©fuelfor 2009

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1st April 2009 I Glasgow, Scotland

+ fuel for NHS ScotlandPatient experience master class

©fuelfor 2009

Patient experience master class I Introduction

“Help people to sustain and improve their health, especially in

disadvantaged communities, ensuring better, local and faster

access to health care”

BETTER HEALTH, BETTER CARE:ACTION PLAN

In 2008, NHS Scotland launched its national Patient Experience Program, Better Together (www.bettertogetherscotland.com), which aims to empower patients, carers and health care staff to work in partnership to provide patient centred and equitable care, as well as improving NHS service planning and delivery. Believing that a design approach to health care innovation could provide valuable insight and additional skills for their national Im-provement and Support Team (IST), NHS Scotland’s Health De-livery Directorate asked fuelfor to create a 1 day master class in Patient Experience for 40 senior leaders as part of their Service Innovation and Transformation Program. Building on current NHS patient experience research tools and LEAN process improvement techniques, the master class was designed to meet the following objectives: + Provide an introduction to Experience Design for Health Care + Demonstrate a design approach for understanding patient experience and its implications for service innovation + Provide a set of principles that can be used to apply a patient experience approach within current service innovation practice

©fuelfor 2009

Patient experience master class I Toolkit

Context scenes

Experience design principles

Needs cards

Voting dots

Relationship mapExperience journey

Stakeholder profiles

A set of visual and interactive workshop tools enabled participants to ‘step into the shoes’ of patients, their loved ones and care givers, and ‘walk through’ the experience journey identifying issues, needs and eventually opportunities for experience-driven service innovation.

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Issues

Needs

Waiting at GP’s officeCreate a map of the key stakeholders in the neonatal unit such as parents, family members, nursing staff and physicians. Try to describe their roles and inter-relationships. What are their main challenges, joys and needs?

©2009 fuelfor

©2009 fuelfor

Stakeholder map Create a map of the key stakeholders in the neonatal unit such as parents, family members, nursing staff and physicians. Try to describe their roles and inter-relationships. What are their main challenges, joys and needs?

Wife and Children

Patient

Rheumatologist

Rheumatologist nurse

Physiotherapist

GP

OT / Arithritis care class facilitator

©2009 fuelfor

Stakeholder profilesCreate a map of the key stakeholders in the neonatal unit such as parents, family members, nursing staff and physicians. Try to describe their roles and inter-relationships. What are their main challenges, joys and needs?

“I love closing my eyes during yoga and just breathing slow and carefully.”

“I take care of my children and try to notice every change as they grow.”

“Since I started my treatments my sleeping patterns have changed a lot.They are days that therapy tires me out - I take it easy and get some rest.”

“ At night I sit in bed with my husband and read or watch television and talk quietly about our days. I really value those times.”

“Now that the Chemotherapy and nausea are finished, I love to go out for dinner with my husband and kids - I just couldn’t face that during chemo.”

“It has been very important for me to stay looking good...when I lost my hair I got a wig and started wearing red lipstick! Ido not want anybody to feel sorry for me. Looking good helps me to feel good.”

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My daily routine

“I’m worried that this disease will leave me forever scarred””“I‘m scared of losing it in front of my children.”

“I‘m nervous my daughter could get breast cancer one day.”

My fears and concerns“I want to enjoy my husband and really nurture our relationship - itsbeen damaged by my disease.”

“ I want to see my children watch my children graduate from high school”

“I want to know that my cancer is gone for good.”

“I try to live each day to the fullest, to not sweat the small stuff and to appreciate the good things in my life.”

My hopes and dreams

other patients...“ I‘ve gotten to know a couple of other patients during treatment - a woman who comes to radiation at the same time as me, and another whom I saw at chemo. It’s really helpful to share stories and to understand that I’m not alone. When this is all over I really want to be an advocate and help inspire others who are going through this.”

“ I have to admit I don’t really like support groups though, because I don’t want to sit around and complain about my situation, or just listen to other people complaining about theirs. I’d rather go outside and be inspired and think positive.”

clinical staff...“My chemo nurse Rebecca has become a good friend to me. I confide in her more than most people. We are about the same age and she has two kids too so I think she can see my perspective pretty well.”

“My relationship with most of doctors are less close, but I also have a great deal of respect for them. I researched a great deal beforehand and got asecond opinion of my diagnosis - we wanted to know we were going with the best.”

Cancer is...“...a monster trying to overtake me, to kill what is good inside of me.But I’m not going to let it.”

Wellbeing is...“...being strong and having an attitude that can beat anything. It’s aboutholding yourself together even when times are tough. It’s about being able to take advantage of the magical aspects of life. It also has to do withmy strong connection to God and my church community. When I am with them I feel strong and safe.”

Healing is...“...mind over matter - it’s about overcoming your obstacles and persevering.It is about accepting your faith and being thankful for the valuables lessons learnt.”

