What is the challenge your project is going to address and how does it connect to your chosen theme?

Local QI work has demonstrated areas of excellent communication between patients and health care professional about patient preferences in the event of the need for urgent treatment, where the likelihood of improvement is uncertain or low. In these cases agreements about patient’s wishes in relation to realistic treatment options are clear and well documented . However, our QI work has also identified that this is not consistent and there is a need to improve the quality of these conversations and increase confidence in healthcare professionals when they are involved in shared decision-making with patients and families.

We are in the process of implementing ReSPECT (Record Summary Plan of Emergency Care Treatment) in our local health community.  Whilst there are training materials (eLearning, videos) which have been produced by national teams, there is little available which involves both patients and staff to improve the quality of conversations and confidence and experience.

What does your project aim to achieve?

By focusing on the experience of the conversations patients and families have with healthcare professionals about preferences for emergency treatment, we will identify where the strengths are and areas for improvement. The aim is to surface change ideas from both staff and patients by using focus groups and then hold co-design events to expand on identified themes from which we can capture ideas for change. We would then use QI methodology to test the ideas and measure impact with patients and clinical teams. Depending on the interventions chosen, we would want to create materials and approaches for training of healthcare teams to improve patient experience of conversations about future emergency care. We would see an improvement in the quality of these conversations with personalised patient preferences being captured.

We would also be keen to explore what information is helpful to make available to the public to create “readiness” and a better experience for these conversations.

How will the project be delivered?

We will be using both Model for Improvement and Experience Based Co-design as a guiding methodology to gather experience of these conversations for patients and for staff. The aim is to host co-design events where touch points are discussed and then plan co-design activities and test ideas. Through these events it will become clearer where we will focus our improvement interventions. We will involve our Patient Leaders in the local area and our Patient Experience team to support selection of staff and patients to participate. We have met with a local Patient Leader who has agreed to put us in touch with the West of England Patient Change Makers with whom we will hold our first focus groups. We have support from colleagues in the West of England Academic Health and Science Network to arrange co-design events and will use their experience to help us.  The WEAHSN is leading the regional project for our healthcare communities to move to using the ReSPECT process.

What and how is your project going to share learning throughout?

We plan to share through our Twitter channels, through our local AHSN and through the Patient Experience Q Community SIG. We also have a CCG working group who will be able to support sharing of our work. I am learning (slowly) how to sketch note so will try to update progress using sketches! We will also use networks such as the Bristol Death Cafe and other community groups such as Bristol Older People’s Forum.