Jean Tucker Patient Experience Improvement Team @thejeantucker @gloshospitals

Small Steps, Big Changes Project The aim of this initial year-long project was to understand how we could best use insight to improve the patient experience on one ward - 7A Data is feedback of any kind it stemmed from a period of adversity when the ward was recovering from a particularly challenging time and the team chose to look forward

30 acute beds (funded for 28) Gastroenterology Vacancies – 6 to 8 WTE Band 5 staff nurses Long-stay patient impact High incidence of Violence and Aggression Red staff stress survey Long established band 7 Sister as it stemmed from a period of adversity when the ward was recovering from a particularly challenging time and the team chose to look forward

…..a great opportunity To make a difference To be heard To influence care To ‘make it better’ To be ‘part of’ To be special

Collecting Feedback Multi – method approach that captured the views of the patients at different times and in different formats to offer us the fullest picture of the experience of the patients. But first…..

Their ideas for improving the patient experience In order to improve the patient experience of the ward, we first had to listen to the staff. What matters to them Their ideas for improving the patient experience Embed a culture of improvement Anecdotal Encourage the front line staff to innovate in response to feedback with the fear of retribution Ownership of the initiative In a recent study by Kings Fund, a point was made that if you intend to bring about a culture that is genuinely looking at patient experience, then you have to look at the staff experience too

‘’Culture eats strategy for breakfast’’

Staff feedback

Patient feedback Surveys Focus groups Anecdotal evidence Observations national, local and FFT Focus groups Anecdotal evidence Observations Use surveys to measure impact

Acting on feedback Admissions packs – increased efficiency on admission ensuring all documentation is completed Hearing aid boxes

Sleep masks – in response to patients comments about lights at night. Its OK to Ask – a poster and badge campaign

Walking stick holder Suggested and sourced by a patient who knew what he needed to make his life easier..

Information boards Condition specific boards with a range of relevant information next to them.

Continuous feedback

Feedback to staff

Measurement Survey on ward prior to project Re survey one year later We did not measure individual initiatives – we just did it!

Question Change in results ‘yes always’ increased from 68% to 74% Q8 When you had important questions to ask a doctor, did you get answers that you could understand? ‘Yes, always’ increased from 50% to 56% Q11 Were you involved as much as you wanted to be in decisions about your care and treatment? ‘yes definitely’ increased from 42% to 51% Q12 Did you have confidence in the decisions made about your condition or treatment? ‘yes, always’ increased from 54% to 57% Q13 How much information about your condition or treatment was given to you? ‘The right amount’ increased from 62% to 78% Q21 Beforehand,(before operation or procedure), did a member of staff answer your questions about the operation or procedure in a way that you could understand? ‘yes, completely’ increased from 53% to 65% Q23 After the operation or procedure, did a member of staff explain how the operation or procedure had gone in a way that you could understand? Q10 In your opinion, did the members of staff caring for you work well together? ‘yes always’ increased from 68% to 74% Q25 During your hospital stay, did you feel well looked after by hospital staff? ‘yes always’ increased from 73% to 77%

Low Point of the Project The start High Points There are many… Empowered staff taking ownership The change in culture Other wards wanting ‘what 7A had!’

Benefits Staff feel enabled to drive change + impact on morale and fulfilment Enjoy their work and socialise more – tombola/fundraising Quality Academy Silver award