Ms Suzanne O’Boyle

1. 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. Essence of Care in NI to date • Varying degrees of uptake • Primarily within rather than across organisations • Primarily Acute Sector

4. The Project • 16 Trusts • 9 Nursing Homes • Prison Service Nursing • Marie Curie

5. National – DHSSPS Level • Essence of Care Links to:- • Standard Development Task Group (SDTG) • Standards and Guidelines Unit • Health and Social Services Regulation and Improvement Authority (HSSRIA) • Clinical and Social Care Governance Support Team (CSCGT)

6. Institutional Level • Essence of Care provides a:- • Focus on the Fundamentals of Care • Structured approach to Comparing and Sharing Best Practice within and between organisations within and between disciplines

7. Individual Level • Essence of Care • Involves individual practitioners in the benchmarking process • Promotes user involvement • Encourages practitioners to seek and use evidence

8. 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

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

10. 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

11. Hygiene Pressure Ulcers Continence Self Care Safety Record Keeping Privacy & Dignity Nutrition Fundamental Aspects of Care • Published 2001, revised format 2003 • All benchmarks are interrelated & relevant to all health & social care settings • National framework-local approach! Communication “seeing things through the patients eyes”

12. The Toolkit - What’s in it? • An overallagreed 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

13. 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!

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

15. Embedding into Practice • Integration • Coherence with other organisational activities / business planning • Coherence with other organisational Q.A structures • Sufficient Time • Time to build into everyday practice - Embedded into the ethos • Ownership • Staff involvement at all levels - Staff must be actively engaged in achieving quality improvements • Reflected in policies & procedures

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

17. Success Factors • Champions • Timing • Cultural fit • Support • Facilitation • Teamwork

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

19. Impact of Essence of Care • Staff • Time out • Enhanced multidisciplinary / professional working for the benefit of patients • Development of relationships with patients and their carers in addressing issues that matter to them • Non – traditional learning • Shared governance

20. Key Principles • Structured approach to improve quality of care • A vehicle for effective leadership & continuing development • Action plans to support practice developments that are responsive to patient needs • Promotes effective & meaningful multidisciplinary & inter agency working

21. 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.

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

23. 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

24. Lessons learnt • Leadership – crucial • Realistic timescales – “ Rome was not built in a day2 If there are no timescales it will get pushed to the back • Not to be used as a tick box exercise • As you become familiar with the process it gets easier!

25. Lessons learned • Evidence of effectiveness – staff need to see it makes a difference as well as patients! findings are fed back in terms of objectives and business planning within the organisation. • Keep it simple! Otherwise becomes complicated, unwieldy and lose sight of the little things that make a difference.

26. 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.

27. 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!

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

29. Contact Information Address Suzanne O’Boyle Essence of Care Manager NIPEC, Centre House 79 Chichester Street BELFAST, BT1 4JE Tel : 028 9023 8152 Fax : 028 9033 3298 Suzanne.oboyle@nipec.n-i.nhs.uk