Annie Laverty Director of Patient Experience and Quality

1. Improving the Patient Experience The Northumbrian Way Annie Laverty Director of Patient Experience and Quality

2. Northumbria Healthcare • Employing almost 10,000 staff. • Largest area of any health trust in England • Providing integrated health and social care • Three general hospitals and seven community hospitals.

3. 2013 Systematic review. “patient experience is consistently positively associated with patient safety and clinical effectiveness across a wide range of disease areas, study designs, settings, population groups and outcome measures” “clinicians should resist side-lining patient experience as too subjective or mood orientated, divorced form “real” clinical work of measuring safety and effectiveness”.

4. Leadership at all levels focused on compassionate care andservice improvement

5. Patients, staff and other key stakeholders actively engaged on quality • Performance reviewed at every level • Transparency, a cornerstone of our improvement • Clinically lead, frontline change

7. Values in action. Value Based Recruitment : “The nurses are wonderful. You cannot make a nurse, they are a certain kind of person. They do wonders.” The importance of ‘being held in mind.’ (PAWL,1995) “Every day Teresa gives me my tea just how I like it and always with a lovely, big smile. She is so kind with me. ” “ I think this Trust chooses it’s nurses because of how friendly they are.”

8. Using insights from patients and families to improve care

9. Responding to patient feedback • Feedback from more than 50,000 people every year • Measuring what matters most to patients in a variety of ways and at different points of care • Right time’ data giving site, specialty, and individual consultant data, externally validated to feed through appraisal system • Real time measurement fed back to clinical teams within 24 hours

10. Health Quality CheckersTeam

11. Individual consultants.

12. Real time data

13. What matters most to inpatients. • Consistency and coordination of care • Treatment with respect and dignity • Involvement • Doctors • Nurses • Cleanliness • Pain control

14. Real Time Report – Ward 10 Wansbeck 20 01 2015 100% of patients surveyed would highly recommend this ward to their Family and Friends The baseline data is established on responses patients surveyed in 2014. Number of respondents 12 (60%)

16. Real Time Data – By Business Unit 2014

17. Commissioning for quality.

18. Real time improvements (n= 12,000)

19. Real Time Domain Averages 2014 to date

20. Real Time Domain Averages 2014

21. Negative Themes Q1 Negative Themes Q2 Top 3 Positive Themes Q1 Quality of the staff 28% Quality of the care 28% Kind empathetic caring staff 14% Top 3 Positive Themes Q2 Quality of the staff 29% Quality of the care 20% Kind empathetic caring staff 15%

22. Data that drives • Timely • Owned • Actionable • Specific • Talked about

23. September 2014 Results 53% of patients surveyed would highly recommend this ward to their families and friends.

24. Patient Comments Analysis – (August 2014)

25. December 2014 Results

26. Being open and honest with patients, families and the public

29. Sharepoint available to all on the intranet

31. Sustained engagement in making measurable improvements

32. Staff well being and patient experience Seven staff variables (‘wellbeing bundles’) which are linked to good patient-reported experience. These are: • good local (team)/work-group climate • perceived organisational support • high levels of co-worker support • low emotional exhaustion • good job satisfaction • supervisor support • good organisational climate

33. Strong staff engagement as our foundation. Our Staff Survey Performance • Best response 3 years in a row. • 2013 - 78% • 2012 – 71% • 2011 – 75% • 2010 – 68% • Engagement scores • 2013 - 3.88 • 2012 -3.79 Acute Average is 3.74 Medical Engagement at the heart of our organisation

34. Number of staff believing high quality patient care isthe No1 priority of the trust. Our story of moving the dot. “You cannot make things happen, but you can create a space in which what you want is more likely to happen.” – Chinese proverb

35. #6. Celebrating compassion and rewarding staff

36. Quality ImprovementUsing our data to drive change

37. Complaints Improvement Project Phase 1: project planning Phase 2: evidence gathering Defining objectives & scope; focus on Trust-wide complaints process and its outcomes Phase 3: stakeholder engagement Mapping of the complaints process and analysis of data against metrics Phase 4: recommendations Focus groups & interviews of all key stakeholder groups, including patients. Phase 5: implementation Developed and tested with all key stakeholder groups, designed around SMART principles. Post EMT approval of recommendations, full implementation plans will need to be developed.

38. Our shared purpose Our commitment to dignified and compassionate care for frail older people.

39. Support for Junior Doctors with QI Free subscription to BMJ Quality improvement programme. Supports meeting FY and ARCP requirements. Learning modules to develop knowledge re QI. Publication in a BMJ Journal!

40. Key things we have learnt. The benefits of real time reporting at team level. Executive management team support is crucial. Ensure patients & families are part of your improvement team. Focusing on things that matter most has made sense. Investing in improvement has helped. Qualitative feedback appears particularly important. Transparency of reporting matters.

41. Thanks for listening.Any questions.