1. Presentation title: 32pt Arial Regular, black Recommended maximum length: 1 line © NHS Institute for Innovation and Improvement, 2011 About The 15 Steps Challenge June 2012

2. “I can tell what kind of care my daughter is going to get within 15 steps of walking on to a ward” How? What does good look like? To patients, to carers, to staff, to others?

3. The 15 Steps Challenge is simply..... A short and simple document that is easy to use at the front line of care Has strategic linkages to Board level A structured ward walkaround A clear framework to help with observations of quality care across four categories Focus is on feedback and continuous improvement

4. We need to see through “Fresh Eyes” We look at things from a particular perspective and see what we expect to see Important to challenge our tunnel vision Staff and patients sometimes see different things What do patients and carers think? And want to improve? Essential to have patient/carer and board involvement The Challenge tool was co-designed by patients and staff and seeks to “look” through fresh eyes http://www.youtube.com/watch?v=ubNF9QNEQLA http://www.youtube.com/watch?v=voAntzB7EwE&feature=related

5. We focus on four areas of care: 1.Is it welcoming? 2.Is it safe? 3.Is it caring and involving? 4.Is it calm and well organised?

6. Action 6 Repeat the Challenge! See through the eyes of patients/service users on a regular basis Action 5 Action plans for improvement and sharing good practice Quick win actions and longer plans Action 4 3 way feedback – to the ward team, to the Trust sponsor, to the Board Celebrate and learn from what went well Action 3 Use this Challenge tool and undertake ward walkabouts Use the five senses, understand what to look out for Action 2 Identify your Challenge team Include patients, staff, governors, patient groups Process Action 1 Identify a trust sponsor to support the challenge Champion of continuous improvement

7. What it is..... A way of understanding patients first impressions more clearly Developing ways to build confidence in care from the outset A tool to hear the patient’s voice Supports continuous improvement A useful method to identify what works well and what could be improved – supports sharing good practice and concentrating on some patient experience improvements What it isn't.... Performance management An audit (clinical, quality, safety or otherwise)

8. Strategic Alignments for The 15 Steps Challenge Regulation - Care Quality Commission essential standards NHS Operating framework NHS Outcomes framework Annual Inspections (PEAT etc) Royal College of Nursing Principles of Nursing practice Increased focus on engaging patient sin improvement

9. What organisations said.... “We linked it to the Productives (RTC), patient communication and patient experience. As a new organisation, we hope to integrate this with all of our patient quality and safety agenda.” Chief Nurse, First Community Health & Care C.I.C. (Community Interest Company) As part of the trial we used the tool on three of our visits, which were to a maternity unit, an elderly care ward and a rehabilitation unit. Our visits covered three very different care settings but the principle of the 15 Steps Challenge remained the same and showed that the tool can also be used by commissioners.” NHS Hertfordshire, Quality and Patient Experience Team

10. What organisations said.... “[Using the tool while] visiting other ward areas and comparing the differences between the wards, enabled the sharing of ideas and good practices.” Ward Sister, Nottingham University Hospitals NHS Trust “People really liked this tool, for the first time we had more patient representatives than staff involved in our walkarounds.” Deputy Director of Nursing, Maidstone and Tunbridge Wells NHS Trust

11. Versions available for community and mental health settings A 15 steps challenge version for mental health inpatients – includes a section for children and young people’s services and for high secure settings Community version focuses on care in patients own homes