1. Presentation Title 36pt Arial Bold Sub heading 24pt Arial Patient Experience and Staff Engagement Cathy White Patient Experience Survey Manager December 2013 An Associated University Hospital of Brighton and Sussex Medical School

2. System Requirements Slide 2 We needed a better way of understanding Patient Experience: -Include more patients as systematically as possible -Be more aligned with National Inpatient Survey -Have quick, open access to the results -Recognise good performance -Involve staff more -Listen and respond to patients’ comments

3. “The thinking behind the new programme came from wanting our patients to feel that Surrey and Sussex Healthcare NHS Trust is at the heart of their community and that we welcome their ideas. We wanted to move past static measures of performance to a more ‘caring’ solution that gauges our patients’ experience and most importantly, enables us to take actions based upon their views.” Michael Wilson, CEO at Surrey and Sussex Healthcare NHS Trust Slide 3

4. Our Solution – Your Care Matters Card given to every patient with verbal explanation and request Stress that relatives/carers can assist Options are: Online Via QR code Paper version in Discharge Lounge Freephone number (shorter version) Sent a text or letter reminder within 48hrs of visit (depending on pathway) Opportunity to opt out of text reminders and also arrange to have a translator Slide 4

5. Survey first page Slide 5

6. The Survey Generated through discussions with staff at all levels Key issues covered: Slide 6 Respect & Dignity Care & Compassion Cleanliness Emotional Support Pain Control Privacy Confidence & trust in staff Food Communication (Doctors, nurses, medication) Noise

7. Free Text Options Staff going ‘above and beyond’ Additional comments Started in Inpatient wards and Emergency Department, now rolled out to Outpatients, Day Cases and Maternity Slide 7

8. We are reaching a great range of patients 8 48% 50% 2% prefer not to answer Source: Surrey and Sussex Healthcare Inpatients, April to September 2013 Surrey and Sussex Admissions data Surrey and Sussex Survey respondents

9. 9 How our patients access Your Care Matters In patients44%2%29%25% ED57%13%30% Out patients58%7%35% Day Cases59%6%35% InternetMobile IVR – Free Phone Paper Source: Surrey and Sussex Healthcare survey data, April to September 2013

