wessexahsn.org.uk arise model... · web viewthe word arise is an acronym for aims – recruit –...

A R I S E

The Wessex Patient Safety Collaborative

model for patient engagement

Aims What are the aims of this engagement

process What are the roles for patients:

Strategic, Operational, Project, Administrative, Consumer Advisers? Recruit

How to identify and recruit the patients

How to identify and use local patient networks

Integrate Patient representatives to be equal

and effective partners with staff Staff to be equal and effective

partners with patient representatives

Support To ensure patient

representatives receive appropriate support

To ensure patient representatives can access appropriate development opportunities

ARISE v1.0 Nov 2015.

Evaluate To evaluate progress To continually improve patient

engagement practice

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Forward

Patient involvement in the NHS has a long history but it has come a great deal further than just asking people about car parking or hospital visiting hours. Involving ‘customers’ in the design and delivery of services has, over the years, led to a marked improvement in efficiency. This in turn has led to greater satisfaction and better outcomes for both patients and health staff. However, as always, it must be recognised that along with the gains comes some challenges. How do you find these patients/carers? How do we best make use of them? How do we support them whilst they are working with us? Also, most importantly, how do we try and ensure we have not ended up trying to put a square peg into a round hole.

The ARISE model that has been developed by Wessex Patient Safety Collaborative is an excellent tool to assist anyone who is looking for the answers to these questions. Patients and carers are an enormous, largely untapped, resource. I am sure that the information given here will be of help to healthcare professionals who want to utilise that resource to ensure meaningful patient engagement in both service design and delivery.

Georgette Houlbrook, Patient Representative – Wessex Patient Safety Collaborative Faculty

Acknowledgements

Wessex Patient Safety Collaborative would like to acknowledge the contribution of the following organisations in helping to develop this model:

Wessex Community Voices (WCV)

Patient and Public Involvement Solutions (WCV)

Healthwatch Organisations from Dorset, Hampshire, Isle of Wight, Portsmouth & Southampton

National Society for the Prevention of Cruelty to Children (NSPCC)

Professional Partnerships & Consultancy Services (NSPCC)

RAISE Health and Social Care, a project delivered through South West Forum

The Kings Fund

National Institute for Health Research - Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) – Northwest London

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ARISE model for patient engagement

The ARISE model for patient1 engagement has been developed by Wessex Patient Safety Collaborative (PSC) in response to requests from NHS organisations across Wessex for guidance about how to engage effectively with patients.

The ARISE model has been developed by a working party of Wessex PSC organisations based on their experiences of attempting to develop patient engagement across a year long Breakthrough Series project.

The model is aligned with the Patient and Public Participation approach being developed by the NHSE and the CLAHRC initiative based on the NSUN (National Survivor User Network) standards.

How to use the ARISE model

The ARISE model highlights established practices familiar to NHS staff such as: establishing aims & objectives; recruiting people; team building; developing individuals and evaluating progress and demonstrates how these processes can be applied when working with the voluntary sector.

The ARISE model also aims to help NHS organisations to recruit the most suitable people to work with the patient safety agenda. Key to this approach is the assessment of the attitudes, values and motives of those who are applying for the job.

The steps in the ARISE model

The ARISE model consists of 5 steps. The word ARISE is an acronym for Aims – Recruit – Integrate – Support – Evaluate.

These stages also reflect 5 questions that seem to come up very frequently: What do want patient representatives for; where do we find them; how do we integrate them into our team; how can we support them once we’ve found them and how do we know if our engagement process has yielded any benefits?

The ARISE model helps teams plan the process of patient engagement from the “why do it”, through the “how to do it” to the “how well did we do it”.

1 The term patient includes other terms such as service user as well as friends, family, carers etc.

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ARISE model for patient engagement – Step 1: Aims

The first step in the ARISE model for patient engagement is defining the purpose, aims and objectives of the proposed workstream.

Principleso The rationale for engaging with patientso Co-design, co-productiono Beginning with engagement

Aims / Objectives / Expected Outcomeso What are the aims of this engagement processo Where is the pressure to engage coming fromo Do patient reps change staff behaviouro How do we know what we want the patients to doo What are the roles for patients: Strategic, Operational, Project, Administrative,

Consumer Advisers?

