Transcript Document

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Co-designing a Patient Experience Strategy:
Overview of Approach and Outcomes
Collaborative: bringing together
clinicians, staff, patients, service users
and the community together as equal
partners
Evidence-based: engaging to co-design
evidence based and locally appropriate
solutions to promote integrated health
and social care
Asset-based : developing the capacity
of patients, service users and the
community to engage effectively in
identifying needs, project planning and
development, procurement,
implementation and evaluation.
Continuous and iterative: engaging to
build and refine sustainable models for
local delivery that reflect the needs and
aspirations of local people and frontline
staff
1. Initial workshop held with CCG Lay/Patient
Reps and PPI Engagement Leads to develop a
draft definition of patient experience and a
draft patient experience strategy (6th June)
2. Follow up workshops were co-ordinated and
facilitated involving patients, communities,
clinicians and managers to share and further
refine the draft definition and strategy so that it
reflects the views and perspectives of all
stakeholders (July – Dec. 2013)
3. Review of relevant documents/reports was
undertaken to further inform the development
of the definition and strategy (Sept. 2013).
4. A Final Patient Experience in Contracts
workshop Service User Panel and Lay Reps took
place to present and agree the final draft of the
Patient Experience Framework and priorities
which have been taken into consideration the
contracting round (Jan. 2014).
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HOW DID WE USE THIS INFORMATION?
The engagement with patients and staff has highlighted key priorities for us to take
forward during 2014/2015 include:
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Delivery of Series of Seminars and Learning Events for Staff and Governing Body Members on ‘Effective
Leadership to enhance Patient Experience’.
•
Development and Implementation of programme of training for CCG Lay Reps and Patient Champions to
enable them to promote patient perspective at decision making levels and in considering CCG plans and
proposals.
•
Work with providers to deliver quarterly patient experience Learning Events themed around a the
service and issues highlighted below across health and social care
o Impact of staff Experience on Patient Experience
o Experience of people with Dementia and their Carers
o Transfer of Care
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Map out the current data gathered on patient experience against the statements highlighted in the
Patient Experience Statements
o Where there is ambiguity or gap in information, a piece of work would be undertaken to work with
local patient groups and Healthwatch to gather patient and carer feedback to address the gap in
data.
o Work with providers to produce quarterly patient experience reports that real-time qualitative as well
as quantitative feedback and captures the diversity of patients, service users and carers
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More Specifically,
It enabled us Identify the following statements to capture experience
Theme
Patient Experience Indicator*
1. Promoting and recognizing (1a) I have access to information about services (including what services are available,
independence
how services work, what I can expect and how systems are changing), support, care
in care
(including what is best practice), illness and health promotion that is relevant, useful,
sensitive, up-to-date and available in different formats
(1b) Staff provide me with time to talk, ask questions, discuss issues and options, and
give me explanations and information that is understandable and useful.
(1c) My care is planned with me, is centered on my needs and is inclusive of my family
and carers
(1d) My family, carers and I have access to volunteers and the opportunity to learn and
gain support from other patients
(1e) I am provided with opportunities to get involved in shaping and influencing the
service and the organization as a whole
2. Coordination, Integration
(2a) My care is coordinated across health, social care and third sector services
and Continuation across Care (2b) Staff work in partnership with me, my family and carers, and other professionals
Pathway
(2c) Staff are effective at communicating and sharing information with me and also
with other staff within and across health, social and third sector services
(2d) I receive consistent and continued care which helps me to build relationships with
staff promoting holistic approaches
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*Based on Patient Experience information collected across tri-borough through workshops and a consolidation of reports, 2005 – 2013, outlined in Appendix 1 and 2
Theme
Patient Experience Indicators*
3. Safety, dignity
and respect
(3a) My care is provided in appropriate environments that are accessible, clean, welcoming and
enable privacy and dignity to be maintained
(3b) Staff maintain my confidentiality, privacy and dignity and treat everyone with respect
(3c) Services are valued and used responsibly by both me and staff caring for me
4. High quality care (4a) Organizations provide comprehensive services that are easily accessible, responsive, offer
choice and that provide timely treatment and care
(4b) Equipment and resources are available to meet my needs and demands
(4c) Staff are prepared and informed about me, my care needs and other services
5. Confidence and
accountability in
providers
(5a) Staff/services/organizations are committed to learning and improving - a no blame culture
exists in which people take complaints seriously, respond quickly and learn from mistakes
(5b) Staff have a positive experience of work
