pen awards webinar – 29 sept 2015

#PENNA2015 #PatExp

What’s working well in patient experience?PEN Awards Webinar Series

29th September, 12 - 1pm13th October, 12 - 1pm6th October, 12 - 1pm20th October, 12 - 1pm27th October, 12 - 1pm3rd November, 12 - 1pm

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patientexperiencenetwork.org

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RUTH EVANSManaging Director Patient Experience Network

WELCOME

What’s working well in patientexperience?PEN Awards Webinar Series


#PENNA2015 #PatExp

Webinar content – 29th September 2015

Welcome and introduction

• Ruth Evans - PEN: Launch of the Winning Principles and overarching Framework

• Bridget Hopwood - Picker Institute

• Andrew Hasler - NHS Improving Quality

Questions

• Jimmy Endicott - Leicestershire Partnership NHS Trust: ChatHealth School Nurse Messaging Service

• Allan Anderson - Positively UK: HIV Peer support Improving well-being

Questions


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Welcome to the UK’s leading awards event that recognises Patient Experience excellence

Wednesday 11 March 2015


PEN National Awards 2014

Re:thinking the experience

LET’S CELEBRATE A YEAR OF SUCCESS


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Intention and Outlook

• Passion and determination

• The most successful initiatives are driven by an individual or team with a firm belief in what they are doing, and the need to invest time and money to make it happen and bring about change.

• Broadening perspectives

• A key milestone for success is supporting and educating fellow professionals to look beyond their own situations and embrace and adapt work going on elsewhere.

• Keeping it simple

• Making initiatives easy for people to understand and adopt is crucial. Clear communication, posting results and evidencing improvements encourages engagement and continuation with projects.


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Organisational Support

• Culture

• Creating a culture where everyone is engaged in patient experience and understands the role they have to play in improving it is vital to success. All successful initiatives are delivered by teams, not individuals.

• Management

• Senior level support is often key to the success of a project. The best results are seen where improving patient experience is encouraged and prioritised by management.

• Leadership

• Clinical and senior management leadership, particularly in the form of empowering staff to identify, develop and implement changes is key to sustainable improvement.


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Evidence & Impact• Financial impact

• It is clear that positive patient experience pays dividends, and our most successful entries demonstrate how time and financial investment in well thought out projects can yield an excellent return.

• Building professional relationships

• Working in partnership with teams within and outside your organisation, as well as with volunteers and other groups is key to ensuring ongoing success in spreading and embedding positive practice.

• Spread and sustainability

• Evidencing sustainability and transferability are key to success. Demonstrating how initiatives have been or could be adapted provides an opportunity to share and embed successful practices.


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Bridget HopwoodDirector of Health Experiences Picker Institute Europe

MEASURING AND IMPROVING PATIENT EXPERIENCE FOR ALL

Measuring and improving Patient Experience for allBridget Hopwood, Director of Health Experiences

Picker Institute Europe

www.pickereurope.org

An international charity dedicated to ensuring the highest quality health and social care for allOur work is underpinned by a commitment to the Picker Institute principles of person centred care and our core aims are to:

o Influence policy and practice so that health and social care systems are always centred around people’s needs and preferences;

o Inspire the delivery of the highest quality care, developing tools and services which enable all experiences to be better understood; and

o Empower those working in health and social care to improve experiences by effectively measuring and acting upon people’s feedback.

Picker Institute Europe

Our partners and customers

Picker Institute Europe 12

Quality care is...

Quality

Clinical Effectiveness Safety

People’s Experience

“...what actually happens to patients as people in the process of receiving care & treatment “

Achieving Patient-Centred Healthcare: Indicators of Progress and Success

Patient experience

Because “to measure is to know” and “if you cannot measure it, you cannot improve it”

Core to an organisation’s reputation &

productivity

A risk management issue

A key indicator of quality and safety

An opportunity!

Achieving Patient-Centred Healthcare: Indicators of Progress and Success

Measuring patient experience – why?

Four Principles of PREM development

Patient involvement throughoutPatient centred care requires patient centred questions

Experience based questions not satisfaction

Thoroughly test with the target groupChoose most appropriate method of data collection


One size doesn’t fit all!

