Improving Experience and Outcomes for the People of
Highland
Maimie Thompson
Head of Public Relations and Engagement
NHS Highland, March 11
• Are we committed to gaining and acting upon patient experience?
• Do we have systems in place to know what our patients are experiencing at the pace we need to know it?
• Are we ready and able to make improvements
How do we capture experience?
• Day to Day interactions – being in touch• Standard feedback mechanisms• Patient Diaries• Better Together Results – Hospital and General
Practice• Thank you letters and cards• Complaints• Patient Opinion
BUT …………………
“The problem is they usually come back good or very good as
patients don’t like to complain.”
Consultant Cardiologist
Why don’t patients complain
• Big resistance to criticise health care
• Fear of repercussions for staff– “They were trying their best”
• Fear of repercussions for self/relative – “It takes a lot of confidence and self belief to
criticise a service you are dependant on.”
AND
If we keep asking the same things in the same way …
We will just get more of the same
Nibbling at the Edges
Complaints etcCards and chocolates
“I have always thought that our current mechanism of assessing patient satisfaction is poor and insensitive. If staff deliver questionnaire they are almost always positive and complaints are usually from a tiny minority of people who may have other issues.”
“Some times we seem to be more focussed on meeting the needs
of staff not patients”
BUT
Hearing it as it is
Hearing patients, carers, staff telling us of their experiences can be very powerful and moving;
Not always about the quantity of feed-back
But be alert to use and abuse of patient feed-back – find the feed-back to suit the agenda
Balanced approach
Cant look after patients if you don’t look after staff
Values
ExpectationsResources
Patient SafetyPatient SafetyQuality of care andQuality of care and
ExperienceExperience
Leadership
Needs of Needs of Service, staff Service, staff
& communities& communities
Competing for centre stage
Simply
Complex
Comfort of familiarity
Patient Opinion in Context
Opinion
“Judgement or belief not founded on certainty or
proof”
“An evaluation or judgement given by
an expert.”
Context
• Don’t harm me• SAFETY
• Make me better• QUALITY OF CLINICAL CARE
• Treat me well• CARE & EXPERIENCE
Patient Diaries – Referral to Treatment
1. Staff were kind and helpful
2. Knew why I was being referred
3. Seen promptly
4. Clear about what was happening
5. Everyone told me the same thing
1. Lack of information and poor communications
2. Parking and access difficulties
3. Opening hours of refreshment services
4. Smoking around entrances
X
Newspaper send to everyone household in Highland
From our CEO Tell us about your care?
• If you have first hand experience on recent care and services we want to know about it.
• If you are invited to take part in feed-back, please do so. It helps us to help you.
Using PO to drive patient-centred service improvements
From: Robin Creelman [mailto:[email protected]] Sent: 01 September 2011 09:18To: Mead Elaine (NHS HIGHLAND)Cc: May Heidi (NHS HIGHLAND); Coutts Garry (NHS HIGHLAND)Subject: Fw: Using PO to drive patient-centred service improvements
Elaine, Below is an email received from Richard McLennan. I will respond to him stating
that I have passed it on to the executive/clinical part of the organisation for their consideration/decision regarding this.
My own view is that being a part of the development of a project like this is usually beneficial………
I would appreciate being kept in the loop regarding this. Regards, Robin
Board level support and leadership
Tongue Sparky
“We should not be pushing patients out, but supporting them gently away from their area of treatment”,
“I have discussed these issues with staff and they will make sure patients are comfortable before the procedure starts. “
Digging deeper
• I'm not sure how valuable this is without specific patient details.
• The story is obviously complex but without the patient details and notes it is unlikely we could get to the bottom of the problem.
• We have a well organised follow up system for patients with acoustic neuromas but the follow up criteria have changed recently. Perhaps this is at the root of the misunderstanding.
• If the patient wishes this to be looked into I would be happy to oblige,
Corporate NHS
Feb 11
Overview
These stories illuminate the gulf between the principles and value of the NHS and the felt reality of being an older person in the care
of the NHS in England
Mind the Gap
Customer Care
“ Our work has found staff who are absolutely dedicated to their work
and who feel they hold strong values around patient care.”
“The problem is that on closer inspection of the behaviours they exhibit in their every day working lives there seems to be a bit of a
‘disconnect’ “
“Some staff are slightly short sighted in realising that the small things, they feel are
insignificant, are having a such a negative affect on patient
experience.”
Swallow Story
From National Healthcare Quality Strategy
“What will make Scotland a world leader will be the combined effect of millions of individual care encounters that are consistently person-centred, clinically effective and safe for every person, all the time”
We tend to remember the exceptions-the extraordinary things
What would be truly extraordinary would be doing the ordinary everyday things well