Rosy Wells Paediatric ST7 Patient Experience Rosy Wells Paediatric ST7

Where to start? Children’s Allergy Service Food challenges run most days on day unit Awareness of problems with the booking service and admin/information both from patients and staff Inspired by patient experience lecture First step: speaking to children/parents attending service

Current System for food challenges booking/information Children seen in OP clinic Clinic letter written to include confirmation of FC and phone number to call for parents Parent then call admin (Jim) to book in challenge If Jim not available, message left for him to call back Info about food challenge and recipe then sent to family No text reminder. Parents advised to call nurses if questions or child unwell

Emotional mapping Female 8 years having nut challenge Happy Excited Bored Worried Scared But a bit excited In outpatient clinic Letter arrived Waiting for appointment Day of appointment Arriving at hospital

Emotional mapping Mother of child having nut challenge Pleased, relieved Confused Frustrated, upset Happy, satisfied Disappointed, frustrated, confused Anxious, unsure, mixed happy In outpatient clinic Letter arrived Trying to book appointment Booking appointment Information received Arriving at hospital

Quantative data with medical student Web-based, 5-10 min questionnaire Patient responses collected during appointment on food challenges unit Patient/parent used trust I pads to respond n = 55, 3 month period

Additional comments about pre appointment information: “A video link is a good idea. I am a sleep deprived mother so as much hand holding as possible would be good!” “Advice on preparing your child” “A website that explains it all- lots of information/recipe ideas about how to prepare for the test.” “The amount of milk needed stated in the letter would have been helpful but I did call and was given the information.” ”A website that explains it all- lots of information/recipe ideas about how to prepare for the test.”

Comments on the booking system

Observations from working on the unit Often cancellations on the day Frequently sending children home due to illness, asthma symptoms, hay fever, recent use of salbutamol, taken antihistamine Frustration for patients and for children Cost of travel, time off work, arranging childcare, cooking food, rearranging Waste of resources, time, cost for hospital Several times involved children having had salbutamol- changed information sheet to include this information on information sheet

Audit of cancellations Done by Jim (admin) and Ruth (dietician) Objective: To review the number of unused slots on EDCU between January and march 2017 To identify the reason slots are unused To see if we can develop new strategies to better utilise the FC service

Overview of findings Food Challenges Total number FC booked 180 Total number attended 121 Number of booked but unused slots 59 33% slots lost Supervised Feeds Total number SF booked 202 Total number attended 138 Number of booked but unused slots 64 31% slots lost

How can we make it better? Meeting/workshop involving Allergy service lead, dietician, nursing staff, medical staff, admin, patients and IT (external and internal) Improve pre appointment information Improve booking system Better information/preparation for the children

Improving patient experience Prototype link https://marvelapp.com/2d81j27/screen/15186201 Shown to parents and families on the unit Funding issues Looking at other examples: http://www.evelinalondon.nhs.uk/our-services/hospital/Operations/pre-assessment.aspx

Better information/preparation for the children Patient information video Meeting with communications team at Evelina to discuss £5000 (approx) for 3 min video Meeting with anaphylaxis campaign to discuss grant/support for video Draft script and meeting with nurses/dietician/psychology and patients to discuss