Survey design process


Qualitative Scoping

• Focus groups and/or depth interviews to scope main issues/views

Questionnaire Design

• Priority areas identified in qualitative stage

• Format, length and design appropriate to target audience

Cognitive Testing

• F2F or telephone

• Test for interpretation, recall, responses options, format

• Amend and retest

Data Collection

• Select appropriate methodology for population

• Test approach (pilot)

• Implement surveys/ data gather

Different experiences, different priorities

Type of patientOld vs youngMale vs femaleEthnicityChronic vs Acute conditions Cognitive Ability


Type of ExperienceInpatientOutpatientUrgent CareCommunity Care – eg GP / walk-in centre/ home delivered careResidential care/care homes

Health Experiences Team - vulnerable and lesser-heard groups e.g. children & young people; elderly; learning disabilities and condition

specific

Examples of our feedback tools - children and young people


Children’s FFT Paediatric inpatient and day case survey

Acute hospital careInpatient & day case (now national CQC)Outpatients (DH Innovation in outcomes competition winner) Emergency DepartmentNeonatal (parents’ experiences)Transition CYP Friends and Family Test

Children’s community – SaLT; OT; physio

Chronic conditionsAllergiesSickle cell disease

Learning disabilities Inpatient survey


Case Studieswww.pickereurope.org

Understanding the care experiences of people living with a chronic health condition: a focus on Sickle Cell Disease

STAKEHOLDERS: collaboration between the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London (NWL), Picker Institute Europe and the Sickle Cell Society

PATIENTS with Sickle Cell Disease (SCD) and their families:(i) adults; (ii) children; (iii) parents

Focus groups revealed:Access to good quality primary care and A&E services is variable Psychology services are valued, but access to them is inconsistent Transition from paediatric to adult services often induces anxiety Age-appropriate information and social support needs improving Greater understanding of the ‘hidden’ condition across society would improve quality of life


Survey DevelopmentSurveys developed and being implemented in England using an online methodology. Three versions:

Adults 16 yrs + Children 8-15 yrs Parents 0-15 yrs

Surveys will help to: Understand SCD care experiences on a national scale

Inform the delivery, design and commissioning of SCD services

Influencing - success stories


o Meningitis Now: survey commissioned in 2012 highlighted concerns around awareness of Viral Meningitis with 97% of its victims left with sometimes debilitating after-effects.

o As a result, first ever Viral Meningitis Week, held in May 2013 - to improve awareness of viral meningitis and its true impact.

• 2013 survey exploring support needs for 14-24yr olds affected by meningitis – revealed information gaps.

• Led to expansion of Young Ambassadors group and introductions of “Believe and Achieve” weekends

o End of Life Guide: created by the Motor Neurone Disorder Association (MND Association), and formed around evidence from a Picker Institute Europe research study, has been awarded Patient Resource of the Year at this year’s British Medical Association (BMA) Awards.

o Based on qualitative and quantitative data from key stakeholders - including people living with MND, their families and carers, MND staff and volunteers and covered issues including end of life choices

http://www.mndassociation.org/news-and-events/latest-news/end-of-life-guide-wins-patient-information-of-the-year/

http://bma.org.uk/

Influencing - success stories (2)


o National CYP Inpatients Survey: developed by the Picker Institute; incorporated into CQC national survey programme from 2014

o CYP Outpatients survey: developed in conjunction with Sheffield Children’s Hospital and winner of Department of Health’s Innovation in Outcomes award in 2011

o Sheffield Children’s NHS Foundation Trust: building services around people’s experiences, their capital building programme has largely been informed by the survey findings. Concerns highlighted in the survey, such as sign-posting, parking, disabled access, privacy and dignity needs on wards have informed their design.

o Info gained about parent accommodation needs factored into ward design, and resulted in the Sick Children's Trust charity providing dedicated accommodation for critical care families

Always Events

An Always Event is a clear, action-oriented, and pervasive practice or set of behaviours that provides:

A foundation for partnering with patients, service users and their carers;

Actions that will ensure optimal care experiences and improved outcomes; and

A unifying force for all that demonstrates an ongoing commitment to person and family centred care.

They are the aspects of care experience that are so important to patients, service users and carers that providers must perform them for every patient, every time.

