A peer network for patient experience facilitators.
Meet the team: The Yorkshire Patient Experience Toolkit (Yorkshire PET)
- Patient representatives: Philip Elphick, Richard Eastoe, Fran Senior
- Academic advisors: Rebecca Lawton, Laura Sheard, Rose Peacock
- Patient Experience Team advisors: Krystina Kozlowska
The desire to use patient experience feedback to improve
Over a 3 year research study based in acute hospital Trusts, we have found that staff across the board, from clinical teams to patient experience leads, are searching for effective ways to use patient feedback to improve experience of care for patients. Different types of feedback are collected (e.g. Picker survey, Friends & Family Test, complaints, internet reviews or patient stories) but staff on the ground find this information difficult to use to inform any improvements.
Clinical teams are frustrated at this and patient experience teams are trialling better ways to streamline this information to make it easier for them.
The Yorkshire Patient Experience Toolkit (Yorkshire PET)
We (the Yorkshire Quality & Safety team in partnership with the Yorkshire & Humber AHSN Improvement Academy) received funding from National Institute for Health Research (NIHR) to work with 3 hospital Trusts to develop solutions to these challenges. We completed this project in May 2018 and we have lots of learning to share and develop further with others. We have captured our learning so far in the Yorkshire PET.
Co-designed by clinical staff, patient representatives, patient experience leads, improvement specialists and researchers, this toolkit will support clinical teams to make sense of patient experience feedback within their wards/departments, and respond to make things better for their patients.
The toolkit provides guidance and resources to help teams:
· talk to current patients (not rely on routinely collected data although this may be useful too)
· celebrate good feedback
· understand the types of responses required for different issues (broken windows need fixing but emotions needs the human touch)
· use small steps to achieve big changes
· work with patient representatives and volunteers
· ask for help (e.g. from patient experience or QI teams)
· find suitable ways to measure success
It outlines a series of steps that the research found to be important and these are indicated in a flow diagram (attached below).
More than a toolkit: a facilitators guide
We learnt that there is little point giving clinical teams the toolkit without providing them with support to work with its ideas, and we have identified a role for a facilitator in coaching them through the steps and connecting with appropriate people to help at different points. This facilitation role is challenging and requires time, energy, enthusiasm and many different skills including supporting patient representatives, handling feedback, facilitating group reflection with staff teams, and some (simple) quality improvement techniques. We are not sure who could fulfil these facilitation roles so want to pilot some ideas. We wonder if there are people within patient experience teams, QI teams, patient involvement teams, or any other roles (even matrons?) who are looking to develop capacity in this area. Possibly the role could be shared.
Our proposed pilot
We will be looking for 5 people from ANY healthcare setting across Yorkshire & Humber to join a pilot peer network for facilitators. The toolkit was developed in acute hospital settings but, we think, could be helpful in any. These people could be Qs and/or they could be Yorkshire & Humber Improvement Fellows but they do not need to be. We are really keen to use this pilot to explore WHO and WHAT ROLE-TYPES within NHS Trusts, could take on this role, and WHAT SUPPORT they would need. Many teams/individuals have an interest in supporting staff to improve patient experience either in their own clinical areas (e.g. matrons), or across the organisation (e.g. patient experience or QI teams). Others have an interest in involving and listening to patients (e.g. volunteers or patient involvement teams). This toolkit has been designed flexibly so that it could potentially suit the many and varying needs of people from any these groups. We think that it is the type of person that is more important than their discipline or their role: they need to be focused on the importance of patient/carer voice, able to forge relationships, make connections, work with patient volunteers and be willing to inspire and motivate others.
We would then provide them with training on the PET toolkit steps, and on-the-job coaching as they work with PET over a 12 month period.
We will adopt the following engagement/recruitment strategy:
- Connect into current networks run by the Improvement Academy (i.e. Improvement Fellows Scheme – we will present the toolkit approach at next networking event 10 July (http://www.improvementacademy.org/about-us/improvement-fellows.html) and the Quality Improvement Training Network for trained facilitators of QI.
- Link with other regional and national networks for Patient Experience (e.g. the Point of Foundation HOPE network)
- Snowball recruitment building on the links made with 3 Trusts in the research project that developed PET.
- Use the September edition of the Improvement Academy Newsletter (http://www.improvementacademy.org/about-us/newsletter.html) in which we have booked space for dissemination of PET. Current circulation of approximately 2000.
Impact, benefits, learning
Finding meaningful ways to assess impact of improvement work on patients is integral to the role of the PET and techniques for helping clinical teams to do so are included. In addition to supporting facilitators with this task, this project will be capturing further understanding about the crucial role of the facilitators themselves – how the PET process helps them with aspects of their own work remits, what support/skills/resources they need, and the types of people, including job roles, who could take this on. We will then share learning with the networks listed above.
Where the toolkit was developed
The teams involved in co-designing the Yorkshire PET were based in a variety of hospital departments (medical ward, surgical wards, emergency department, maternity, elderly rehabilitation). We think the toolkit could be useful in other settings too and would not need to restrict this pilot to hospitals.
How you can contribute
- a sense of the level of demand: are there 'would-be facilitators' out there?
- if so, what support are these people looking for?
- ideas for developing this network effectively
- critical friends
Flow-diagram May 2018 (DOC, 209KB)