(5c) Senior managers, as well as frontline staff, are professional, honest and accountable
(5d) Staff have good communication skills and use clear and appropriate language
(5e) Staff are approachable, kind, compassionate and empathetic
(5f) Staff have the right knowledge, attitude and skills and adhere to policies
(5g) Staff are culturally aware and sensitive to the needs of and state of mind of patients,
families and carers
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*Based on Patient Experience information collected across tri-borough through workshops and a consolidation of reports, 2005 – 2013, outlined in Appendix 1 and 2
“It’s my doctor who let me know about this place (Nubian Life). He gives me good information and I am grateful. ” Elderly
African Caribbean Man
“I don’t want a doctor who patronizes me. I want a doctor who lets me
talk about what matters to me, before deciding what to do…” Diabetes
Promoting and recognizing independence
in care
Service User
Coordination, Integration and
Continuation across Care Pathway
“The NHS and Council, they’re doing a lot of things, but the missing link is
pushing it right through to the community.” Community Champion, White City
“I think when you go to a normal doctor they look down on you, I think they are a bit
worried in case you give them something, its just the way they were talking, looking,
sitting away from me.” Polish Rough Sleeper
High quality care
Safety, dignity and respect
“It is against our ethos to just kick people out onto the street but that’s what happens… At present,
we’re not really sure when we direct people what kind of service they are going to get and whether
they are actually going to get the help they need.” A&E nurse talking about a Polish Rough Sleeper
“I had my second child at my local hospital; the midwife was fantastic and the nurses
on the ward were very kind, I was very happy. When I was leaving I bought them
some flowers as a thank you and on the way out one of the nurses said ‘see you next
year…’. I know she didn't’t mean it but that comment made me so upset and its what
stayed with me. If I do have another child I don’t want to go there again”. Somali
Confidence and accountability in
providers
Woman
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*Based on extracts from Patient Experience Workshops across tri-borough through workshops and a consolidation of reports, 2005 – 2013, detailed in Appendix 1 and 2
THE PICKER MEASURE OF INTERGRATED HEALTH AND SOCIAL CARE
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Picker developed an integrated measure for assessing people’s experience of integrated care, based on
consultation and engagement in four focus groups with patients, service users and carers aged 21 – 85 years
with a range of comorbid mental health / physical health diagnoses
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Items are grouped into six key themes, yielding 18 questions, with adapted carer versions, and 12
corresponding ‘I’ statements
Theme
Picker ‘I’ Statements*
My Goals
(A1) All my needs as a person are assessed
(A2) My carer / family have their needs recognized and are given support to care for me
(A4) Taken together, my care an support help me live the life I want to the best of my ability
Care Planning
(B6) I have regular reviews of my care and treatment, and of my care and support plan
(B7) I have regular, comprehensive reviews of my medicines
(B8) When something is planned, it happens
Communication
(C4) The professionals involved with my care talk to each other. We all work as a team
(C5) I always know who is coordinating my care
(C6) (a) I have one first point of contact. (b) They understand both me and my condition(s). (c) I
can go to them with questions at any time
Decision-Making
(E1) I am as involved in discussions and decisions about my care , support and treatment as I
want to be
(E2) My family or carer is also involved in these decisions as much as I want them to be
Transitions
(F3) I know in advance where I am going, what I will be provided with and who will be the main
point of professional contact
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*Source Measuring health and social care integration: new research and recommendations
HOW DO THE PATIENT EXPERIENCE INDICATORS COMPARE TO THE
PICKER ‘I’ STATEMENTS?
Theme
Picker ‘I’ Statement
Patient Experience Indicators
Promoting and recognizing independence
in care
(A1) All Goals
my needs
as a person are assessed
Picker Theme(s):
& Decision-Making
None
(A2) My carer / family have their needs
recognized and are given support to care for me
(A4) Taken together, my care and support help
me live the life I want to the best of my ability
(E1) I am as involved in discussion and decisions
about my care, support and treatment as I want
to be
None
(1a) I have access to information about services
(including what services are available, how services
work, what I can expect and how systems are
changing), support, care (including what is best
practice), illness and health promotion that is
relevant, useful, sensitive, up-to-date and available in
different formats
(1b) Staff provide me with time to talk, ask questions,
discuss issues and options, and give me explanations
and information that is understandable and useful.
(E1) & (E2) My family or carer are also involved in (1c) My care is planned with me, is centered on my
these decisions as much as I want them to be
needs and is inclusive of my family and carers
(1d) My family, carers and I have access to volunteers
None
and the opportunity to learn and gain support from
other patients
None
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(1e) I am provided with opportunities to get involved
in shaping and influencing the service and the
organization as a whole
HOW DO THE PATIENT EXPERIENCE INDICATORS COMPARE TO THE
PICKER ‘I’ STATEMENTS?
