The Musgrove story Our journey towards excellent
patient experience
Martine Price, Head of Patient Experience
Dr Robert Whiting, Consultant Stroke Physician
Our story …
Our journey
A CLEARCLEAR ambition
• Patient safety To achieve zero avoidable harm to patients
• Patient experience To ensure that 95% of patients rate their care as excellent
• Making the most of Musgrove To achieve a reference cost index below 90
Improving patient experience
Learning for improvement
- Patient Safety
- Patient Experience
- Making the most of Musgrove
Zero avoidable harm to patients
95% of patients rate their care as excellent
Reference cost index below 90
Improvement workstream groups
Pathway improvement
groups
The Dunkery Chapter
The Dunkery chapter …
Identifying the problems:
Pathway mapping
Patient shadowing
Staff shadowing
Patient user focus groups
Feedback questionnaires
Key issues:– Getting patients to
stroke unit– Co-ordination of care – Information provision
for patients & families– Discharge planning– End of life care– Staff wellbeing
Patients spending more time in the right place!
Proportion of patients spending 90% of their stay on stroke unit
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Apr-09
May-09
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
Jan-10
Feb-10
Mar-10
Apr-10
May-10
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
Jan-11
Feb-11
Mar-11
Apr-11
May-11
Jun-11
Jul-11
Aug-11
Sep-11
% Achieving
Improvement across key quality indicators
Antiplatelet Therapy within 48 hours
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11
Swallow Screening within 24 hours
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11
Physiotherapy Assessment within 72 hours
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11
Rehabilitation goals agreed by MDT
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11
Mortality rate
Treated with dignity & respect
Would recommend…
7-day mortality
0%
5%10%
15%
20%25%
30%
35%
40%45%
50%
May-10
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
Jan-11
Feb-11
Mar-11
Apr-11
May-11
Jun-11
Jul-11
Aug-11
Sep-11
Mortality rate30-day mortality
0%
5%10%
15%
20%25%
30%
35%
40%45%
50%
May-10
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec-10
Jan-11
Feb-11
Mar-11
Apr-11
May-11
Jun-11
Jul-11
Aug-11
Sep-11
Mortality rate
• “What makes a good or bad day?”
• Building “resilience”
• “Snorkel” exercise– Generating new ideas
for service improvement
Staff engagement day
Looking to the future…
What have we achieved
April 2009 May 2009 June 2009 July 2009August 2009September 2009
October 2009 November 2009 December 2009 January 2010 February 2010March 2010 April 2010 May 2010 June 2010 July 2010
August 2010September 2010
October 2010 November 2010 December 2010 January 2011 February 2011March 2011 April 2011 May 2011 June 2011 July 2011
August 2011September 2011
80.0%
85.0%
90.0%
95.0%
100.0%
Target: 95%
April 2010: Point ofCare Project
February 2011: ImprovementNetwork launched
Patient Experience: Always treated with respect & dignity
Our learning
•What’s it like to be a patient at Musgrove•Have a plan – Driver Diagram•Measurement •Leadership•Staff engagement
What next ...