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:robincreelman@yahoo.co.uk] 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