Aims and objectives:
In line with the NHS Improvement Plan: putting people at the heart of public services, June 2004, the FACE initiative demonstrates local investment in buildings, equipment and infrastructure to enable staff to deliver modern, safe, convenient and high-quality care. The taskforce has listened to the patient voice by inviting lay members and staff from the trust's Patient Advice and Liaison Service to be members of the taskforce. The initiative is linked into the national "Better Hospital Food Programme". Commitment to establishing this taskforce demonstrates that improving the patient experience is one of the main priorities at QMC. In achieving these improvements parallel benefits will also be secured to improve the quality of working lives for staff.
Support for the change:
The FACE taskforce has a wide membership including staff from across both clinical and non-clinical areas of the hospital and lay members who are current or past users of the services provided by the trust
The membership is as follows:
Operations Director for the Diagnostic and Facilities Division
Hotel Services Manager
Head Nurse Matrons for Children’s Services and Out Patients
Head of Estates
Capital Planning Manager
Ward Housekeeping Project Manager
Arts for Health Coordinator
Occupational Therapy Manager
Medirest General Manager (catering providers)
Patient and Public Involvement Manager
Commuter Planning Manager
2 lay members
All members are champions for change and the principles of PDSA (plan, do, study, act) are used.
Each year a series of action plans are agreed that correlate with the aims of the taskforce. Each action plan is drawn up by a lead officer from the taskforce and identifies:
· The objectives
· How the objectives will be achieved
· Target/success measures
Patient and public influence:
Information from local and national surveys has been used to influence the annual action plans, for example the national in-patient and out patient surveys. Both the PEAT (patient environment action team) and the National Standards of Cleanliness audits have involved lay members. The Family Group has had major involvement in the development of the children's menu offers.
In addition feedback from users through PALS, complaints and compliments helps to focus the work of the taskforce. The two lay members actively participate and contribute to all the FACE projects. They provide essential experiential “know how” and form a link to user groups and to the trust’s patient partnership group. Recently on behalf of the ward housekeeping project, the two lay members undertook a baseline audit of patient experience on six wards across the trust. Three wards are participating in the ward housekeeping project and three are control wards. This valuable qualitative study has provided information that will contribute to monitoring the effectiveness of this initiative.
Impact on the workforce:
The ward housekeeper project will contribute to changing the workforce and issues identified through the various action plans have resulted in changes made to the content and delivery of customer care training.
Measuring the results:
It is very difficult to measure results, however during 2003/04 there was a reduction of complaints relating to car parking.
A number of stakeholders have been involved in various projects including patients and carers, staff within the trust, Nottingham team for visual impairment, Nottingham interpreting services, team for people with learning disabilities, voluntary services, previous complainants and The Highways Agency.
Staff actively monitor the catering contract via audits/spot checks to ensure quality and hygiene of the services managed by Medirest. In addition the staff monitor the food safety for commercial outlets within the hospital. The patient meal experience is monitored by the Food Quality and Hygiene audit, focussing on food quality and temperature, presentation, patient environment, delivery of the service and assistance with eating meals. Patient satisfaction surveys are undertaken bi-monthly.
Improved performance:
Some examples of achievements include:
Development of ownership standards
Ownership standards have been developed for public areas including corridors and waiting areas setting out minimum standards and housekeeping procedures
Developing standards for waiting areas, receptions and entrances (WAREs)
The standards are used as an integral part of refurbishment/new build projects and the design checklists are used in all building programmes.
Developing an arts in health strategy
The arts coordinator is a key member of the FACE taskforce involved in design projects. Recent and current work includes including commissioning art for public corridors, participatory art workshops for children on wards and in clinic areas, development of a children’s art gallery, emergency department photography project and salsa dancing for staff.
Integrated transport improvements
On site parking is difficult and has resulted in a number of complaints. Working with the local council, the trust has established a free bus service from the local Park and Ride car park. Usage has been beyond expectations with an average of 700 patients a week using the service. A further 200-car parking spaces have been developed on site together with additional dedicated disabled spaces. This work has resulted in a reduction in complaints.
Development and implementation of a way finding strategy
This work has been undertaken in conjunction with a number of stakeholders, including the Highways Agency, and has resulted in revised internal signposting, way finding maps, way finding colour scheme, improved external signposting and improvements to the off-site trunk road signposting.
Better hospital food
The trust achieved 6 better hospital food targets in 2003/04
Development of a block identity scheme
There are 4 blocks that make up the building making way finding difficult. Work was commissioned with an external company to develop a new approach to improve block identity. As areas are refurbished the new colour schemes are used to give a clearer identity to wards, departments and public areas within each of the blocks.
Sharing the learning:
This work has been short listed for the Designing Better Healthcare Awards run by NHS Estates.
Staff on the workforce publicise this initiative with colleagues and the lay members through their work on the trust's patient partnership group and with links into the local community.
It has been pleasing to note that other trusts are very interested in this concept of integration, and Guy’s and St Thomas’s NHS Trust in London have requested to use the FACE acronym and approach. In addition, the Trust’s most recent PEAT inspection also remarked that they thought the FACE initiative was working well and engendered better working between facilities and clinical teams.
Outstanding features:
Members of the taskforce are aware that all trusts in England are working towards achieving improvements in the whole patient experience and in particular enhancing the environment. However the integrated approach developed by QMC would appear to be rare. The taskforce has developed as an enthusiastic, self motivated group working in partnership with patients, carers and staff actively listening to and taking account of the diverse needs of the people served by and working within the trust.
