What is person-centred care?

HOSPITAL

What’s the problem?

Everyone aims to do a good job, but The subliminal message? More, more, more Faster, faster, faster with less What’s our priority – the system or the people?

Comprehensive systematic measurement infrastructure NHS Board 18 wks RTT HSMR 4 hour A&E NHS Board 4 hour 18 wks HSMR 4 hour 18 wks HSMR 4 hour 18 wks HSMR 4 hour 18 wks HSMR But, where is care experience? The voice of the service user?

Current State Staff Experience Team vitality Pulse surveys Complaints Bi-annual survey System Outcomes People Focused Outcomes Patient Groups Better Together Local surveys 4 hours 18 wks Finance Access Targets Etc

Obs of Care System Outcomes Staff Experience Real-time Feed back Team vitality Pulse surveys System Measures Personal goals Staff wellbeing Care Experience Real-time feedback Loved Ones Comp- liments Must do With Me Measurement for Improvement Values based Reflect. Nothing about me System Measures System Outcomes System outcomes System outcome System outcomes Future State

Are we serious about improving person-centred care? Then we need to measure the right stuff!

“Every system is perfectly designed to get the results it gets...”

Overall, we found that the service:  provided very good care, which was tailored to meet the individual needs of people who used the service  supported people through a committed, caring and dedicated multidisciplinary team  ensured people were being consulted about the quality of their care and the development of the service  ensured people were treated with dignity and respect, and  was valued by the people who used it and everyone we spoke with spoke of the care and treatment being excellent. “The focus of all their activity is on the patient, families and carers.” (Healthcare Improvement Scotland inspection report of Strathcarron Hospice March 2013)

Its not just about getting the measurement culture right...

NHS Scotland - The 6 Cs Caring & Compassionate staff & services Clear Communication & explanation Effective Collaboration between clinicians, patients & others Clean and safe care environment Clinical excellence What do the people want & need?

The feelings and emotions of the patients, under critical circumstances, require to be known and to be attended to, no less than the symptoms of their diseases. Medical Ethics, Thomas Percival, , Edinburgh physician and author

“The secret of caring for the patient, is caring for the patient” Francis Weld Peabody

Aims of the collaborative? 1.To re-establish the core values and behaviours of health & care services

Its all about people……. …….and relationships

Aims of the collaborative? 1.To re-establish the core values and behaviours of health & care services 2.To design processes of care that focus on the needs of the people, not on the needs of the system or the profession

By December 2015 people using services will have a positive experience and get the outcomes they expect Services are delivered in active, collaborative partnership with people Technical care is delivered reliably and based on person-centred principles Physical & cultural environments support the delivery of person-centred care AimPrimary DriversSecondary Drivers Technical care is delivered in alignment with “Person-Centred Principles” 1) Active, equal partnership 2) Information sharing is timely, open and complete 3) Participation in decisions 4) Collaboration in design & delivery of services Reliable application of the 5 “Must do with Me” elements Weekly environmental walk rounds & Observations of Care by: a) Leaders; b) facilities teams; c)Clinical teams d)Service user / volunteer groups using person- centredness checklist Walk-rounds & Observations focus on: 1.People & interactions (conversations with people using & delivering service, observations of care, etc) 2.Environment of care (signage, way-finding, etc) Person-Centred Health & Care: Care Experience Person-centred care is everyone’s business Distributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executives Values & behaviours form basis of recruitment, development & management of staff Reliable use of recognised tools to promote optimal team functioning Person-centred values & behaviours are evident in words & actions at all levels of leadership See also “Leadership” change package for key interventions & structures Reliable application of the five “Must do with Me” elements: 1. What matters to you? – finding out what’s important to people and using this info to collaboratively plan care 2.Who matters to you? – making it easy & routine for people to involve their personal support network if they choose 3.What information do you need? - information is timely, full and understandable & decisions are collaborative 4.Personalised contact – as much as is possible timing & method of contact with services is flexible 5.Nothing about me without me – people are involved with communications, handovers and transitions at the level they choose Dignity and respect frame all communication and interactions Teams test and adapt tools to measure and improve communication

Aims of the collaborative? 1.To re-establish the core values and behaviours of health & care services 2.To design processes of care that focus on the needs of the people, not on the needs of the system or the profession 3.To measure person-centredness as systematically & comprehensively as we measure HAI or financial performance

How to Measure Person-Centredness?

Listen 3 times 1.Before (expectations) 2.During (POC experience) 3.After (objective reflection) In Real-time

Listen in different ways Survey Story Unsolicited feedback Advisory councils Obs of care People with first-hand experience Multi-method Multi-trait Systematically & Comprehensively

Sir Winston Churchill

By 2015 All health and care services are centred around people Aim Primary Drivers Secondary Drivers Improved Care Experience Improved Staff Experience Co-Production Co-designing with NHS, Local Authority and 3 rd Sector Leadership

By 2015 All health and care services are centred around people Aim Primary Drivers Secondary Drivers Leadership Care Experience Staff Experience Coproduction Co-designing with NHS, Local Authority and 3 rd Sector

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