what’s the problem? everyone aims to do a good job, but...... the subliminal message? more, more,...
TRANSCRIPT
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
Staff Experience
Teamvitality
Pulse surveys
ComplaintsBi-annual
survey
SystemOutcomes
People FocusedOutcomes
PatientGroups
BetterTogether
Local surveys
4 hours 18 wks
FinancialPerformanceAccess
Targets
Comprehensive systematic measurement infrastructure
NHS BoardNHS
Board
18 wks RTT
18 wks RTT HSMRHSMR 4 hour
A&E4 hour
A&E
NHS BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
BoardNHS
Board
4 hour
4 hour
18 wks
18 wks
HSMRHSMR 4 hour
4 hour
18 wks
18 wks
HSMRHSMR 4 hour
4 hour
18 wks
18 wks
HSMRHSMR 4 hour
4 hour
18 wks
18 wks
HSMRHSMR
But, where is care experience? The voice of the service user?
Obs ofCare
System Performance
Staff Experience
Real-timeFeedback
Teamvitality
Pulse surveys
SystemMeasures
PersonalgoalsStaff
wellbeing
Care Experience
Real-time feedback
LovedOnes
Comp-liments
Must doWith Me
Measurement for Improvement
Values basedReflect.
Nothing about
me
SystemMeasures
SystemOutcomes
Systemoutcomes
Systemoutcome
Systemoutcomes
Future State
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
Focus on the people......
NHS Scotland - The 6 Cs• Caring & Compassionate staff & services• Clear Communication & explanation• Effective Collaboration between clinicians,
patients & others• Clean and safe care environment• Clinical excellence
What do the people want & need?
All health and careservices are centred around people
Aim Primary Drivers Secondary Drivers
Improved Care Experience
Improved Staff Experience
Co-Production
Leadership
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
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
Physical & cultural environments
support the delivery of person-centred
care
Aim Primary Drivers Secondary Drivers
•Reliable application of the five “Must do with Me” elements:1. What matters to you? – Personal outcome goals agreed 2.Who matters to you? – Involvement of personal support network3.What information do you need? - information is timely, full and understandable4.Personalised contact – timing & method of contact with services is flexible5.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
•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
•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:
1. People & interactions (conversations with people using & delivering service, observations of care, etc)
2. Environment of care (signage, way-finding, etc)
Person-Centred Health & Care: Care Experience
Person-centred care is everyone’s
business
•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
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
Physical & cultural environments
support the delivery of person-centred
care
Aim Primary Drivers Secondary Drivers
•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
•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:
1. People & interactions (conversations with people using & delivering service, observations of care, etc)
2. Environment of care (signage, way-finding, etc)
Person-Centred Health & Care: Care Experience
Person-centred care is everyone’s
business
•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
•Reliable application of the five “Must do with Me” elements:1. What matters to you? – finding out what’s important to people and using this info to collaboratively plan care2.Who matters to you? – making it easy & routine for people to involve their personal support network if they choose3.What information do you need? - information is timely, full and understandable & decisions are collaborative4.Personalised contact – as much as is possible timing & method of contact with services is flexible5.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
• 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!