What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

During the Covid-19 pandemic, visitors were excluded from wards unless the patient was in the final stages of life. On our ward, where patients had given consent, we called their family every day. This enabled us to provide up dates,  ask families what mattered to them and their loved one, and deliver personalised care.

This vital communication was supported by a Family Liaison Clinician (FLiC). This service was provided by a small team of staff redeployed during the height of Covid-19. The feedback from families who had received this service demonstrated its hugely positive impact.

Post intervention analysis of PALS, Complaints, What Matters To You (WMTY)  themes and staff surveys has provided robust baseline data confirming the need for continued focus on this aspect of communication.

Ensuring that there is consistent and effective communication is as vital as ever with a collaborative MDT required to embed this approach.

What does your project aim to achieve?

This project aims to improve communications between the ward and the patient’s families in order to improve care. We want to ensure that patients who are unable to liaise directly with their family have an equal opportunity to let keep their family informed – particular impact for patients disadvantaged by learning disability, communication impairment and limited access to digital devices. We know that communication with families could be improved in other areas of the Trust. We want to develop a sustainable process for achieving this improvement which can be scaled and spread throughout the Trust.

Our aim is that all patients’ next of kin will be provided with an update on care. We will measure if this improvement leads to improvement in:

a. Patient, family and carer experience

b. Reduced errors and complaints

c. Staff confidence and satisfaction in communication with patient’s families

How will the project be delivered?

The project team was formed as soon as the Family Liaison Clinician service was withdrawn with a passionate determination that effective communication be maintained and mainstreamed through this proactive approach. There is a diverse team of clinical support workers, nurses, discharge team members, end of life nurses, palliative education nurses, ward clerk, junior doctors and consultants supported by a Continuous Quality Improvement Coach.

We want to test change ideas on ward 10BN with staff who are all enthusiastic and committed to this work  before spreading the improvement Trust wide . Includes:

Ensuring families are aware of the how they will be communicated with
Allocate the phone calls to the most appropriate person in the MDT
Allocate protected time to prioritise communication with families
Offer support to patients to communicate directly with their family via supported phone and video calls
Provide bitesize communication in the areas  staff have highlighted of least confidence

How is your project going to share learning?

• An additional QI coach allocated to this specific project would provide support to the other wards in the Trust with locally owned “Crucial Conversations” projects to test the approach and adapt as necessary  for their own areas.
• The Trust has several established and emergent L&OD sharing conduits including:

Huddles, Trust rolling half days, Quarterly Patient Carer and Partnership Group Trust and patient carer stories to board. Sharing  qualitative and run chart data to win hearts and minds to embed a culture which places high value on the relationship with both the patient and their family, ENHT Trust website- internal and public facing pages, display boards in main thoroughfares

• Promotional video
• Presentation at QI conference events
• Q community and local QI partner networks
• Social media platforms