? HOSPITAL Smiles everyone!
Everyone aims to do a good job, but...... The subliminal message? More, more, more....... Faster, faster, faster...... with less....... What’s our priority – the system or the people?
Comprehensive systematic measurement infrastructure 18 wks RTT HSMR 4 hour A&E HSMR HSMR 4 hour 4 hour 18 wks HSMR HSMR 18 wks 4 hour 4 hour 18 wks 18 wks NHS Board NHS Board NHS Board NHS Board NHS Board NHS Board NHS Board But, where is care experience? The voice of the service user?
Current State System Outcomes People Focused Outcomes Staff Experience Etc Local surveys Patient Groups Finance Access Targets Team vitality Better Together Complaints 4 hours 18 wks Pulse surveys Bi-annual survey
Future State Measurement for Improvement Care Experience System Outcomes Staff Experience Personal goals Real-time feedback Loved Ones System Measures System outcome Real-time Feed back Staff wellbeing System Measures Team vitality Values based Reflect. Pulse surveys System Outcomes System outcomes System outcomes Obs of Care Comp- liments Nothing about me Must do With Me
Are we serious about improving person-centred care?Then we need to measure the right stuff!
Overall, we found that the service: provided very good care, which was tailored to meet the individual needs of people who used the service supported people through a committed, caring and dedicated multidisciplinary team ensured people were being consulted about the quality of their care and the development of the service ensured people were treated with dignity and respect, and was valued by the people who used it and everyone we spoke with spoke of the care and treatment being excellent. “The focus of all their activity is on the patient, families and carers.” (Healthcare Improvement Scotland inspection report of Strathcarron Hospice March 2013)
What do the people want & need? NHS Scotland - The 6 Cs • Caring & Compassionate staff & services • ClearCommunication & explanation • EffectiveCollaborationbetween clinicians, patients & others • Clean and safe care environment • Clinical excellence
The feelings and emotions of the patients, under critical circumstances, require to be known and to be attended to, no less than the symptoms of their diseases. Medical Ethics, Thomas Percival, 1740-1804, Edinburgh physician and author
“The secret of caring for the patient, is caring for the patient” Francis Weld Peabody 1881-1927
Aims of the collaborative? • To re-establish the core values and behaviours of health & care services
Its all about people……. …….and relationships
Aims of the collaborative? • To re-establish the core values and behaviours of health & care services • To design processes of care that focus on the needs of the people, not on the needs of the system or the profession
Person-Centred Health & Care: Care Experience Aim Primary Drivers Secondary Drivers • Distributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executives • Values & behaviours form basis of recruitment , development & management of staff • Reliable use of recognised tools to promote optimal team functioning • Person-centred values & behaviours are evident in words & actions at all levels of leadership • See also “Leadership” change package for key interventions & structures Person-centred care is everyone’s business • Reliable application of the five “Must do with Me” elements: • What matters to you? – finding out what’s important to people and using this info to collaboratively plan care • Who matters to you? – making it easy & routine for people to involve their personal support network if they choose • What information do you need? - information is timely, full and understandable & decisions are collaborative • Personalised contact – as much as is possible timing & method of contact with services is flexible • Nothing about me without me – people are involved with communications, handovers and transitions at the level they choose • Dignity and respect frame all communication and interactions • Teams test and adapt tools to measure and improve communication By December 2015 people using services will have a positive experience and get the outcomes they expect Services are delivered in active, collaborative partnership with people Technical care is delivered reliably and based on person-centred principles • Technical care is delivered in alignment with “Person-Centred Principles” • 1) Active, equal partnership • 2) Information sharing is timely, open and complete • 3) Participation in decisions • 4) Collaboration in design & delivery of services • Reliable application of the 5 “Must do with Me” elements Physical & cultural environments support the delivery of person-centred care • Weekly environmental walk rounds & Observations of Care by: a) Leaders; b) facilities teams; c)Clinical teams d)Service user / volunteer groups using person-centredness checklist • Walk-rounds & Observations focus on: • People & interactions (conversations with people using & delivering service, observations of care, etc) • Environment of care (signage, way-finding, etc)
Aims of the collaborative? • To re-establish the core values and behaviours of health & care services • To design processes of care that focus on the needs of the people, not on the needs of the system or the profession • To measure person-centredness as systematically & comprehensively as we measure HAI or financial performance
Listen 3 times 1.Before (expectations) 2.During (POC experience) 3.After (objective reflection) In Real-time
Listen in different ways • Survey • Story • Unsolicited feedback • Advisory councils • Obs of care • People with first-hand experience Multi-method Multi-trait Systematically & Comprehensively
Aim Primary Drivers Secondary Drivers Improved Care Experience By 2015 All health and care services are centred around people Improved Staff Experience Co-designing with NHS, Local Authority and 3rd Sector Leadership Co-Production
Aim Primary Drivers Secondary Drivers Leadership Care Experience Staff Experience Coproduction By 2015 All health and care services are centred around people Co-designing with NHS, Local Authority and 3rd Sector
Next learning Session... • May 30th-31st SECC, Glasgow • Registration now open at www.eventage.co.uk