Transcript Miss Judith Hil

Ms Suzanne O’Boyle
Project Manager
NI Essence of Care Project
Essence of Care – Where has it come From?
 English Nursing Strategy
“Making a Difference” (1999)
 The NHS Plan (2000) reinforced
importance of improving the patient
experience
 Benchmark standards tested, refined
and endorsed.
 Version 1 (2001) / Version 2 (2003)
Essence of Care Presentation
Update
 16 Trusts
 6 Nursing Homes
 Prison Service Nursing
 Marie Curie
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Clinical Governance
 Consultation and patient involvement
 Clinical Risk Management
 Clinical Audit
 Research and effectiveness
 Use of information about the patients’ and or
carers’ experience
 Staffing and staff management
 Education, training and CPD
 Strategic capacity
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Essence of Care ??
 A Tool to help practitioners
To take a patient focused
And
Structured approach to sharing
and comparing best Practice
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Benchmarking
 Acts as a standard
 Enables practitioners / organisations
compare practice and share difficulties.
 Several approaches can be used:
wards / directorates / primary care
teams / organisations can compare
processes and structures
 There must be a willingness to share
practice
Essence of Care Presentation
Fundamental Aspects of Care
 Published 2001,
revised format 2003
 All benchmarks are
interrelated &
relevant to all health
& social care
settings
 National frameworklocal approach!
“seeing things through
the patients eyes”
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The Toolkit - What’s in it?
 An overall agreed patient-focused
outcome that expresses what patients
or carer’s want from care in a particular
area of practice
 factors that need to be considered to
achieve the overall patient outcome
Essence of Care Presentation
The Toolkit - What’s in it?
 A benchmark of best practice for each
factor on a continuum
 Indicators for best practice identified
by the patients, carers and
professionals!
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The Benchmark Process
STAGE 1
Agree best practice
STAGE 2
Assess clinical area against best
practice
STAGE 3
Produce & Implement action plans
aimed at achieving best practice
STAGE 4
Review achievement towards best
practice
STAGE 5
Disseminate improvements & or
review action plans
Agree best practice
STAGE 6/1
Essence of Care Presentation
Benchmarks for Food & Nutrition
 Agreed patient-focused outcome“patients are enabled to consume food which
meets their individual need”
 The ‘benchmark’ comprises of 10 ‘factors’each with it’s own benchmark of best
practice
Essence of Care Presentation
The Factors
Screening & Assessment



essential to identify
nutritional requirements
identifies ‘at risk’
establish individuals
nutritional status
Planning & Implementation



support ranges from simple
to high risk invasive
interventions
care planning
evaluation
The Environment



conducive to eatingacceptable sights, smells
activities
cultural/ ethnic
considerations
Assistance



skill, sensitivity & patience
links to oral hygiene
cultural/ ethnic
consideration
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The Factors
Obtaining Food
 adequate information/
Communication
 cultural, age related, special
needs ethnic considerations
Food Provided & Availability
 meets the needs of individuals,
appetising
 appealing portion sizes
Monitoring & Promotion
 accurate recording of
amounts eaten
 appropriate action taken
 opportunities for health
promotion
 staff training available
 multi-agency partnerships
 alternative food/ access
 own food/religious, cultural,
issues
Essence of Care Presentation
The Continuum
Best
Practice
E
D
C
B
A
Stepping Stones for Development
Benchmark
Best of
best practice
Practice
E
A
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Factor 1- Screening & Assessment
Benchmark of Best Practice
Patients
nutritional needs
are not
ascertained
E
Nutritional screening
progresses to further
assessment for all patients
identified as at risk”
A
Essence of Care Presentation
The Benchmark Process
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Agree best practice
Assess clinical area against best
practice
Produce & Implement action plans
aimed at achieving best practice
Review achievement towards best
practice
Disseminate improvements & or
review action plans
Stage 6/1 Agree best practice
Essence of Care Presentation
Using the Benchmarks – How?
 Stage 1 : Agree best practice –
- consider patients carer’s experiences and how
current care is delivered.*1, 2
- agree which benchmarks to take forward
- set up your comparison group with ground rules*4
- using general indicators and specific indicators
agree evidence needed to provide best practice
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Assess Clinical Area Against Best
Practice – Stage 2
 Obtain baseline information
 Consider the indicators and provide
evidence that shows current achievement
towards best practice*3
 Consider barriers which prevent
achievement of best practice*3
 Compare and share best practice so that
good practice is not wasted. The E – A
scoring can be used to stimulate discussion
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Producing and Implementing Action Plan
– Stage 3
 Action plan to include*5
• Changes to be made to improve practice
• Who is responsible
• Timescale
Actions should be realistic, achievable and
measurable
Aim for quick wins
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Review Achievement Towards Best
Practice – Stage 4
 Evaluation of action plan *6
 did the patient / carer’s experience improve
 If no improvement review activities in action
plan – does it need refocusing on?
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Disseminate Improvements / Review
Action Plan /Stage 5
 Disseminate good practice by all available
resources throughout the organization/(s)
 Build into organizational business plan,
clinical and social care governance plan, and
quality reports*1,7
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Agree Best Practice – Stage 6/1
 The whole cycle continues again!!
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Success Factors
 Steering group
 Driven from the top but grow from the
grass roots.
 Embedded into practice – creating time,
ownership, integration
 Recognition - Celebrate success
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Success Factors
 Champions
 Timing
 Cultural fit
 Support
 Facilitation
 Teamwork
Essence of Care Presentation
Service Users
 Very important!
 Patient Support
Officer
 Forums / Groups
 Partnerships
Essence of Care Presentation
Role of Project Officer
 Facilitate at organizational level those wishing
to implement the Essence of Care Toolkit
 Co-ordinating benchmarking across
organizations
 Assess the need for “tailoring” of the
benchmarks to fit the Northern Ireland context
 Ultimately ensure that the project links to the
development of the overall Clinical and social
Care Governance Structures as they take
shape within northern Ireland.
Essence of Care Presentation
Facilitators Role
 Set up Essence of Care
 Lead
 Inform / Raising awareness
 Maintain momentum
 Produce reports for project officer
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Team Leaders Role
 Direct facilitation of the benchmark
 Co-ordinate all activity in relation to
benchmark selected
 Produce reports to the facilitator regularly
 Produce timely minutes of each group
meeting
 Represent group at higher level meetings /
presentations etc
Essence of Care Presentation
Summary
 Working to achieve best practice in
fundamental care
 It’s about what matters to patients,
carer’s and health care personnel
 It is integral to good clinical
governance management.
Essence of Care Presentation
Finally
 Benchmarking through The Essence of
care challenges us to think outside the
box and own our decisions.
 The process is evolutionary not
revolutionary – aim for quick wins!
 Its the wee things that count!
Essence of Care Presentation
Essence of Care
“The authority to engage in the
Humanity of Care”
Essence of Care Presentation
Contact Information
Address
Suzanne O’Boyle
Essence of Care Manager
NIPEC, Centre House
79 Chichester Street
BELFAST, BT1 4JE
Tel : 028 9023 8152
Fax : 028 9033 3298
[email protected]
Essence of Care Presentation