Toolso ARISE Roadmapo Engagement Cycleo Baseline Assessment Ladder of Engagemento Patient engagement standards (NHSE; NSUN)o MfI 3 questions

Deliverableso Driver Diagramo Project Plan / Gantt Chart / Critical Patho Role Outlineo Appropriate metrics / measurement methodologyo Template documents for organisations / teams

Using the ARISE model will help organisations and teams address questions such as: What do we want our patient representatives to do? How can we assess our culture, identify good practice and address coercive behaviours?

o How does the organisation think / behave to patients & staff?o How effective is the Board to Ward communications / strategy?o Is there an individual patient focus linked to service delivery?

How can we recognise and reduce resistance to patient engagement? Do we know where the patient representatives are in our organisation and what do we do

if we don’t? Should we recruit patients then decide projects or decide projects then recruit patients? How can we identify the most appropriate engagement method to fit the “work”?

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ARISE model for patient engagement – Step 2: Recruit

The second step in the ARISE model is to clarify the role of the desired patient representatives and following on from that how, and where, to go about recruiting them.

Principleso Meaningful engagement in equal and reciprocal relationships between

professionals, people using services, their families and their neighbours.

Aims / Objectives / Expected Outcomeso How to identify and recruit the patients that we want to engage witho How to identify and use local patient networkso Do to better understand the patients personal agenda / motivation

Toolso Values based interviewingo Network Map o Directory of Resources

Deliverableso Recruitment strategyo Volunteer Fairo Websiteo Social Media Platformo Patient representativeso Succession strategy

Using the ARISE model will help organisations and teams address questions such as:

How can we meaningfully engage with patients? Is it easier to engage with patients on some projects than others? How can we best target patient engagement? How can we engage with “hard to reach” patients? When should we consider developing a new local patient network / media platform? What is the best selection / appointment process for patient reps? Should our patient reps be remunerated? Can one patient represent any other / all patients? Should we be looking for individual patient stories or establishing a broader perspective? How can we ensure that we select the right patient for the right project? How can we decide best context for Patient stories and avoid re-traumatising the patient? When should we consider a broader engagement methodology e.g. focus groups /surveys? How to achieve a balance of positive patient experience alongside the challenging stories? Can we positively discriminate to achieve a balance of representation? How do we allow for differences in staff attitudes and patient rep background Should we consider engaging with staff patients?

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ARISE model for patient engagement – Step 3: Integrate

The third step in the ARISE model is to enable patient representatives to be equal and effective partners in the process, and to help organisations ensure the patient representatives develop reciprocal relationships within their teams.

Principleso Patient representatives to be equal and effective partners with staffo Staff to be equal and effective partners with patient representatives

Aims / Objectives / Expected Outcomeso To integrate patient representatives as equal and effective team memberso To ensure staff are able to work as equal and effective team members with patient

representatives

Toolso Induction Planner Checklisto Team building

Deliverableso Induction / Integration Process


Are Patient Engagement difficulties due to a knowledge gap or an implementation gap? What should we consider when preparing to work with patients as equals? How we can develop staff who have low confidence in the ability or willingness of patients

to engage with us? How can we help our teams to work together, improve multidisciplinary communications in

meetings and consider whether there is a need to establish role boundaries? How can we address cynicism about patient engagement? How should we deal with challenging patients?

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ARISE model for patient engagement – Step 4: Support

The fourth step in the ARISE model is to ensure that the patient representatives receive the appropriate support and personal development in their role.

Principleso To ensure patient representatives receive appropriate support on a personal and

role related basiso To ensure patient representatives can access appropriate personal and role related

development opportunities to ensure they are now, and continue to be effective members of the team

Aims / Objectives / Expected Outcomeso To provide patient representatives receive appropriate support and development

opportunities

Toolso Development Needs Analysiso Training Needs Analysis

Deliverableso Role related guidance / handbooko Training Resources (Course Directory / Training Materials)


What are the development and support needs of our patient reps? How can we train / coach / educate our patient reps? How can we develop our patient reps to improve their effectiveness /communication skills? What resources are available to help us develop patient reps? Do patient reps need to be familiar with the NHS Constitution?