10. Outputs 1- Monthly Ward Dashboards 125 - Woodland Amber Green YTD (Ave)Jan-13Feb-13Mar-13Apr-13May-13Jun-13Jul-13Aug-13Sep-13Sparkline Discharges (Potential respondents) 136134152136121119151124140150 -Friends and Family Single Question Record count (Respondents) 42303344303754564351 Response Rate (Target - 15%) 30.8%22.4%21.7%32.4%24.8%31.1%35.8%45.2%30.7%34% Friends and Family Test Score (net promoter) 654048.563.656.766.757.480.476.798 -Your Care Matters Survey Record count (Respondents) 42303344303754564348 Response Rate (Target - 15%) 30.6%22.4%21.7%32.4%24.8%31.1%35.8%45.2%30.7%32.0% Overall experience at East Surrey Hospital 8.87.78.68.58.99.18.89.09.3 -Access and waiting Time on waiting list7.68.4 7.8 8.78.17.09.15.97.29.17.08.0 Wait a long time for bed on ward8.29.0 7.0 6.57.06.44.49.07.77.26.08.8 -Safe, high quality, co-ordinated care Members of staff saying different things7.78.5 8.3 7.07.68.18.39.18.79.08.88.0 Was discharge delayed for any reason6.77.5 7.6 7.28.77.08.08.17.07.96.77.4 Staff told you about danger signals after leaving hospital6.87.6 6.7 5.05.86.97.67.45.38.27.37.1 -Better information, more choice Involved enough in decisions about care and treatment7.88.6 8.2 7.57.98.68.08.58.18.88.18.6 Staff explained the purpose of the medicines in a way you could understand8.79.5 9.2 8.68.89.39.79.68.69.89.39.0 Staff informed you about medication side effects to watch for when went home6.87.6 5.9 4.24.06.1 9.13.56.47.46.0 -Building closer relationships Received answers could understand from doctors 8.59.3 8.5 7.78.88.47.47.98.39.29.39.8 Doctors talk in front of you as if you weren't there8.29.0 9.5 8.49.89.28.910.09.59.99.410.0 Received answers you could understand from nurses 8.49.2 9.1 7.89.59.39.48.89.29.59.19.5 Nurses talk in front of you as if you weren't there8.79.5 8.69.89.5 9.6 9.510.0 Had confidence and trust in doctors treating you 8.99.7 9.1 8.58.9 9.19.38.69.5 9.9 Had confidence and trust in nurses treating you 8.79.5 9.1 8.58.99.19.39.1 9.69.49.3 Given enough emotional support from staff during stay 7.28.0 8.7 7.28.3 8.69.08.99.4 9.3 -Clean, comfortable, friendly place to be Bothered by patient noise at night7.28.0 6.8 5.65.77.06.56.77.37.18.27.1 Bothered by staff noise at night8.29.0 8.2 7.07.38.08.38.68.38.29.38.5 Cleanliness of room or ward 8.99.7 9.4 8.99.39.6 9.09.59.49.69.8 Hospital food rating4.75.5 5.6 5.85.55.75.05.55.26.1 5.7 Given enough privacy when being examined or treated 8.79.5 9.09.59.79.39.78.99.710.0 Staff did everything to control pain 8.69.4 9.2 8.39.29.48.79.49.19.69.89.1 Treated with dignity and respect 8.99.7 9.5 8.89.59.19.59.6 9.7 Enough help from staff to eat meals 8.6 N/A 8.310.06.710.08.08.3 Treated with care and compassion 9.8 N/A 10.0 9.39.8 9.7 -Other Staff went 'above and beyond' 61% 52%57%47%75%62%63%62%68%65% How well did staff prepare for surgery 9.4 N/A 9.48.89.29.49.69.8 Staff told you who to contact if worried about condition or treatment8.69.4 8.5 8.17.38.69.68.88.28.68.98.2 -Number of Commendations 16 1013 151125211820 -Number of 'Other' comments 19 171018151430271224 125 - Woodland Amber Green YTD (Ave)Jan-13Feb-13Mar-13Apr-13May-13Jun-13Jul-13Aug-13Sep-13Sparkline Slide 10

11. Output 2 – Daily Staff Commendations Slide 11 Laura, Zoe and nearly all the staff on Brockham ward were fantastic, but Zoe and Laura made me smile. Were there when I needed a shoulder to cry on and gave me everything I needed. They were stars Andrea. Always willing, totally efficient, stayed after the end of her shift to finish a treatment, just an excellent example of good nursing 100% care and attention ward sister Kate 5ft bundle of energy The beverages man on Brook ward, very friendly and kind. Really helped to see a friendly smiling face. Made sure I was comfortable, provided seat for my husband. Gave us both a cup of tea and was very kind and considerate. … was very grateful for all their help and reassurance. My wife has dementia and both Jenny and Anne made a point of talking to her so she felt included even though she didn`t necessarily understand what was going on, and both treated her with kindness Liz and Laura midwives working birthing pool on 16th October were amazing and stayed with us through the whole experience, couldn't have done it without there help and support. Truly amazing, thank you

12. Output 3 – Monthly Additional Comment Reports Slide 12 Overall I have no complaint but I do have this observation, noise at night with particular problems being noise from the staff rest rooms /false warnings from monitoring equipment that carried on for ages before being reset or switched off and loud trollies moving through the corridors. I must admit I was glad to get home for a rest With all the bad press I was pleasantly surprised and extremely satisfied with the stay at East Surrey I have to say that I was a bit apprehensive about treatment at ESH, following bad press, and also bad personal experiences from other people, but nothing was further from the truth. I would definitely not think twice about having treatment there again and would recommend ESH to friends and family. The only criticism that I have is that the night nursing staff were noisy, banging bins, turning lights on and off and generally being noisy, apart from that a very caring, clean and professional hospital Some way of notifying you as to how long you would need to wait before being seen.

