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“More than a condition, more than a uniform”

This article examines the connection between patient and staff experience in healthcare settings and explores the impact on patient safety and clinical effectiveness. It highlights the importance of staff engagement in delivering high-quality care and provides examples of interventions and initiatives aimed at improving patient experience.

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“More than a condition, more than a uniform”

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  1. “More than a condition, more than a uniform” Exploring the links between patient and staff experience

  2. “Engaged staff think and act in a positive way about the work they do, the people they work with and the organisation that they work in.” NHS Employers, Staff Engagement Toolkit

  3. Staff experience Patient experience Patient safety Patient experience Patient safety Clinical Effectiveness Clinical Effectiveness

  4. Why it’s important • Macmillan analysed two national datasets and found that in Trusts scoring highly on a whole range of staff survey measures, experiences reported by cancer patients are also higher. And conversely where staff report more negative views of their workplace, the experiences of cancer patients also tends to be more negative. • Trusts where clinical staff report the highest levels of discrimination are up to 18 times more likely to provide cancer patients with a poorer quality experience during their hospital stay compared with trusts with the lowest levels of discrimination.

  5. For an “ordinary” (1 s.d.) increase in overall engagement, this is equivalent in an average acute trust to a saving of around £150,000 in salary costs alone

  6. Two sides of the coin • “If you don’t have the staff to provide the service and people are doing potentially one or two roles they don’t have the time to build that rapport, or sit for the extra 10 minutes with someone’s relative to explain what’s happened with their scan result. Even an extra five minutes to make someone a cup of tea is what people remember” • Healthcare Practitioner

  7. Two sides of the coin • “It’s chaotic here, the nurses are running around. I wish I could get hold of the one I remember, I felt comfortable with him. But I was told he’s off now and no one was sure when he would be back. The truth is that I’m scared and I need a familiar face who has seen me at my worst – but he always looked busy and stressed and now it feels like he has disappeared because of that. I’m scared” • - Patient

  8. Relational Care • Naming: “I am the expert on me”. • Private communication: “My business is my business”. • Communicating with more sensitivity: “ I’m more than my condition” • Clinical treatment and decision-making: “I’d like to understand what will happen to me”. • Acknowledge me if I’m in urgent need of support: “I’d like not to be ignored”. • Control over my personal space and environment: “I’d like to feel comfortable”. • Managing on my own: “I don’t want to feel alone in this”. • Getting care right: “My concerns can be acted upon”

  9. VBS in London • Imperial College Healthcare NHS Trust: • With interventions it can sometimes be hard to measure whether a difference is being made, so Macmillan and Imperial wanted to look at how on-going measurement could be used to see whether patient experience was being improved. • Imperial introduced a ‘real-time’ monitoring system of measuring patient experience, whilst Macmillan ensured that the questions being asked of patients were linked to the Values Based Standard, as well as the National Cancer Patient Experience Survey. • The monitoring was collected while on the ward and, combined with staff surveys, the data was fed back and examined to compare both patient and staff experience.

  10. VBS in London • Kings College Hospital NHS Foundation Trust • The Values Based Standard was piloted within the Chemotherapy Unit as well as on a Haematology Ward. • In order to help the ward team more easily adopt the behaviours set out in the Values Based Standard, the nurse manager on the Haematology Ward was trained to interview and record patients telling the story of their care. • These were shown on a regular basis to encourage staff to focus on the moments that matter for patients and families.

  11. Health Care Assistants “Healthcare assistants (HCAs) make up around a third of the caring workforce in hospitals, but research suggests that they now spend more time than nurses at the bedside. If the NHS wants to improve patient care, it should see healthcare assistants as a critical, strategic resource. Yet many HCAs feel undervalued and overlooked.” - Camilla Cavendish, The Cavendish Review

  12. “Aspects of a negative culture have emerged at all levels of the NHS system. These include: a lack of consideration of risks to patients, defensiveness, looking inwards not outwards, secrecy, misplaced assumptions of trust, acceptance of poor standards and, above all, a failure to put the patient first in everything done. The emergence of such attitudes in otherwise caring and conscientious people may be a mechanism to cope with immense difficulties and challenges thrown up by their working lives” - Robert Francis

  13. Schwartz Centre Rounds These rounds provide a forum for MDTs to come together to talk about the social and emotional challenges of caring for patients. 24 sites across the UK 7 sites in London at present, with another 10 coming on board in 2015

  14. Any questions?

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