They are co-produced and designed within each care setting dynamically, ensuring the Always Events remain relevant and are true to their target population

Currently in its second phase of piloting and evaluation

Further information and case studies on the programme can be found at www.pickereurope.org

http://www.pickereurope.org/

Perception

Awareness

Value Impact


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Andrew HaslerSenior Improvement ManagerNHS Improving Quality

LATEST NEWS ABOUT IMPROVING THE PATIENT EXPERIENCE

Understanding what really matters

‘Personalised care will only happen when statutory services recognise that patients’ own life goals are what really count’.

National Voices – 5YFV

Commissioned by NHS England, the person-centred outcomes programme of work is about:• achieving the best possible (optimum) quality of life

outcomes for individuals (patients, carers and citizens);• understanding and modelling these at a population level,

and;• leveraging influence within the overall system to enable

effective commissioning and best use of resources.

Mapping, Modelling, Measuring and Mainstreaming

Deliverables1. Support to the pathfinder sites (x8)2. Evidence scan3. Definition4. Summit / roundtable – experts in the room5. Top tips publication on the relevance and application of

person-centred outcomes.6. A model that brings together PROMs, PREMs and PCOMS

into a single framework that focuses on patients / people.7. PCOMs case studies8. International conference

What examples can be found to demonstrate where person-centred information is used in a structured way to influence population-level commissioning decisions with the intention of improving population health and wellbeing

Evidence scan – key question

Examples and ideas to [email protected]

mailto:[email protected]

TweetChatWednesday 7th October

20:30 hrs

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Questions?


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OVERALL WINNER’S PRESENTATION

ChatHealth School Nurse Messaging Service

Celebrating Success

Jimmy Endicott - Leicestershire Partnership NHS Trust

@LPTnhs @jimmyendicott

SCHOOL NURSEMESSAGING SERVICE

@ChatHealthNHS @jimmyendicott

Jimmy EndicottMobile Media Development Manager

AMBITION

To transform access to healthcare for young people


• Imminent high risk• 24/7• Shared responsibility• Availability changes• Missed messages• Excessive record keeping • Identity verification

CLINICIAN’S THOUGHTS ON RISK IN MESSAGING …



Since 1980 - young people with DEPRESSION has doubledSince 2004 - hospital admissions with SELF HARM up 70%

• School Nurses• Young People• Police• NSPCC• Royal College of Nursing• Safeguarding Leads• Information Governance

Leads• Teachers and Governors• British Youth Council• Sexual health text helplines

FOLLOW US

SAFETY

WHO WE CONSULTED …

http://www.leics.police.uk/

http://www.nspcc.org.uk/

http://www.rcn.org.uk/

http://www.txtm8.com/index.htm

FOLLOW US

PATIENTRECORD

FOLLOW US

http://www.twitter.com/jimmyendicott


STAFF IMPACT

Manageable Sustainable Improves safety Inter-agency

working Earlier intervention Released time 1200 more contacts

ONE TRIAGE NURSE SUPPORTS 65,000

YOUNG PEOPLE 11-19

East Riding of Yorkshire Council Hertfordshire Community NHS Trust North Bristol

NHS Trust Northamptonshire Healthcare Foundation Trust Northumbria

Healthcare NHS Foundation Trust South Tees NHS Trust North Lincolnshire

and Goole NHS Foundation Trust Suffolk County Council Bradford District

Community NHS Trust Staffordshire and Stoke on Trent Partnership NHS

Foundation Trust QNI Liverpool Community Health NHS Trust BBC

Radio Worcester Health and Care NHS Nottinghamshire Healthcare Foundation

Trust Journal of School Nursing Bedford Borough Council Norfolk Community

Health and Care NHS Trust Derbyshire Healthcare Foundation Trust SAPHNA

Journal of Nursing for Children and Young People East London NHS Foundation Trust

Journal of Primary Health Care Chesterfield Royal Hospital NHS Foundation Trust

Walsall Healthcare NHS Trust Pennine Care NHS Foundation Trust Central

Manchester University Hospitals NHS Trust Sheffield Children's NHS

Public Health England South Warwickshire NHS Foundation Trust

Rotherham Doncaster and South Humber NHS Foundation Trust Department

of Health North Somerset Community Partnership CIC Birmingham Community

Healthcare NHS Trust Stockport NHS Foundation Trust

FOLLOW US

MEASUREMENT

• Student survey (2,000 respondents)• Patient and staff satisfaction video

interviews• “Mystery shopper”• Staff reference group• Peer review (150 conversation transcripts)