Theme
Picker ‘I’ Statement
Patient Experience Indicators
Coordination, Integration and Continuation
across Care Pathway
None
(B6) I have
regular reviews
of my care and & Transitions
Picker Theme(s):
Care-Planning,
Communication
treatment, and of my care and support plan
(B7) I have regular, comprehensive reviews of
my medicines
None
(B8) When something is planned, it happens
None
(C6) (a) I have one first point of contact. (b) They
understand both me and my condition(s). (c) I can
go to them with questions at any time
(C4) The professionals involved with my care talk
to each other. We all work as a team
(C4) As above
(C5) I always know who is coordinating my care
(F3) I know in advance where I am going, what I
will be provided with and who will be the main
point of professional contact
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None
(2b) Staff work in partnership with me, my family and
carers, and other professionals
(2c) Staff are effective at communicating and sharing
information with me and also with other staff within
and across health, social and third sector services
(2d) I receive consistent and continued care which
helps me to build relationships with staff promoting
holistic approaches
(2a) My care is coordinated across health, social care
and third sector services
HOW DO THE PATIENT EXPERIENCE INDICATORS COMPARE TO THE
PICKER ‘I’ STATEMENTS?
Theme
Picker ‘I’ Statement
Patient Experience Indicators
(3a) My care is provided in appropriate environments
that are accessible, clean, welcoming and enable
privacy and dignity to be maintained
(3b) Staff maintain my confidentiality, privacy and
dignity and treat everyone with respect
Safety, dignity
and respect
None None
Picker Theme(s):
Theme
None
None
(3c) Services are valued and used responsibly by both
me and staff caring for me
Picker ‘I’ Statement
Patient Experience Indicators
(4a) Organizations provide comprehensive services
that are easily accessible, responsive, offer choice and
that provide timely treatment and care
(4b) Equipment and resources are available to meet
my needs and demands
(4c) Staff are prepared and informed about me, my
care needs and other services
High quality
care
None None
Picker Theme(s):
None
None
SBO
HOW DO THE PATIENT EXPERIENCE INDICATORS COMPARE TO THE
PICKER ‘I’ STATEMENTS?
Theme
Picker ‘I’ Statement
Patient Experience Indicators
(5a) Staff/services/organizations are committed to
learning and improving - a no blame culture exists in
which people take complaints seriously, respond
quickly and learn from mistakes
Confidence and accountability in
providers
None None
Picker Theme(s):
None
(5b) Staff have a positive experience of work
(5c) Senior managers, as well as frontline staff, are
professional, honest and accountable
(5d) Staff have good communication skills and use
clear and appropriate language
(5e) Staff are approachable, kind, compassionate and
empathetic
(5f) Staff have the right knowledge, attitude and skills
and adhere to policies
(5g) Staff are culturally aware and sensitive to the
needs of and state of mind of patients, families and
carers
None
None
None
None
None
SBO
COMBINED PICKER ‘I’ STATEMENTS AND PATIENT EXPERIENCE
INDICATORS
Picker ‘I’ Statements
(A1) All my needs as a person are assessed
(A2) My carer / family have their needs recognized and are given support to care for me
(A4) Taken together, my care an support help me live the life I want to the best of my ability
(B6) I have regular reviews of my care and treatment, and of my care and support plan
(B7) I have regular, comprehensive reviews of my medicines
(B8) When something is planned, it happens
(C4) The professionals involved with my care talk to each other. We all work as a team
(C5) I always know who is coordinating my care
(C6) (a) I have one first point of contact. (b) They understand both me and my condition(s). (c) I can go to them with questions at any time
(E1) I am as involved in discussions and decisions about my care , support and treatment as I want to be
(E2) My family or carer is also involved in these decisions as much as I want them to be
(F3) I know in advance where I am going, what I will be provided with and who will be the main point of professional contact
Potential additions from Patient Experience Indicators (that were not covered by the Picker)
(1d) My family, carers and I have access to volunteers and the opportunity to learn and gain support from other patients
(1e) I am provided with opportunities to get involved in shaping and influencing the service and the organization as a whole
(3a) My care is provided in appropriate environments that are accessible, clean, welcoming and enable privacy and dignity to be maintained
(3b) Staff maintain my confidentiality, privacy and dignity and treat everyone with respect
(3c) Services are valued and used responsibly by both me and staff caring for me