My attitudes towards my health

My relationships with...

“My husband has been very supportive through it all and tries to keep my spirits up, but it’s clear that he’s terrified and feels like he can’t show it.”

“ It’s been hard to accept my new body shape and myself as a sexual being. I am thinking about having breast

“The health insurance issues are a continual hassle”

“ I’m worried about my husband not being able to cope with the kids if I die.”

“ I’m worried the cancer may come back in other places in my body”.

“I don’t want to get stressed, because I associate that with getting cancer.”

Some highs...

Some lows...

“ Night time for me has a whole new meaning for better or worse. It is now the silent time when I find myself thinking and reflecting about my life - sometimes it’s when I am alone with my fears”

“I clean the house and take care of all of our errands - I’m a taskmaster and I find it hard to ask for help.”

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family & friends...

“My Oncologist, Dr. Winfrey has become a crucial person in my life. His charisma, professionalism, personal care and kindness has comforted me a lot. He has involved my family’ and understood our situation by offering us steady comfort and assistance throughout this process.”

“I want my doctors and nurses to be honest with me, to give me all of theinformation I need in a clear and intelligent manner, but also to show methat they care. If they have a bad bedside manner, they’re out. They needto treat me with respect.”

“ My kids are just too young to really understand what is happening, so I’m doing my best to keep up with their usual routines so that they don’t get worried or upset. Eventually, when this is all over, maybe I’ll explain to them what I’ve been through.”

Kate’s sister says...“ We have always had a very close relationship, especially since our mother diedfive years ago. We talk everyday, I think she finds it easier to tell me some thingsshe can’t talk to her husband about. I worry about her but I am just so proud of howshe is handling this whole thing - I don’t think I could be that strong!”

“ I used to make friends very easily, I was an open book, now I takes me much longer to share with others my experience and to talk about it. I am just not willing to share my life with others the way I used to. I find it harder to get closer to people.”

Kate’s fellow chemo patient says...“ She always comes in looking great, with really nice clothes! Actually, I find myself wondering, “What will Kate be wearing today?” when I get ready to go to chemo!”

Kate’s daughter says...“ I want to shave all my hair off to be like mummy, she looks cool!”

Kate’s chemo nurse Rebecca says...“ It’s a little tough sometimes to care for Kate as I see so much of myself in her. I have two small children too and I know it must be tough for her,wanting to be strong for them and for her husband.”

Personal story: I am 34 years old and live in Norwalk, Connecticut. I used towork as an accountant, but quit five years ago when mydaughter Aubrey was born. I also have a two year-old namedJacob. My husband and I enjoy spending time with friends andgoing sailing or to the park or on hikes. I’m also very active atmy daughter’s school. I try to go to my yoga classes twice a week.

Cancer story:I have a family history of cancer; I was diagnosed with stage IIIA breast cancer after my annual mammogram revealed a lump in my breast and a biopsy gave me the bad news. I had chemo-therapy treatment and a lumpectomy. I am currently undergoing radiotherapy treatment. I am hopeful things will work out and I’ll be myself again soon. I’m trying to stay positive for my kids.

“All you can really do in your life is strive - to survive, to maximize every moment, to be good to the peopleyou love. You have to relish each moment of it.”

Patient experience master class I Process

Experience design presentation Enrich stakeholder profiles Share profiles Review experience journey

Identify key needs Consolidate multi-stakeholder needs

Discuss key experience stages Vote for experience improvement hotspots

Working in smaller groups and presenting in plenary sessions participants were able to share collective insights and discover new ways of thinking as a team about health care experiences.

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Patient experience master class I Mindset change

Sub group exercises were facilitated by key IST program directors, helping transfer new thinking and skills into the organi-sation for sustainable change.

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Patient experience master class I Outcome

The result of the workshop was an experience journey poster capturing key stakeholder needs over time, and identifying opportunities for improving health care experience through service innovation.

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Participants were given a memento of the workshop; a booklet reminding them of the key principles of experience design for health care and a set of red dots to continue identifying experience-based improvement areas for NHS Scotland.

Patient experience master class I Reminder

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After the workshop an on-line evaluation form was sent to participants in order to gather feedback on the content, process and experience of the Master Class.

Patient experience master class I Feedback

95.7%Of the workshop participants found the workshop content relevant and useful.

“It showed another tool for gathering service user experience and how to use this feedback when redesigning services.”

“The content was similar to the work we already do but it had subtle differences. I could easily see how this could be incorpo-rated into my work.”

“Very well facilitated, well paced. Materials use very relevant.”

Of the workshop participants would recommend this course to others.95.5%

©fuelfor 2009

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©fuelfor 2009

+ for more information or to arrange a similar workshop for your organisation, please contact us

contact@fuelfor.netwww.fuelfor.net

+34 672 252 681