IMPROVED PATIENT EXPERIENCE

• Improved access 1,200 more patients annually • Less stigma – half contacts are anonymous • Reaches underserved teens - 1/5 male users • Improved safety, involving police/social-care

• Age appropriate• More 1st time users• Broader range of enquiries• Engaging sooner

u can express yourself in ways you wouldn’t to ur friends …

i feel less judged when i send a mssg

I’ve never told anyone this before, but …

*

*

*


thank you from the bottom of my heart for helping people like me ;)*


WINNER’S PRESENTATION

HIV Peer support Improving well-being

Celebrating Success

Allan Anderson - Positively UK

@ Positively_UK @allan_anders

Positively UK’s Peer Support Service

Positively UKCharity Aim: to improve the physical, emotional and social well-being of people living with HIV Medium sized, 19 members of staff and more than

50 volunteers All front line staff and

volunteers trained and accredited in delivering peer mentoring and advocacy

Based in London, support 1,000 people per annum

Peer SupportAim: to help people feel more in control of their HIV encompassing one-to-one assessment, information, guidance, mentoring and advocacy. Aligned to Department of Health: NHS Outcomes Framework –

“Ensuring people are supported to manage their condition”

Public Health Outcomes Framework – “People are helped to live healthy lives and make healthy choices”

NHS 5 Year Forward View – encouraging peer-to-peer communities

Evaluation project What impact does peer support have on

well-being? Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)

What is the perception of the service? How does it complement clinical care? How does it impact on other aspects of life?

This research project was supported by an educational grant from MSD, and the secondment of A K Gilbert, researcher, and employee of MSD

Demographics • 71.5% female, 28.5% male• Average age – 46yrs 7mths• Average length of time with HIV

– 11yrs 2mths• Accessing services from Positively UK – average 5yrs 11mths

Heterosexual (straight)

Gay Lesbian Bisexual020406080

100120 109, 85.2%

11, 8.6% 2, 1.6% 6, 4.7%

Are you:

Survey NumberNo of responses collected 154Duplicates -9No of responses analysed 145Not accessing support from Positively UK -8TOTAL 137

Peer support service - satisfaction scale

“..I feel that I am not alone” “extremely satisfied with help and advice” “..I have gained self esteem” “I have learnt to be

positive about life” “…professional, caring and knowledgeable” “..they help me cope with my new life condition” “they are very dedicated in supporting clients”

92.5% -very or extremely satisfied with

peer support

Why do you say this? (quotes)

Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)14 statements relating to mental well-being Lowest score = 14, Highest score = 70

Please tick the box that best describes your experience of each over the last 2 weeks Results - average score = 50.3 with a range 27 to 70

Please tick the box that best describes your experience of each before you accessed peer support? Results - average score = 41.5 with a range 14 to 70

Positively UK’s peer support significantly improves well-being

12% improvement* (an average of 9 points)

*statistically significant p≤0.01 (Mann-Whitney)

Face to face with one person

One to one on the telephone

One to one through email

Group support

Short modular courses/workshop

Web support

On-line support

Mobile app

0 10 20 30 40 50 60 70 80 90 100

78 (66.1%)

53 (44.9%)

47 (39.8%)

92 (78%)

54 (45.8%)

33 (28%)

34 (28.8%)

29 (24.6%)

In the future, how would you prefer to access peer support?

To summarise…. Peer support significantly improves well-being Complements clinical care Has a positive impact on other aspects of living

with HIV Overall people are very satisfied with the service

This project has been supported by an educational grant from MSD, and the secondment of A K Gilbert, researcher, and employee of MSD

Peer Support – Relevance to other groups Peer support model can be used in any setting and

in any therapeutic area Started very small, growing to supporting 1000

people a year Other organisations

could start with just a local peer-led service

Seek to influence the commissioning of effective services across the UK

Peer Support – key elements Patient-led, services are

developed and delivered by people living with HIV

Highlights an undervalued and underfunded service

Robust evaluation proved the value of peer support in long-term condition management and improving well-being

Collaborative service drawing on strengths of the voluntary sector to support clinical care

Peer Support – future success Working with local authorities who commission peer

support ready to re-tender in 2015/16 Aim for peer support to be commissioned as key

component of HIV care Project 100 roll out our peer support model

nationally over 4 years Working with patient groups, NGOs and HIV clinics Wide-scale evaluation and financial modelling

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Questions?


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Thank you


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