Improving the Patient Experience

Transcription

1 February 2013 Improving the Patient Experience Ruth Holt, Director of Nursing NHS Confederation

2 The context Patient experience: is complex and involves every aspect of how care is delivered is not a new concept for the NHS but commitment is not widespread and change is sometimes slow support at national level essential but for patients experiences to become a priority for staff, a big cultural shift at many hospitals is needed is a recognised component of high-quality care (Darzi 2008)

3 Quality (Darzi 2008) Patient Safety Patient Experience Outcome- Effectiveness Outcomes- Effectiveness

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7 Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) 290 recommendations including: Putting patients first Fundamental standards of behaviour Responsibility for and effectiveness of health care standards Enhancement of supportive agencies Effective complaints handling Commissioning for standards Medical education Nursing Leadership

8 The win-win case for delivering a high-quality experience Improving outcomes emerging evidence that organisations with a strong emphasis on patient experience have found it is linked to better health outcomes Indicating poor care understanding how patients experience care can help highlight poor care Reducing costs research in the USA has linked high quality patient experience with lower overhead costs (DiGioia 2007) Informing choice with patient choice due to expand, responding to patients preferences and improving their experience is increasingly important

9 Organisations that have a good reputation for customer experience

10 Why do private sector companies improve their customer experience? make more sales increase loyalty improved reputation to attract more customers to attract the best staff What influences a great customer experience? easy to understand processes great staff treat you as a person sort out problems without fuss go the extra mile

11 Can we compare Patient Experience in the NHS with Customer Experience in the private sector? Why do private sector companies improve customer experience? Why should we improve the patient experience? What influences a great customer experience? What influences a great patient experience?

12 Patient experience and Customer experience are essentially the same. Being cared for Kindness Quality Trust Feeling safe Staff attitude Dignity and Respect Consistency Value Knowledge Confidence and the reasons for improving it are very similar

13 Some improvements to a Patient s experience can save us money Improved Patient experience self management self service self referral self treatment For many long term conditions for the majority of patients, self management gives much better clinical outcomes and an improved patient experience

14 What makes a great experience?

15 Patient Experience How to create a positive patient experience? Get the basics right don t leave it to chance Ensure staff are competent, Don t loose my notes, Keep the place clean Fit in to my life not force me to fit in to yours Make the service easy to access, Give me convenient options, Don t waste my time

16 Patient Experience How to create a positive patient experience? Treat me as a person not a symptom Listen to me and take me seriously, Understand the wider context of my condition, Treat me with respect and dignity Work with me as a partner in my health not just a recipient of care Encourage me to keep control of the process, Equip me to look after my own health Give me the support I need

17 The evidence suggest patients want to feel better Research shows this is as much about:- How they feel about the service they received (emotional experience) as The clinical outcome they were seeking (PROM)

18 A great experience ticks all the boxes Head Rational Heart Emotional Magic Basics

19 Getting the basics right!

20 However...a Patient Experience is not one experience, it is a series of experiences on a journey

21 An example of a patient journey Emotional state Difficulty parking Can t find the dept Happy to wait for 30mins but now I ve had to wait for 1 hr Enough time to ask questions Need for privacy on a mixed ward How far through the hospital? What will the scan be like? Getting settled onto another ward. How to get home. Right medication - clear instructions? Letter arrives at home journey and arrival waiting clinical In bed consultatio on a ns/interven ward tions moving around the hospital discharge and leaving

22 How will we measure success? The Friends and Family Test How likely are you to recommend our ward/a&e department to friends and family if they needed similar care or treatment? Staff - access to up-to-date patient feedback immediate action can be taken to tackle areas of weak performance and build on success Patients - able to use the information to make decisions about their care Commissioners - to benchmark providers and use in contract discussions. Tracking trends - validation of where targeted improvements are most effective

23 Patient stories Why use patient stories? Connect with patients and relatives Connect with front line staff. Improve understanding of human factors in harm and error. Make patient safety personal Different ways to collect and reproduce

24 Telling a story.. Stories are important cognitive events, for they encapsulate, into one compact package, information, knowledge, context and emotion. Don Norman

25 Why we established a Commission on improving dignity in care for older people

26 Who we care for In million (17 per cent of the population) in the UK aged 65 and over The number of people aged 85 and over is projected to double in size from 1.4 million in 2010 to 2.8 million in 2030 In England, more than 400,000 people aged over 65 are living in over 18,000 care homes. There are currently 800,000 people living with dementia in the UK - projected to rise to 1 million by About a third of all people with dementia live in care homes Around a quarter of older people on acute wards are estimated to have dementia, much of it undiagnosed.

27 Changing society s attitudes to older people Age discrimination is the most common form of discrimination in the UK. Increased life expectancy is a positive development Our view of older people: focuses almost exclusively on biological decline, a problem for health and social care services, a demographic time-bomb, or a crisis we cannot afford. the economic and social contribution of older people rarely acknowledged. Health and social care staff and their organisations should be beacons for the rest of the community

28 The standards of care older people have a right to expect Dignity in care means bridging the gap between the principles and rights set out in the NHS Constitution and the reality of being an older person in care. The overarching commitment is to help keep us mentally and physically well, to involve us in decisions about our care, to help us get better when we are ill and, when we cannot fully recover, to stay as well as we can and live as independently as we can until the end of our lives. Those hospitals, care homes and staff providing excellent care recognise the humanity and individuality of each person they are working with, and respond to them with sensitivity, professionalism and compassion.

29 The aims of the Commission were to: Understand the aspirations of older people and their families Identify the physical and personal care that older people have a right to expect Establish what works in improving care Drive improvements across health and social care.

30 Key themes and recommendations of the report Always events the foundations of dignified care

31 Delivering Dignity the final report of the Commission on Dignity July 2012

32 The next phase implementation The NHS Confederation, Local Government Association and Age UK have agreed to continue their partnership for 2-3 more years to support the implementation of the Commission s recommendations

33 Key drivers for achieving a consistently excellent experience Reaching all levels leadership and culture Engaging staff and winning hearts and minds Engaging patients, families and carers Creating a healing environment Implementing evidence based care

34 Common factors across successful organisations Transformational leadership with a clear vision and drive Changes is effected across the whole system Patients, families and carers are engaged There is an emphasis on continual feedback and measurement for improvement There is a consistent and integrated programme of activities Values and behaviours are embedded across the whole organisation Staff are empowered to make changes themselves There is greater clinical engagement and professional empowerment

35 Patient Experience How to create a positive patient experience? A customer is the most important visitor on our premises. He is not dependent on us. We are dependent on him. He is not an interruption in our work. He is the purpose of it. He is not an outsider in our business. He is part of it. We are not doing him a favor by serving him. He is doing us a favor by giving us an opportunity to do so. (Mahatma Gandhi)

36 Thank you... AQUA - Advancing Quality Alliance, Salford