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What is person-centred care?. ?. ?. HOSPITAL. Smiles everyone!. What’s the problem?. ?. 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?.

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slide3

?

HOSPITAL

Smiles everyone!

everyone aims to do a good job but
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
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
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
Future StateMeasurement 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

slide12

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
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
slide16

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

slide17

“The secret of caring for the patient, is caring for the patient”

Francis Weld Peabody 1881-1927

aims of the collaborative
Aims of the collaborative?
  • To re-establish the core values and behaviours of health & care services
slide19
Its all about people…….

…….and relationships

aims of the collaborative1
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
slide21

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 collaborative2
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
Listen 3 times

1.Before

(expectations)

2.During

(POC experience)

3.After

(objective reflection)

In Real-time

listen in different ways
Listen in different ways
  • Survey
  • Story
  • Unsolicited feedback
  • Advisory councils
  • Obs of care
  • People with first-hand

experience

Multi-method

Multi-trait

Systematically & Comprehensively

slide27

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

slide28

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
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  • Registration now open at www.eventage.co.uk