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What’s the problem?

What’s the problem?. ?. Everyone aims to do a good job, but. The subliminal message? More, more, more....... Faster, faster, faster...... And do it with less. Current State. System Outcomes. People Focused Outcomes. Staff Experience. Local surveys. Patient Groups. Financial

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What’s the problem?

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  1. What’s the problem? ?

  2. Everyone aims to do a good job, but...... The subliminal message? More, more, more....... Faster, faster, faster...... And do it with less.......

  3. Current State System Outcomes People Focused Outcomes Staff Experience Local surveys Patient Groups Financial Performance Access Targets Team vitality Better Together Complaints 4 hours 18 wks Pulse surveys Bi-annual survey

  4. Comprehensive systematic measurement infrastructure 18 wks RTT HSMR 4 hour A&E HSMR HSMR 4 hour 4 hour 18 wks HSMR HSMR 18 wks 4 hour 4 hour 18 wks 18 wks NHS Board NHS Board NHS Board NHS Board NHS Board NHS Board NHS Board But, where is care experience? The voice of the service user?

  5. Future State Measurement for Improvement Care Experience System Performance Staff Experience Personal goals Real-time feedback Loved Ones System Measures System outcome Real-time Feed back Staff wellbeing System Measures Team vitality Values based Reflect. Pulse surveys System Outcomes System outcomes System outcomes Obs of Care Comp- liments Nothing about me Must do With Me

  6. The feelings and emotions of the patients, under critical circumstances, require to be known and to be attended to, no less than the symptoms of their diseases. Medical Ethics, Thomas Percival, 1740-1804, English physician and author

  7. Focus on the people......

  8. What do the people want & need? NHS Scotland - The 6 Cs • Caring & Compassionate staff & services • ClearCommunication & explanation • EffectiveCollaborationbetween clinicians, patients & others • Clean and safe care environment • Clinical excellence

  9. Aim Primary Drivers Secondary Drivers Improved Care Experience Improved Staff Experience All health and care services are centred around people Co-Production Leadership

  10. Focus on...... • Culture, culture, culture • Values & behaviours • High impact leverage points that will make a difference to the lived experience • Reliable opportunities to personalise care • “Must do with Me” elements • Breakthrough series model • Accelerate & share learning • Spread • Scale • Momentum

  11. Person-Centred Health & Care: Care Experience Aim Primary Drivers Secondary Drivers • Distributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executives • Values & behaviours form basis of recruitment , development & management of staff • Reliable use of recognised tools to promote optimal team functioning • Person-centred values & behaviours are evident in words & actions at all levels of leadership • See also “Leadership” change package for key interventions & structures Person-centred care is everyone’s business • Reliable application of the five “Must do with Me” elements: • What matters to you? – Personal outcome goals agreed • Who matters to you? – Involvement of personal support network • What information do you need? - information is timely, full and understandable • Personalised contact – timing & method of contact with services is flexible • Nothing about me without me!- involved with communication, handovers and transitions at the level they choose • Dignity and respect frame all communication and interaction with people who use our services. • Teams test and adapt tools to measure and improve communication By December 2015 people using services will have a positive experience and get the outcomes they expect Services are delivered in active, collaborative partnership with people Technical care is delivered reliably and based on person-centred principles • Technical care is delivered in alignment with “Person-Centred Principles” • 1) Active, equal partnership • 2) Information sharing is timely, open and complete • 3) Participation in decisions • 4) Collaboration in design & delivery of services • Reliable application of the 5 “Must do with Me” elements Physical & cultural environments support the delivery of person-centred care • Weekly environmental walk rounds & Observations of Care by: a) Leaders; b) facilities teams; c)Clinical teams d)Service user / volunteer groups using person-centredness checklist • Walk-rounds & Observations focus on: • People & interactions (conversations with people using & delivering service, observations of care, etc) • Environment of care (signage, way-finding, etc)

  12. Person-Centred Health & Care: Care Experience Aim Primary Drivers Secondary Drivers • Distributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executives • Values & behaviours form basis of recruitment , development & management of staff • Reliable use of recognised tools to promote optimal team functioning • Person-centred values & behaviours are evident in words & actions at all levels of leadership • See also “Leadership” change package for key interventions & structures Person-centred care is everyone’s business • Reliable application of the five “Must do with Me” elements: • What matters to you? – finding out what’s important to people and using this info to collaboratively plan care • Who matters to you? – making it easy & routine for people to involve their personal support network if they choose • What information do you need? - information is timely, full and understandable & decisions are collaborative • Personalised contact – as much as is possible timing & method of contact with services is flexible • Nothing about me without me – people are involved with communications, handovers and transitions at the level they choose • Dignity and respect frame all communication and interactions • Teams test and adapt tools to measure and improve communication By December 2015 people using services will have a positive experience and get the outcomes they expect Services are delivered in active, collaborative partnership with people Technical care is delivered reliably and based on person-centred principles • Technical care is delivered in alignment with “Person-Centred Principles” • 1) Active, equal partnership • 2) Information sharing is timely, open and complete • 3) Participation in decisions • 4) Collaboration in design & delivery of services • Reliable application of the 5 “Must do with Me” elements Physical & cultural environments support the delivery of person-centred care • Weekly environmental walk rounds & Observations of Care by: a) Leaders; b) facilities teams; c)Clinical teams d)Service user / volunteer groups using person-centredness checklist • Walk-rounds & Observations focus on: • People & interactions (conversations with people using & delivering service, observations of care, etc) • Environment of care (signage, way-finding, etc)

  13. Morally & ethically the right thing to do – its a basic human right! • Reduces harm / provides early warning of harm • We are under-utilising a valuable resource – people!

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