1. Rosy Wells Paediatric ST7
Patient Experience
Rosy Wells
Paediatric ST7

2. Where to start? Children’s Allergy Service
Food challenges run most days on day unit
Awareness of problems with the booking service and admin/information both from patients and staff
Inspired by patient experience lecture
First step: speaking to children/parents attending service

3. Current System for food challenges booking/information
Children seen in OP clinic
Clinic letter written to include confirmation of FC and phone number to call for parents
Parent then call admin (Jim) to book in challenge
If Jim not available, message left for him to call back
Info about food challenge and recipe then sent to family
No text reminder. Parents advised to call nurses if questions or child unwell

6. Emotional mapping Female 8 years having nut challenge
Happy
Excited
Bored
Worried
Scared
But a bit excited
In outpatient clinic
Letter arrived
Waiting for appointment
Day of appointment
Arriving at hospital

7. Emotional mapping Mother of child having nut challenge
Pleased, relieved
Confused
Frustrated, upset
Happy, satisfied
Disappointed, frustrated, confused
Anxious, unsure, mixed happy
In outpatient clinic
Letter arrived
Trying to book appointment
Booking appointment
Information received
Arriving at hospital

8. Quantative data with medical student
Web-based, 5-10 min questionnaire
Patient responses collected during appointment on food challenges unit
Patient/parent used trust I pads to respond
n = 55, 3 month period

11. Additional comments about pre appointment information:
“A video link is a good idea. I am a sleep deprived mother so as much hand holding as possible would be good!”
“Advice on preparing your child”
“A website that explains it all- lots of information/recipe ideas about how to prepare for the test.”
“The amount of milk needed stated in the letter would have been helpful but I did call and was given the information.”
”A website that explains it all- lots of information/recipe ideas about how to prepare for the test.”

12. Comments on the booking system

13. Observations from working on the unit
Often cancellations on the day
Frequently sending children home due to illness, asthma symptoms, hay fever, recent use of salbutamol, taken antihistamine
Frustration for patients and for children
Cost of travel, time off work, arranging childcare, cooking food, rearranging
Waste of resources, time, cost for hospital
Several times involved children having had salbutamol- changed information sheet to include this information on information sheet

14. Audit of cancellations
Done by Jim (admin) and Ruth (dietician)
Objective:
To review the number of unused slots on EDCU between January and march 2017
To identify the reason slots are unused
To see if we can develop new strategies to better utilise the FC service

15. Overview of findings Food Challenges Total number FC booked 180
Total number attended 121
Number of booked but unused slots 59
33% slots lost
Supervised Feeds
Total number SF booked 202
Total number attended 138
Number of booked but unused slots 64
31% slots lost

16. How can we make it better?
Meeting/workshop involving
Allergy service lead, dietician, nursing staff, medical staff, admin, patients and IT (external and internal)
Improve pre appointment information
Improve booking system
Better information/preparation for the children

17. Improving patient experience
Prototype link
Shown to parents and families on the unit
Funding issues
Looking at other examples:

18. Better information/preparation for the children Patient information video
Meeting with communications team at Evelina to discuss
£5000 (approx) for 3 min video
Meeting with anaphylaxis campaign to discuss grant/support for video
Draft script and meeting with nurses/dietician/psychology and patients to discuss