Aims and objectives:
The fast pace of change in the NHS has to be continually measured against the needs and values of the people who do, and will use our services. Section 7 and II of the Health and Social Care act firmly establishes the duty of NHS Trusts to collect, measure and value our patients' experiences.
The patient provides feedback about their experience by responding to questions on a device located in the department or provided by staff on the wards by pressing their responses to questions, the information is then fed back to an independent secure data point. Reports that are produced are automatically emailed to the relevant managers on a weekly basis. These reports are in easily assimilated graphic form, providing an unrivalled insight into working with patient experiences.
By developing this flexible, simple and fast method of collecting such information opens the way for this data to take its rightful place as the cornerstone for future NHS provision and development.
Support for the change:
The value of information begins and ends at the point of service delivery, one of the most critical areas where change must happen. Valuing patient experiences is key to the success of this method. Front-line staff have ownership of the information, they review the data enabling them to address their patients' concerns and compliments.
The staff meet weekly to discuss the results, they identify the issues and collectively decide on an action plan to improve their service. The returned data is displayed on a large poster for all patients and carers to view.
Patient and public influence:
The analysed information in jargon free formats is presented on information boards. The results and service changes are displayed on the wards and departments to openly inform patients, service users and carers.
For example, the data told one particular ward that a small number of patients didn't feel the atmosphere was friendly during 'doctor's round', due to the busy nature of that time. The staff decided that throughout this time they should simply smile more. Within only one week patient responses no longer reflected this issue.
Impact on the workforce:
The most essential aspect to workforce development is the bigger part that Patient and Public Involvement (PPI) plays in enhancing National Health Service provision based on the continually developing and changing needs of service users.
Staff collect, receive results and share action and practice with other areas and service users. Most importantly, the staff now recognise that by working proactively, patient experiences can improve their service and highlight good practice. For example, much of the patient data for the diagnostic and treatment centre highlights an exemplary service. The team feel that the feedback has boosted their working morale. The cost to the Trust has been minimal.
Measuring the results:
Patient satisfaction was measured across two Primary Care Trusts in the minor injuries units. To equip us with the tools to compare across the two sites we designed a 'Validity Profile'. The profile asks the staff to map their ward or department, the number of staff, environment, patient numbers and patient length of stay. This formula helped us use 'the patient experience tracker' to effectively compare equivalent areas to share results and good practice.
The feedback means that patients can see real changes and improvements and they are provided with a 'gateway' opportunity to be further involved, if they wish.
Improved performance:
There are three areas of investigation, covering 'information provision', 'privacy & dignity' and 'patient satisfaction’ with five questions to each area. The 'tracker' or the device is offered to all patients or carers. Those wishing to participate answer each question on a scale from 1-4. Every answer and each set of answers has a score attributed to it and each response is automatically time and date stamped, showing scores and volumes of answers that allows staff to act on events at the time they occurred. The data is used to generate reports that are sent back to the staff, the steering group and appropriate managers.
The data is focused on ongoing current service and patient experiences and not as a 'one-off' initiative. It has become an ingrained, continuous way of operating and demonstrates to patients a commitment to service improvement and patient involvement.
Reflecting diversity:
For true representation of the system, we piloted the 'tracker' at the Minor Injuries Unit, Out-Patients Department, The Diagnostic and Treatment Centre and three wards. All these areas tested the system’s versatility with different client groups. Asking patients to anonymously provide their opinion and by involving staff at all levels, guarantees that the 'Patient Experience Tracker' captures the diverse views of patients. This enables front-line staff to directly understand what the patients, their carers and families think.
The questions can be set in different languages and Braille. Everyone has access to expressing their own opinion of their experiences.
Sharing the learning:
We have written a guide to ensure that the system is used in the most appropriate way for the health service and patient needs. This guide has been shared across Southern Derbyshire and we plan to compare and share our findings with other Primary Care Trusts and Trust Hospitals within the Trent region and nationally.
As yet, this work has not been entered for any other awards.
Outstanding features:
The main features are utilising a consumer service tool in an effective valid format for the NHS. Secondly, it enables front-line staff to make service changes in line with what patients want. These small changes, with little cost implications; often provide real impact and a real difference. Thirdly, the guide written to accompany the 'tracker' ensures that other Trusts can utilise the system to share good practice.
The ‘tracker’ returns far higher response rates when compared with other methods of patient experience data collection. It is far more effective for eliciting views from our elderly patients than questionnaires posted after discharge.