(4a) Organizations provide comprehensive services that are easily accessible, responsive, offer choice and that provide timely treatment and
care
(4b) Equipment and resources are available to meet my needs and demands
(4c) Staff are prepared and informed about me, my care needs and other services
(5a) Staff/services/organizations are committed to learning and improving - a no blame culture exists in which people take complaints
seriously, respond quickly and learn from mistakes
(5b) Staff have a positive experience of work
(5c) Senior managers, as well as frontline staff, are professional, honest and accountable
(5d) Staff have good communication skills and use clear and appropriate language
(5e) Staff are approachable, kind, compassionate and empathetic
(5f) Staff have the right knowledge, attitude and skills and adhere to policies
SBO
(5g) Staff are culturally aware and sensitive to the needs of and state of mind of patients, families and carers
APPENDIX 1: SUMMARY OF PATIENT EXPERIENCE WORKSHOPS*
Workshop/event
Attendees
Patient Experience Workshop 6th June 2013
Over 30 attendees – Patients, Carers, CCG Lay Reps, Governing Body GP
Patient Reps, Healthwatch, NHSE Quality Team, BME Health Forum, CWHH
Engagement Leads and CLHARC North West London
34 attendees – Bangladeshi, Somali and Residents on Church Street Estate
Area
Family Mosaics, 8th July 2013,
Diabetes Service Users Group, 17th July 2013,
18 attendees – Service Users and Carers in Tri-Borough Area
Health and Wellbeing Voluntary Organisations Forum,
23rd July 2013, West London CCG
Over 50 participants – Voluntary and Community Sector Representatives
across West London and Central London CCGs.
Community Champions, Ladbroke Grove, 25th July 2013,
West London CCG
6 attendees – community champions and project leader
Workshop for people living and working in Westminster,
Greenside Community Centre, NW8, 5th September 2013,
7 attendees – representatives from diabetes service user group and children’s
centre, patient rep, CCG employees
Workshop for people living and working in Westminster,
Marylebone Road, NW1, 10th September 2013, Central
London CCG
6 attendees – patients/expert patients, user involvement service
managers/leads, member of patient/user panel, student services
representative, CCG employee
Workshop for people living and working in Westminster,
Victoria Medical Centre, SW1V, 12th September 2013,
Central London CCG
7 attendees – Healthwatch, representatives from Breathe Easy and Diabetes
UK, carer, expert patient, representative from Migrants Resource Centre
*This is just a selection of some of the many patient experience workshops that
have been used to inform the CWHHE patient experience strategy and the Better
SBO
Care Plans.
APPENDIX 2: SUMMARY OF PATIENT EXPERIENCE REPORTS*
Relevant Reports
• Community Interpreting and Translation Service, Feedback Notes on Patient Experience in GP Practices and Hospital Services, 2007 / 2009/ 2010 /
2012/ 2013
• Focus Group with Clients Using Migrant Resource Centre, April 2013 (Eastern European and Middle Eastern Communities)
• Church Street Baseline Health Report, Bangladeshi Community Baseline Health and Wellbeing Survey, February 2013
• H&F LINk, Community Mental Health Services – The Service User Experience in Hammersmith and Fulham, March 2013 (Hammersmith and Fulham
CCG)
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• Central London Community Healthcare NHS Trust 15 Steps Feedback on Jade Ward (Central London CCG) March 2013
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• Hammersmith and Fulham CCG, Report of a Diabetes Workshop, 13th February, 2013
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• NWL Commissioning Support Unit, Patient Experience Report, West London CCG, 2013
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• BME Health Forum, A study into the experiences of Black and Minority Ethnic Maternity Service Users at Imperial College Healthcare NHS Trust ,
April 2011-March 2013
• H&F LINk, Ravenscourt and Lillie Wards – Dignity Champion Assessment, West London Mental Health NHS Trust, 2012 (West London CCG)
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• JSNA, Carers Evidence Pack for Kensington and Chelsea, Report, 2012 (West London CCG)
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• CaVSA, Joint Strategic Needs Assessment: CaVSA Community Consultation Report, May 2010 (Hammersmith and Fulham CCG)
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• Somali and Eritrean Project, A study into the experiences of Eritrean and Somali residents of accessing health services , Hammersmith and Fulham,
2005
• Kurdish Association, Diabetes Consultation, West London, March 2005
*This is just a selection of some of the many patient experience
SBO reports that have been used to inform CWHHE patient experience
strategy and the Better Care Plans.