1. Annie Laverty Director of Patient Experience and Quality
Improving the
Patient Experience
The Northumbrian Way
Annie Laverty Director of Patient Experience and Quality

2. Northumbria Healthcare
Employing almost 10,000 staff.
Largest area of any health trust in England
Providing integrated health and social care
Three general hospitals and seven community hospitals.
Firstly –thought it may be useful to share a little about our organisation.

3. 2013 Systematic review.
“patient experience is consistently positively associated with patient safety and clinical effectiveness across a wide range of disease areas, study designs, settings, population groups and outcome measures”
“clinicians should resist side-lining patient experience as too subjective or mood orientated, divorced form “real” clinical work of measuring safety and effectiveness”.

4. Leadership at all levels focused on compassionate care and service improvement

5. Patients, staff and other key stakeholders actively engaged on quality
Performance reviewed at every level
Transparency, a cornerstone of our improvement
Clinically lead, frontline change

7. Values in action.
Value Based Recruitment : “The nurses are wonderful. You cannot make a nurse, they are a certain kind of person. They do wonders.” The importance of ‘being held in mind.’ (PAWL,1995)
“Every day Teresa gives me my tea just how I like it and always with a lovely, big smile. She is so kind with me. ”
“ I think this Trust chooses it’s nurses because of how friendly they are.”

8. Using insights from patients and families to improve care

9. Responding to patient feedback
Feedback from more than 50,000 people every year
Measuring what matters most to patients in a variety of ways and at different points of care
Right time’ data giving site, specialty, and individual consultant data, externally validated to feed through appraisal system
Real time measurement fed back to clinical teams within 24 hours

10. Health Quality Checkers Team

11. Individual consultants.

12. Real time data

13. What matters most to inpatients.
Consistency and coordination of care
Treatment with respect and dignity
Involvement
Doctors
Nurses
Cleanliness
Pain control

14. Real Time Report – Ward 10 Wansbeck 20 01 2015
100% of patients surveyed would highly recommend this ward to their Family and Friends
The baseline data is established on responses patients surveyed in 2014.
Number of respondents 12 (60%)

16. Real Time Data – By Business Unit 2014 No of Patients Surveyed
Coor-dination
Respect & dignity
Involve-
ment
Doctors
Nurses
Clean-
liness
Pain Control
Medicines
Kindness & Compassion
Domain Average
Recom-
mendation
Medicine
3665
9.06
9.90
9.38
9.81
9.78
9.85
9.80
8.34
9.86
9.53
9.41
Surgery
2680
9.20
9.84
9.39
9.75
9.83
9.64
8.62
9.82
9.55
9.51
Children
144
9.23
9.93
9.74
10.00
9.89
8.59
9.69
9.77
Total
6489
9.12
9.88
9.79
8.46
9.54
9.46 16

17. Commissioning for quality.

18. Real time improvements (n= 12,000)

19. Real Time Domain Averages 2014 to date

20. Real Time Domain Averages 2014

21. Negative Themes Q1
Negative Themes Q2
Top 3 Positive Themes Q1
Quality of the staff 28%
Quality of the care 28%
Kind empathetic caring staff 14%
Top 3 Positive Themes Q2
Quality of the staff 29%
Quality of the care 20%
Kind empathetic caring staff 15%

22. Data that drives
Timely
Owned
Actionable
Specific
Talked about

23. September 2014 Results
53% of patients surveyed would highly recommend this ward to their families and friends. 23

24. Patient Comments Analysis – (August 2014)
Total number of individual patient comments:
201
Total number of positive transactional themes:
(themes that include the processes we have to deliver care to our patients)
103
47%
Total number of positive themes:
219
62%
Total number of positive relationship themes:
(themes that include the empathy, kindness and compassion we show to our patients)
116
53%
Total number of negative themes:
137
38%
Total number of negative transactional themes: 70
51%
Overall total of positive and negative themes:
356
Total number of negative relationship themes: 67
49%

25. December 2014 Results

26. Being open and honest with patients, families and the public

29. Sharepoint available to all on the intranet

31. Sustained engagement in making measurable improvements

32. Staff well being and patient experience
Seven staff variables (‘wellbeing bundles’) which are linked to good patient-reported experience. These are:
good local (team)/work-group climate
perceived organisational support
high levels of co-worker support
low emotional exhaustion
good job satisfaction
supervisor support
good organisational climate

33. Strong staff engagement as our foundation.
Our Staff Survey Performance
Best response 3 years in a row. %
2012 – 71%
2011 – 75%
2010 – 68%
Engagement scores
Acute Average is 3.74
Medical Engagement at the heart of our organisation

34. Our story of moving the dot.
Number of staff believing high quality patient care is the No1 priority of the trust.
“You cannot make things happen, but you can create a space in which what you want is more likely to happen.”
– Chinese proverb

35. #6. Celebrating compassion and rewarding staff

36. Quality Improvement Using our data to drive change

37. Complaints Improvement Project
Phase 1: project planning
Defining objectives & scope; focus on Trust-wide complaints process and its outcomes
Phase 2: evidence gathering
Mapping of the complaints process and analysis of data against metrics
Phase 3: stakeholder engagement
Focus groups & interviews of all key stakeholder groups, including patients.
Phase 4: recommendations
Developed and tested with all key stakeholder groups, designed around SMART principles.
Post EMT approval of recommendations, full implementation plans will need to be developed.
Phase 5: implementation

38. Our shared purpose
Our commitment to dignified and compassionate care for frail older people.

39. Support for Junior Doctors with QI
Free subscription to BMJ Quality improvement programme.
Supports meeting FY and ARCP requirements.
Learning modules to develop knowledge re QI.
Publication in a BMJ Journal!

40. Key things we have learnt.
The benefits of real time reporting at team level.
Executive management team support is crucial.
Ensure patients & families are part of your improvement team.
Focusing on things that matter most has made sense.
Investing in improvement has helped.
Qualitative feedback appears particularly important.
Transparency of reporting matters.

41. Thanks for listening. Any questions.