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Capturing and Enhancing Patient Experience within Maternity Services at South Tees NHS Foundation Trust Lynne Young - Clinical Matron Alison Russell - Labour Ward Manager The James Cook University Hospital MICB4351 • To capture women’s perceptions of their care and to feedback to the multidisciplinary teams in an attempt to celebrate elements of good practice and to reflect and learn when we could have done better. • Attempt to enhance patient experience and reduce the formal route for complaints Aim for capturing patient experience • Managers/ Matron/ Medical team/FAB forum family reps to utilise a Proforma and conduct a weekly audit within the clinical areas • Address issues as they arise and identify any common themes to feed back quarterly to all staff • Managers /Matrons perform at least 5 audits per month • Consultants perform on a weekend when on call • Lay reps supported by the Manager/ Matron to attend the clinical areas • Utilise the standard proforma Method Patient experience walkarounds • Have you been happy with all aspects of your care ? • Do you feel you were given the choice of place of care during your pregnancy (ie home birth/ care in children’s centres)? • Did all staff introduce themselves at each contact and were the courteous and respectful ? • Did you feel supported in producing your own birth plan? • Did all staff introduce themselves at each contact and were they courteous and respectful at all times • Do you feel you were given the correct amount of information during your pregnancy? • Have all staff given you full explanations about your care and have you been involved in your care? • What one area do you feel could have been improved/ would you like to share a positive experience. Has a member of staff impressed you? • Did you use the advice line when you were pregnant? • If so did you find the advice line useful or what could we have done better? • On a scale of 1-10 would you rate your overall experience Proforma questions • Face to face conversations at the time of the walkarounds • Quarterly summary is produced incorporating feedback and themes which is:- – circulated to ward managers and clinical director to share with their teams – displayed to the KHWD boards – presented at mandatory training, risk/audit meetings • Positive experiences of care highlighted naming individuals who have impressed • Areas for improvement themed and highlighted • Highlights positives to feedback to staff • Identifies areas for improvement to feedback to staff • Partners are usually present and can participate • Nips some issues “in the bud” – gives opportunities for explanations • Increases patient satisfaction enhances experience / increases visibility of manager / matron / involves the lay reps • Reduces the formal route for complaints • Provides on-going evaluation of maternity care via patient experience Feedback to the multidisciplinary team by: Benefits Formal Informal Apr-Jun 2012 5 7 Jul-Sep 2012 6 7 Oct-Dec 2012 12 12 Jan-Mar 2013 8 5 Apr-Jun 2013 6 5 Complaints Background: Within maternity services there are reoccurring themes identified from capturing patient experience and informal and formal complaints. One of these themes identifies that women do not always have a thorough understanding of their birth experiences or maternity care. In an attempt to address this maternity services have developed the ‘talking about birth clinic’ and the ‘debrief process’ Development of the ‘talking about birth clinic’ and ‘debrief process’ “Great care by all” A group of midwives are developing a listening, planning and debriefing service for women. The aim being to fulfil a growing need in women to discuss and plan for their pregnancy/childbirth, or understand issues surrounding or relating to a previous pregnancy. The ultimate aim being that women move forward with confidence and empowerment, as they prepare and plan for the subsequent birth. The aim of this service is to promote normality wherever possible, avoid ‘history repeating itself’, and for some women, reducing their fears and anxieties relating to childbirth. Women are identified primarily by either their Obstetric Consultant or Community Midwife, and then referred to the clinic. The midwives involved work alongside their medical colleagues to prevent unnecessary interventions. In a single 1 to 1 ‘listening and planning’ session, women that have been referred can explore the sometimes deep rooted and complex issues, in a safe environment. A suitable written plan is then formulated. This service has been available for some time within South Tees at the Friarage site and has recently been developed at James Cook. Future plans are being developed to evaluate outcomes in order that the service can be taken forward. Debrief process Talking about birth clinic (TAB) “Felt listened to” “Staff reassuring” “Clean and food good” “High dependency evening very informative” • Encouraging all staff to ask women at every face to face contact if they have any concerns or outstanding questions they need answering • Talking about birth clinic • Debrief process • Performing patient experience walkarounds • Trust wide quarterly patient experience surveys • Natal hypnotherapy • Aromatherapy • Submersion in water for labour • Water blister pain relief for labour • Telemetry in labour • Promotion of normality • High and low dependency evening • High dependency team • Trust wide essence of care audits • 15 steps challenge • Family and birth forum Capture and enhance patient experience by: “Nothing to be improved” “Meals very good” “Felt safe”

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Page 1: Capturing and Enhancing Patient Experience within …...for women. The aim being to fulfil a growing need in women to discuss and plan for their pregnancy/childbirth, or understand

Capturing and Enhancing Patient Experience within Maternity Services at

South Tees NHS Foundation Trust

Lynne Young - Clinical MatronAlison Russell - Labour Ward Manager

The James Cook University Hospital

MIC

B435

1

• Tocapturewomen’sperceptionsoftheircareandtofeedbacktothemultidisciplinaryteamsinanattempttocelebrateelementsofgoodpracticeandtoreflectandlearnwhenwecouldhavedonebetter.

