Transcript Patient Engagement - Beaumont Hospital

Patient Engagement:
The Renal Experience
Eileen McBrearty
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A quality service focuses on Person-Centred Care and
Support (National Standards for Safer Better Healthcare
2012).
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This takes into account the needs and preferences of
service users and involves service users.
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It means having the patient voice heard at every level of
service.
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The goal is for patient partnership in their own care and
in the processes of designing and delivering care.
Patient Engagement refers to:
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The knowledge, skills, ability and willingness of patients
to manage their own health and care.
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The culture of the health care organization that
prioritizes and supports patient engagement.
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The active collaboration between patients and providers
to design, manage and achieve health outcomes.
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A growing body of evidence clearly shows that patients
who engage with their health care providers have much
better clinical outcomes and that health care
organizations that emphasize patient engagement can
improve productivity and patient satisfaction.
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This initiative was designed to complement existing
patient consultation, to be part of the HIQA focus on
patient safety and other quality initiatives.
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Recommendation from NHS reports – patients should be
present and involved at all levels of healthcare
organisations.
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New approach for participating staff to enhance
facilitation and listening skills.
Why Patient Engagement in Renal?
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For Our Patient:
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To hear from patients about the renal service they receive in
Beaumont Hospital.
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To listen to patients in a different environment where staff and
patients are more equal partners, where every opinion counts.
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To give the patient a “voice”
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For patients to share and exchange experiences of the hospital
and renal journey.
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In order to improve this patient experience and quality of care.
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To give a different angle on care delivered and received.
For Our Staff
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To listen and learn from patients and their family
experiences of the service in Beaumont Hospital.
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To reach a fuller understanding of the patient journey
from the patient perspective.
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To gain a baseline of the renal service from the viewpoint
of our patients, their families and the community groups.
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To energise and motivate staff.
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For advocacy and community groups to hear feedback from the
patient and family, with these aim to improve patient
care/their service.
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Beaumont Hospital is committed to patient engagement and
learning from patients experiences.
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It is a priority for Beaumont Hospital at a strategic level.
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Information shared will be used in the road mapping and
development of future TUN service.
When it all began….
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Our first Patient Engagement meeting on July 22nd 2014
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Committee members:
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Petrina Donnelly DNM,
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Angela Bagnall Mary T Murphy Eileen McBrearty -Patient Care Co-ordinators
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Oonagh Smith Dietician
Marion Stacey St Peters ward
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Transplant Co-ordinators
Abi Armstrong Home Therapies
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Olive McEnroe and Ruth O’Malley - Ambulatory Care Nurses
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Catherine Mulcahy
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Margaret Hanna Nurse Counsellor
Veronica Francis CNM3 Haemodialysis,
Eileen Linehan - Clerical support
Dr Colm Magee Consultant Nephrologist
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What is good
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How we could improve
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Patient/Family/Community ideas suggested
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Patient selection divided into 5 modalities and letters of invite
sent.
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Date set for 20th October 2014
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Consultation and Support of Quality and Standards, Learning &
Development and Organisational Development Departments.
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Briefing session with facilitators and renal staff week before.
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Debriefing session held with MDT the week of workshop.
What did we expect?
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Expected criticism of the health services, of the hospital
& the directorate
Expected some negativity
Expected transport issues to dominate
Concern about staff reaction to the feedback
Expected some positives given the strength of the
relationship between patients & staff over a long period
Expected the feedback to be more confined to TUN
directorate
On the day
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38 patients and families on the day
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Advocacy group, Satellite Haemodialysis and PHNs from
the community
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Senior management attended on the day and TUN MDT
including:
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Catering, HCA, Chaplaincy, Pharmacy, OT, Physio, Medical,
Nursing and Patient Representatives office
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Facilitator and scribe at each table
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Graphic artist capturing discussions and depicting same on
posters
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Informal environment established
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MDT staff where possible did not sit at table of the area
they worked in.
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3 conversations held relating to the experience of the
service:
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Before you came into hospital:
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Experience during your stay in hospital
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What it was like on leaving the hospital and aftercare
Pre hospital experience
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Access to treatment
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Access to health care professionals
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Waiting times
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Provision of Information
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Participation in self care
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Any other areas which patients feel are important
Patient and family experience in
Beaumont
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Reflecting the entire journey
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Communication
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Participation in self care
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Diagnostics
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Catering
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Confidentiality
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Dignity and Respect
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Privacy
Discharge from Beaumont
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Patient participation and self care
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Information given to patient/family
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Follow up post discharge
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Services provided
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Links to other services
What we got on the Day?
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Extremely energised, relaxed, feel-good vibe in the room,
great openness, positive buzz in the room.
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Incredible turnout of patients, family and MDT staff.
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Well supported by Senior Management & Medical
Leadership.
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Buzzing conversations at every table.
Before coming into hospital
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Beaumont books, website and videos very useful, be
aware of presumed knowledge
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Buddy system
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Renal Day Care great service
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Streamlining processes/workup,
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OPD waiting times and transplant waiting times
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Communication – mixed feedback, IKA great resource
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“GP’s don’t understand renal”, slow referrals to
Nephrology
Experience during stay in hospital
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Felt well supported and safe and sense of being cared for
Good education, questions encouraged
Accessing renal service directly in Beaumont could be
frustrating, use of regional hospital or ED can be difficult
Food – could be improved, difficult on renal diet
Car parking very expensive
Magic curtain of silence
Environmental
Medical jargon
Hardworking staff with low turnover, consistency key for CKD
population
Emotional support
What it was like on leaving the hospital and
aftercare
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“felt at sea”, “alone”
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No PHN follow up
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Good information given
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Family aware of supports available, out of hours telephone
service
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Community physio wait times
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Being aware of medication changes
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Renal Day Care fantastic service
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Rejection episodes frightening
Themes Emerging:
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Community/Hospital interface: need for greater
engagement & education for GPs & PHNs
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Earlier referrals
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Self Care: improving empowerment of patient &
family, Buddy System
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Access to Information and Education
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Communication
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Importance of Emotional Support
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Transport and parking issue
What I learned on the day
Renal family –they
are strong
relationships
Each person has their
own journey and we
need to come together
as community, patient
to patient
I learned today that
everything I have felt
and still feel is
normal
I’m not living with
dialysis, dialysis is
living with me
What I learned on the day
More
information to
GPs
Reiterate the
importance of open
communication,
education, in
building rapport in
helping to manage
patients and families
anxieties
The nursing staff are
brilliant
Parking is
an issue
What can I do differently after today
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Keep positive, emphasise what a person CAN do
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Nutrition – Review catering menu in hospital
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Increase Peer support – give as much support to each
other as possible, allow patients to network
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Importance of Communication – good communication is
vital throughout the journey, need to treat patients as
individuals
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Post discharge – build better links with the community,
identify point of contact for donors post discharge to
home
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Education and Information - more engagement days/
value of education workshops run, the importance of self
care
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Recognise the dynamic backgrounds of patients and
variety of feelings
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Importance of listening and good communication
Since then……
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TUN:
Nutrition: link in with catering, Nutrition workshop, rerun
cooking evenings
Education: increased our education workshops to 4 a year,
rerunning transplant information evening, planning an overview
of our education pathway next year
Peer Support network to be enhanced
Beaumont:
Put forward CKD education for the GP Education Day January
2015
Aim to improve PHN links and resolve issues, suggested PHN
Education Day for 2015
Raised the car parking issue to management
Feedback to Patients/ Staff
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Display of posters in the hospital
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Letters of feedback to patients
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Attend staff meetings/wards to update on workshop and
future developments
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Raise awareness