Homerton University Hospitals NHS Foundation Trust ­ CASE STUDY

Clinicians queuing up to join patient engagement project

Homerton University Hospitals NHS Foundation Trust began using PET after finding other systems of measuring patient experience too inflexible and generic to make a true difference to the local population. As results often came months later, it was difficult to respond to a survey and make necessary improvements to healthcare delivery in a timely manner. When the problem with patient experience data was identified, a project team was set up to develop business and implementation plans.

Deputy director of nursing, Jennie Negus, says that significant work was put into planning the project and ensuring that departments were fully involved and supportive. There is a possibility that teams can view data capture and analysis as a threat, i.e. that the management is checking up on individual services. For the most part, Homerton was able to avoid that trap by emphasising the initiative's impact on the quality of care offered by the trust as a whole, and by its services in particular.

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PET analysis allows users to see at a glance the results from each patient experience question. Results can be seen in either graph or table formats.

PET's handy size makes it ideal for use by all patients. The handsets can be adapted in a variety of ways, such as asking questions in Braille or extra large type. Homerton has addressed the needs of its ethnically diverse community by providing questions translated into 21 different languages. The handsets can be either portable or static, which allows organisations to adapt the process of data capture to the local environment. In areas of high traffic, like patient waiting rooms, organisations can maintain a fixed point of data capture, while using portable handsets in areas such as wards where there is minimum traffic.

Solution:

Teams volunteered to be a part of the project and, from day one, identified the areas they wanted to concentrate on. These areas ranged from issues raised by previous surveys to complaints and new service developments. Once teams had agreed on what they wanted to address, relevant questions were developed and piloted, and the project was then rolled out across ten areas in the trust.

Clinical performance forms the foundation of patient care and, in addition to being a managerial tool, PET is helping clinicians and their teams drive results.

"Improvements can be difficult to measure and the PET project goes a long way in providing that information," says Negus. "Trust departments knew what they wanted to look at and, while I provide support and ongoing development, it is the clinical areas that own the project. It is data about their area and their practice that we are analysing. It is a partnership and I help them look at ways they could improve their work."

Outcome:

The development team's emphasis on improving the quality of patient care generated so much excitement around the project that there is currently a waiting list to get involved.

PET is now in constant use in ten areas of the trust. Five wards and A&E gather patient experience results 24 hours a day, while outpatient and surgical centres gather information five days a week. Reports are generated bi-weekly and sent from the staff teams to their area leads, managers and clinical governance leads.

Negus skims all the reports in order to maintain an overview of the way the project is working and to identify any trends. One reason she thinks PET has been such a success is that each team runs their part of the project in the way they think best. That means that implementation, management and reporting are all tailored to the specific needs of each area, allowing the trust to get maximum benefit from the project.

With teams quietly gauging who gets the most and best responses, Negus says patients are benefitting from the healthy competition. Examples and lessons learned are shared across the trust, ultimately further improving the patient experience.

Individual development meetings have been held with the teams involved and improvement plans are displayed on posters throughout the trust. This shows visitors how the trust is performing and what it is doing to improve. It also helps staff reassure patients about a low scoring area, as they can show that the problem has been recognised and is being addressed.

Negus coordinates regular emails and updates, as well as working with the project team to provide praise and feedback. The entire trust is seeing the benefits of the project, and monthly reports are presented to the steering group, board of governors and executive team. The Board of Directors has also requested that PET reports be added to their monthly score cards of trust results. Negus believes that the support coming from the top of the organisation is crucial in showing employees that their work is valued.

Plans for the future include increased use of the handsets, new ways of using PET and displaying more posters of survey results around the trust. An interactive workshop is scheduled for May that will help directorates incorporate patient feedback into their business plans.

"I am convinced that once the posters go up, our response rates will continue to increase," adds Negus. "The national inpatient survey run by the Picker Institute yielded just 325 respondents and, between January and March, we have had 1,567. We are doing remarkably well. The posters will act as an advertisement to the public and we may even see some different trends in answers as more people use the system, hopefully encouraged by what they see as our dedication to continually improving.