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ARISE model for patient engagement – Step 5: Evaluate

The final stage of the ARISE model is the evaluation or review process. The ARISE process starts by identifying purpose, aims an objectives and this final stage reviews whether and how this has been achieved.

This is designed to: celebrate success, reflect on challenges, address barriers and to continually improve patient engagement practice!

Principleso To evaluate progresso To continually improve patient engagement practice

Aims / Objectives / Expected Outcomeso Celebrate successo Reflect on challengeso Address barriers

Toolso ARISE Roadmapo Engagement Cycleo Baseline Assessment Ladder of Engagemento Patient engagement standards (NHSE; NSUN)o MfI 3 questionso Metrics model / measurement methodology

Deliverableso Project engagement evaluation report

Using the ARISE model will help organisations and teams address questions such as: Have we met our aims and objectives for our project? Have we achieved meaningful engagement in equal and reciprocal relationships between

professionals, people using services, their families and their neighbours? Have our patient representatives been equipped and empowered to work as equal and

effective partners in the project? Have our patient representatives been able to receive appropriate support and

development opportunities on a personal and role related basis?

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Appendix A: Resources

NHS England

NHSE - Bite Sized Guides to patient and public participation https://www.england.nhs.uk/2014/03/13/pat-pub-participation/

NHSE - Patient and Public Participation Policyhttps://www.england.nhs.uk/ourwork/patients/ppp-policy/https://www.england.nhs.uk/wp-content/uploads/2015/11/ppp-policy.pdf

NHSE – Public Voicehttp://www.england.nhs.uk/ourwork/patients/public-voice/

NHSE - Transforming Participation in Healthcare (Commissioning Guide)https://www.england.nhs.uk/wp-content/uploads/2013/09/trans-part-hc-guid1.pdf

NHSE - Transforming Participation in Health and Care (Resources)https://www.england.nhs.uk/ourwork/patients/participation/

NHSE - Working with our Patient and Public Voice Partners - Reimbursing out of pocket expenses and involvement paymentshttps://www.england.nhs.uk/wp-content/uploads/2015/05/ppv-expenses-involvment-policy.pdf

NHS Employers – Values based recruitment:http://www.nhsemployers.org/your-workforce/recruit/employer-led-recruitment/values-based-recruitment

Other

4Pi National Involvement Standards (National Survivor User Network) http://www.nsun.org.uk/assets/downloadableFiles/4pi.-ni-standards-for-web.pdf

Centre for Patient Leadership (InHealth Associates)http://engagementcycle.org/about-us/centre-for-patient-leadership/

CLAHRC Wessex - Adaptation of the NSUN 4Pi National Involvement. Standards http://www.clahrc-wessex.nihr.ac.uk/patient-and-public-involvement

Health Foundation – Patient Engagementhttp://patientsafety.health.org.uk/area-of-care/safety-management/patient-engagement

Kings Fund – Leading Collaborativelyhttp://www.kingsfund.org.uk/leadership/leading-collaboratively-patients-and-communities

National Voices http://www.nationalvoices.org.uk/

Volunteering.org.ukhttp://www.volunteering.org.uk/

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Appendix B: Application of ARISE model to the BTS methodology

Scopingo Identify Critical Patho Develop ARISE modelo Identify the Facultyo Identify budget (PSC / NHSE)o Develop Change Package / Metrics

Mobilisationo Develop toolkito Develop Training materialso Clarify the patient role/s (for benefit of teams and the patient reps)o Develop any pre-work for the teams to do before the first Learning Event on BTS 2

Deliveryo Familiarise PSC workstreams with the workstreamo Train BTS2 teams to use ARISE model

Reviewo Monitor and Review Progress

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Appendix C: Standards used to develop the ARISE model

NSUN (National Survivor User Network) standards.

4PI framework for involvement: a simple, yet robust framework around which to base standards for good practice, and to measure, monitor and evaluate involvement.

Principles Purpose Presence Process Impact

NHSE Patient and public participation – 3. Planning for participation Why planning for participation?

o Core principleso Practical Stepso The Ladder of Engagement

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