Person Centred Care in Haemodialysis M Wilkie, T Barnes, R Palmer, M Winfrow and the Y & H Shared HD Care team.

Person centred care Treating people with dignity, compassion and respect Ensuring care, support and treatment are both personalised and coordinated Supporting people to recognise and develop their own strengths and abilities to enable them to live a fulfilling life How can person centred care be a reality for patients on haemodialysis? Embed person centred care into mainstream health services 18 NOVEMBER, 2014 | BY SUZANNE WOOD, ADRIAN SIEFF

UK patients The concept… Supporting patient involvement in centre based HD

Y & H shared haemodialysis care developed …. 1.Training course for nurses 2.Patient training 3.Clearly defined competencies 4.Supportive material 5.Defined measures Funded through the Health Foundation Closing the Gap through changing Relationships programme – 2010 to

Essence of Shared Care Patient choice – what they want Patient control – flexibility Coaching – not dictating informed decision making Adaptable partnership between patients and staff Individual pace Not for everyone……... Some patients need or want to be taken care of

Educating to create a cultural change… Explore feelings about engaging patients Experience how each other learn Challenge habits of communication Understand control and how to let go, to trust accept & believe Share barriers & find workable solutions Learn about, share and experience change and sustainability ‘’I have learnt some valuable things about myself as well as patient needs’’ “Compassion has been put to the top of the list. It’s all about the patient!”

Dialysis centres in Yorkshire and Humber 26 haemodialysis units Sheffield York Leeds Bradford Doncaster Hull 180 staff

180 (2011 – 2012) (paeds) Spread of education supported by regional innovation funding

“This programme has given me my life back” [David Sheffield] Shared Care represents freedom! It’s an opportunity to regain some semblance of your former life!” [Christopher Sheffield] Shared Care represents freedom! It’s an opportunity to regain some semblance of your former life!” [Christopher Sheffield] “ Doing Shared Care has given me more understanding & control towards my treatment” [Mike-Hull] “I want to take control” “some kind of control back over an illness that takes away so much”

To understand what is happening To be treated as an individual To be understood and not to be judged To be offered choices To feel in control - to learn at our own speed in the way we like to learn To have consistent messages regarding our care Small steps – at a comfortable rate To receive the support we need What would we want?

Reflection…. Is our approach patient-centred or task orientated? Do our patients have a choice as to how and when they learn? Are opportunities created to make it happen? Is there an alternative way to reach our goals? Do we really listen to people who use our service?

Perceived barriers Motivation Time Attitude Ability Confidence Environment Age

Managing the challenge… Engage those who are keen first Ask patients to influence each other and the staff Small, achievable steps to gain confidence Be creative in working practices Celebrate success with positive feedback Ask patients what they want and involve them in the change

We become open to what patients want! When we challenge our pre conceived ideas about what people are capable of...

Building on experience… Involving patients in their own care at the start of the renal journey

Lessons we learned about engaging patients with their care Empowerment makes patients feel better Small steps can be powerful and built upon, gain confidence to take action Meaningful communication and consultation is central to patients understanding their condition and care Partnership in care facilitates person centred choices Healthcare staff engagement is critical when assessing individual patient needs

Supporting patients in renal outpatients to be partners in their own care Asking if patients already do their own BP at home Trusting home readings for medical management Advising selection of approved monitors and offering BP monitoring records Enabling patients to ask meaningful questions in their consultation

By taking action with this relatively small practical step we hope to sow the seeds in patients minds that they can take an active role in their own care This is a change to the way we have traditionally behaved, operated and delivered our care SHARED CARE IN OUTPATIENTS

In order to provide a service that has compassion, dignity and respect at its heart, we need to believe and trust that our patients are very capable of being active partners in their own care We are then open to overcoming the barriers to success! SHARED CARE IN OUTPATIENTS

Thank you care.org.uk

Compassion, dignity and respect in practice #THFCompassion22 What do I want to know more about? What are the implications of this for my / our work?