• Attempttoenhancepatientexperienceandreducetheformalrouteforcomplaints

Aim for capturing patient experience

• Managers/Matron/Medical

team/FABforumfamilyrepstoutiliseaProformaandconductaweeklyauditwithintheclinicalareas

• Addressissuesastheyariseandidentifyanycommonthemestofeedbackquarterlytoallstaff

• Managers/Matronsperformatleast5auditspermonth

• Consultantsperformonaweekendwhenoncall

• LayrepssupportedbytheManager/Matrontoattendtheclinicalareas

• Utilisethestandardproforma

Method

Patient experience

walkarounds

• Haveyoubeenhappywithallaspectsofyourcare?

• Doyoufeelyouweregiventhechoiceofplaceofcareduringyourpregnancy(iehomebirth/careinchildren’scentres)?

• Didallstaffintroducethemselvesateachcontactandwerethecourteousandrespectful?

• Didyoufeelsupportedinproducingyourownbirthplan?

• Didallstaffintroducethemselvesateachcontactandweretheycourteousandrespectfulatalltimes

• Doyoufeelyouweregiventhecorrectamountofinformationduringyourpregnancy?

• Haveallstaffgivenyoufullexplanationsaboutyourcareandhaveyoubeeninvolvedinyourcare?

• Whatoneareadoyoufeelcouldhavebeenimproved/wouldyouliketoshareapositiveexperience.Hasamemberofstaffimpressedyou?

• Didyouusetheadvicelinewhenyouwerepregnant?

• Ifsodidyoufindtheadvicelineusefulorwhatcouldwehavedonebetter?

• Onascaleof1-10wouldyourateyouroverallexperience

Proforma questions

• Facetofaceconversationsatthetimeofthewalkarounds

• Quarterlysummaryisproducedincorporatingfeedbackandthemeswhichis:-

– circulatedtowardmanagersandclinicaldirector tosharewiththeirteams

– displayedtotheKHWDboards – presentedatmandatorytraining,risk/auditmeetings• Positiveexperiencesofcarehighlightednamingindividualswhohaveimpressed

• Areasforimprovementthemedandhighlighted

• Highlightspositivestofeedbacktostaff

• Identifiesareasforimprovementtofeedbacktostaff

• Partnersareusuallypresentandcanparticipate

• Nipssomeissues“inthebud”–givesopportunitiesforexplanations

• Increasespatientsatisfactionenhancesexperience/increasesvisibilityofmanager/matron/involvesthelayreps

• Reducestheformalrouteforcomplaints

• Provideson-goingevaluationofmaternitycareviapatientexperience

Feedback to the multidisciplinary team by:

Benefits

Formal

Informal

Apr-Jun2012

5

7

Jul-Sep2012

6

7

Oct-Dec2012

12

12

Jan-Mar2013

8

5

Apr-Jun2013

6

5

Complaints

Background:Withinmaternityservicestherearereoccurringthemesidentifiedfromcapturingpatientexperienceandinformalandformalcomplaints.Oneofthesethemesidentifiesthatwomendonotalwayshaveathoroughunderstandingoftheirbirthexperiencesormaternitycare.Inanattempttoaddressthismaternityserviceshavedevelopedthe‘talkingaboutbirthclinic’andthe‘debriefprocess’

Development of the ‘talking about birth clinic’ and ‘debrief process’

“Greatcarebyall”

Agroupofmidwivesaredevelopingalistening,planninganddebriefingserviceforwomen.Theaimbeingtofulfilagrowingneedinwomentodiscussandplanfortheirpregnancy/childbirth,orunderstandissuessurroundingorrelatingtoapreviouspregnancy.

Theultimateaimbeingthatwomenmoveforwardwithconfidenceandempowerment,astheyprepareandplanforthesubsequentbirth.

Theaimofthisserviceistopromotenormalitywhereverpossible,avoid‘historyrepeatingitself’,andforsomewomen,reducingtheirfearsandanxietiesrelatingtochildbirth.

WomenareidentifiedprimarilybyeithertheirObstetricConsultantorCommunityMidwife,andthenreferredtotheclinic.

Themidwivesinvolvedworkalongsidetheirmedicalcolleaguestopreventunnecessaryinterventions.Inasingle1to1‘listeningandplanning’session,womenthathavebeenreferredcanexplorethesometimesdeeprootedandcomplexissues,inasafeenvironment.Asuitablewrittenplanisthenformulated.

ThisservicehasbeenavailableforsometimewithinSouthTeesattheFriaragesiteandhasrecentlybeendevelopedatJamesCook.

Futureplansarebeingdevelopedtoevaluateoutcomesinorderthattheservicecanbetakenforward.

Debrief process

Talking about birth clinic (TAB)

“Feltlistenedto”

“Staff

reassuring” “Cleanandfoodgood”

“High

dependencyeveningveryinformative”

• Encouragingallstafftoaskwomenateveryfacetofacecontactiftheyhaveanyconcernsoroutstandingquestionstheyneedanswering

• Talkingaboutbirthclinic• Debriefprocess• Performingpatientexperiencewalkarounds

• Trustwidequarterlypatientexperiencesurveys

• Natalhypnotherapy• Aromatherapy

• Submersioninwaterforlabour• Waterblisterpainreliefforlabour

• Telemetryinlabour• Promotionofnormality• Highandlowdependencyevening

• Highdependencyteam• Trustwideessenceofcareaudits

• 15stepschallenge• Familyandbirthforum

Capture and enhance patient experience by:

“Nothingtobe

improved”

“Mealsverygood”

“Feltsafe”

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