1. Project Manager NI Essence of Care Project
Ms Suzanne O’Boyle
Project Manager
NI Essence of Care Project

2. Essence of Care – Where has it come From?
English Nursing Strategy
“Making a Difference” (1999)
The NHS Plan (2000) reinforced importance of improving the patient experience
Benchmark standards tested, refined and endorsed.
Version 1 (2001) / Version 2 (2003)

3. Prison Service Nursing Marie Curie
Update
16 Trusts
6 Nursing Homes
Prison Service Nursing
Marie Curie

4. Clinical Governance Consultation and patient involvement
Clinical Risk Management
Clinical Audit
Research and effectiveness
Use of information about the patients’ and or carers’ experience
Staffing and staff management
Education, training and CPD
Strategic capacity

5. Essence of Care ?? A Tool to help practitioners
To take a patient focused
And
Structured approach to sharing and comparing best Practice

6. Benchmarking Acts as a standard
Enables practitioners / organisations compare practice and share difficulties.
Several approaches can be used:
wards / directorates / primary care teams / organisations can compare processes and structures
There must be a willingness to share practice

7. Fundamental Aspects of Care
Safety
Pressure Ulcers
Hygiene
Self Care
Continence
Record Keeping
Privacy & Dignity
Nutrition
Published 2001, revised format 2003
All benchmarks are interrelated & relevant to all health & social care settings
National framework-local approach!
Communication
Relevant to all health and social care settings
Generic format – can be used in any health care environment
Allows health care staff, patients and carer’s to agree the indicators that demonstrate best practice within their area of care!
“seeing things through the patients eyes”

8. The Toolkit - What’s in it?
An overall agreed patient-focused outcome that expresses what patients or carer’s want from care in a particular area of practice
factors that need to be considered to achieve the overall patient outcome

9. The Toolkit - What’s in it?
A benchmark of best practice for each factor on a continuum
Indicators for best practice identified by the patients, carers and professionals!

10. The Benchmark Process STAGE 1 Agree best practice STAGE 2
Assess clinical area against best practice
STAGE 3
Produce & Implement action plans aimed at achieving best practice
STAGE 4
Review achievement towards best practice
STAGE 5
Disseminate improvements & or review action plans
STAGE 6/1
Agree best practice

11. Benchmarks for Food & Nutrition
Agreed patient-focused outcome-
“patients are enabled to consume food which meets their individual need”
The ‘benchmark’ comprises of 10 ‘factors’- each with it’s own benchmark of best practice

12. The Factors Screening & Assessment The Environment Assistance
essential to identify nutritional requirements
identifies ‘at risk’
establish individuals nutritional status
The Environment
conducive to eating- acceptable sights, smells
activities
cultural/ ethnic considerations
Assistance
skill, sensitivity & patience
links to oral hygiene
cultural/ ethnic consideration
Planning & Implementation
support ranges from simple
to high risk invasive interventions
care planning
evaluation

13. The Factors Obtaining Food Monitoring & Promotion
adequate information/ Communication
cultural, age related, special needs ethnic considerations
Food Provided & Availability
meets the needs of individuals, appetising
appealing portion sizes
alternative food/ access
own food/religious, cultural, issues
Monitoring & Promotion
accurate recording of
amounts eaten
appropriate action taken
opportunities for health
promotion
staff training available
multi-agency partnerships

14. Stepping Stones for Development
The Continuum
Best Practice
E D C B A
Stepping Stones for Development
Best Practice
Benchmark of
best practice
E A

15. Factor 1- Screening & Assessment
Patients nutritional needs are not ascertained
Benchmark of Best Practice
Nutritional screening progresses to further assessment for all patients identified as at risk” E A

16. The Benchmark Process Stage 1 Agree best practice
Stage 2 Assess clinical area against best practice
Stage 3 Produce & Implement action plans aimed at achieving best practice
Stage 4 Review achievement towards best practice
Stage 5 Disseminate improvements & or review action plans
Stage 6/1 Agree best practice

17. Using the Benchmarks – How?
Stage 1 : Agree best practice –
- consider patients carer’s experiences and how
current care is delivered.*1, 2
- agree which benchmarks to take forward
- set up your comparison group with ground rules*4
- using general indicators and specific indicators
agree evidence needed to provide best practice

18. Assess Clinical Area Against Best Practice – Stage 2
Obtain baseline information
Consider the indicators and provide evidence that shows current achievement towards best practice*3
Consider barriers which prevent achievement of best practice*3
Compare and share best practice so that good practice is not wasted. The E – A scoring can be used to stimulate discussion

19. Producing and Implementing Action Plan – Stage 3
Action plan to include*5
Changes to be made to improve practice
Who is responsible
Timescale
Actions should be realistic, achievable and measurable
Aim for quick wins

20. Review Achievement Towards Best Practice – Stage 4
Evaluation of action plan *6
did the patient / carer’s experience improve
If no improvement review activities in action plan – does it need refocusing on?

21. Disseminate Improvements / Review Action Plan /Stage 5
Disseminate good practice by all available resources throughout the organization/(s)
Build into organizational business plan, clinical and social care governance plan, and quality reports*1,7

22. Agree Best Practice – Stage 6/1
The whole cycle continues again!!

23. Success Factors Steering group
Driven from the top but grow from the grass roots.
Embedded into practice – creating time, ownership, integration
Recognition - Celebrate success

24. Success Factors Champions Timing Cultural fit Support Facilitation
Teamwork

25. Service Users Very important! Patient Support Officer Forums / Groups
Partnerships

26. Role of Project Officer
Facilitate at organizational level those wishing to implement the Essence of Care Toolkit
Co-ordinating benchmarking across organizations
Assess the need for “tailoring” of the benchmarks to fit the Northern Ireland context
Ultimately ensure that the project links to the development of the overall Clinical and social Care Governance Structures as they take shape within northern Ireland.

27. Facilitators Role Set up Essence of Care Lead
Inform / Raising awareness
Maintain momentum
Produce reports for project officer

28. Team Leaders Role Direct facilitation of the benchmark
Co-ordinate all activity in relation to benchmark selected
Produce reports to the facilitator regularly
Produce timely minutes of each group meeting
Represent group at higher level meetings / presentations etc

29. Summary Working to achieve best practice in fundamental care
It’s about what matters to patients, carer’s and health care personnel
It is integral to good clinical governance management.

30. Finally
Benchmarking through The Essence of care challenges us to think outside the box and own our decisions.
The process is evolutionary not revolutionary – aim for quick wins!
Its the wee things that count!

31. “The authority to engage in the Humanity of Care”
Essence of Care
“The authority to engage in the Humanity of Care”

32. Contact Information
Address
Suzanne O’Boyle
Essence of Care Manager
NIPEC, Centre House
79 Chichester Street
BELFAST, BT1 4JE
Tel :
Fax :