13. The Your Care Matters Patient Survey Staff Commendations Sent to Managers, Matrons and Chiefs daily Additional Comments reports Monthly for each Ward/Dept. Sent to Managers in full Comments coded and reported to Patient Experience Delivery Committee Monthly Dashboard Ward and Directorate level data Month on month trends Available on intranet Reported at Patient Experience Delivery Committee Trust Level Key indicators in Integrated Quality and Performance Report (IQPR) Linked to Trust Performance Reports How YCM Survey Data is Used

14. What changes have we made? Acoustic panels in ED reception area Focus on communicating with relatives Steps to reduce noise at night across wards: -Soft close bins -Ear plugs -Revised staff roster -Deadline for drug rounds New: -Whiteboards and clocks -Tray tables and Ward decor -More chairs Revised some Outpatient appointment letters re waiting times Revised policy on storing equipment Slide 14

15. Our Patient Newsletter “I was dreading coming in” “Despite what you read in the press” “I must have been lucky” “Much better than I expected” Slide 15

16. YCM as a Tool for Ongoing Improvement Dashboards form part of Divisional Chief Nurses monthly Safety and Quality Report Matrons and Ward Managers required to review monthly data Monthly Ward Improvement Plans developed Fed into Divisional Patient Experience Action Plan Key tool for Trust’s Patient Experience Delivery Committee Slide 16

17. The Same Measures Impact Friends and Family and Overall Experience Ratings Measure Treated with dignity and respect In your opinion, how clean was the hospital room or ward that you were in? Staff did everything to help control pain Enough privacy when being examined or treated Enough emotional support Answers you could understand from nurses Confidence and trust in doctors Confidence and trust in nurses Answers you could understand from doctors 17 Insight into key measures and questions to drop to shorten survey

18. Problem Matrix – Identifying Focus Areas Involved enough in decisions about care and treatment Answers you could understand from doctors Nurses talked in front of you as if you weren’t there Enough privacy when examined or treated Cleanliness of room Enough emotional support from staff Confidence and trust in doctors Answers you could understand from nurses Staff did everything to help control pain Treated with dignity and respect Confidence and trust in nurses <5% Patients 5-10% Patients> 10% Patients Effect on Overall Satisfaction Moderate Strong Extreme Source: Surrey and Sussex Healthcare Inpatients YCM Survey data, April to September 2013

19. Insights to Drive Focus – High Impact Factors Impacting on Friends and Family Question 19 InpatientsEDOutpatients High Frequency Waiting timeBeing kept informed at all times Medium Frequency Treated with dignity and respect Respected your views Explained results of tests in a way could understand Low Frequency Treated with dignity and respect Confidence and trust in Nurses Staff did everything they could to control pain Enough emotional support Privacy when examined or treated Confidence and Trust in Doctors Treated with dignity and respect Explained why tests needed in a way could understand Enough privacy when examined or treated Source: Surrey and Sussex Healthcare YCM survey data April to September 2013

20. Benefits of Your Care Matters Slide 20 Staff Engagement Data Availability Developed a positive culture around patient feedback Over 2,200 staff recognised by patients 24/7 access to Trust, Directorate and Ward data Data and patient comments refreshed daily Appreciation of data robustness

21. Key Learnings FFT score varies depending on when and how you ask Positive feedback encourages engagement Slide 21 Small changes make big differences for patients Patient Experience goes beyond Friends and Family

22. Where We Are in the Loop Improved Patient Experience Patient feedback Take ownership of results Implement change Inform patients of changes Slide 22

23. What Next? Patient Reported Outcome Measures (PROMS) Explore use of ‘rescues’ for maternity Additional ways to use free text comments Review our Patient Experience Strategy and TOR for Patient Experience Delivery Committee ‘Proactive’ and ‘Board to Ward’ Slide 23

24. Thank you Any Questions? Slide 24