trust Performance Reports

How YCM Survey Data is Used

What changes have we made?

• Acoustic panels in ED reception area

• Focus on communicating with relatives

• Steps to reduce noise at night across wards:

- Soft close bins- Ear plugs- Revised staff roster- Deadline for drug rounds

• New:

- Whiteboards and clocks- Tray tables and Ward decor- More chairs

• Revised some Outpatient appointment letters re waiting times

• Revised policy on storing equipment

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Our Patient Newsletter

• “I was dreading coming in”

• “Despite what you read in the press”

• “I must have been lucky”

• “Much better than I expected”

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YCM as a Tool for Ongoing Improvement

• Dashboards form part of Divisional Chief Nurses monthly Safety and Quality Report

• Matrons and Ward Managers required to review monthly data

• Monthly Ward Improvement Plans developed

• Fed into Divisional Patient Experience Action Plan

• Key tool for Trust’s Patient Experience Delivery Committee

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The Same Measures Impact Friends and Family and Overall Experience Ratings

Measure

Treated with dignity and respect

In your opinion, how clean was the hospital room or ward that you were in?

Staff did everything to help control pain

Enough privacy when being examined or treated

Enough emotional support

Answers you could understand from nurses

Confidence and trust in doctors

Confidence and trust in nurses

Answers you could understand from doctors

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• Insight into key measures and questions to drop to shorten survey

Problem Matrix – Identifying Focus Areas

Involved enough in decisions about care and treatment

Answers you could understand from doctorsNurses talked in front of you as if you weren’t thereEnough privacy when examined or treatedCleanliness of room

Enough emotional support from staff Confidence and trust in doctorsAnswers you could understand from nursesStaff did everything to help control pain

Treated with dignity and respect

Confidence and trust in nurses

<5% Patients5-10% Patients > 10% Patients

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Source: Surrey and Sussex Healthcare Inpatients YCM Survey data,

April to September 2013

Insights to Drive Focus – High Impact Factors Impacting on Friends and Family Question

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Inpatients ED Outpatients

High FrequencyWaiting time Being kept informed at

all times

Medium Frequency

Treated with dignity and respect

Respected your views

Explained results of tests in a way could

understand

Low Frequency

Treated with dignity and respect

Confidence and trust in Nurses

Staff did everything they could to control pain

Enough emotional support

Privacy when examined or treated

Confidence and Trust in Doctors

Treated with dignity and respect

Explained why tests needed in a way could

understand

Enough privacy when examined or treated

Source: Surrey and Sussex Healthcare YCM survey data

April to September 2013

Benefits of Your Care Matters

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Staff Engagement Data Availability

Developed a positive culture around patient feedback

Over 2,200 staff recognised by patients

24/7 access to Trust, Directorate and Ward data

Data and patient comments refreshed daily

Appreciation of data robustness

Key Learnings

FFT score varies depending on when and how you ask

Positive feedback encourages engagement

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Small changes make big differences for patients

Patient Experience goes beyond Friends and Family

Where We Are in the Loop

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What Next?

• Patient Reported Outcome Measures (PROMS)

• Explore use of ‘rescues’ for maternity

• Additional ways to use free text comments

• Review our Patient Experience Strategy and TOR for Patient Experience Delivery Committee

• ‘Proactive’ and ‘Board to Ward’

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Thank you

Any Questions?

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