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What is person-centred care?
?
What’s the problem?
?
Everyone aims to do a good job, but......
The subliminal message?
More, more, more.......
Faster, faster, faster......
with less.......
What’s our priority – the system or the people?
Comprehensive systematic measurement infrastructure
NHS Board
18 wks RTT HSMR 4 hour
A&E
NHS Board
NHS Board
NHS Board
NHS Board
NHS Board
NHS Board
4 hour
18 wks
HSMR 4 hour
18 wks
HSMR 4 hour
18 wks
HSMR 4 hour
18 wks
HSMR
But, where is care experience? The voice of the service user?
Current State
Staff Experience
Teamvitality
Pulse surveys
ComplaintsBi-annual
survey
SystemOutcomes
People FocusedOutcomes
PatientGroups
BetterTogether
Local surveys
4 hours 18 wks
FinanceAccessTargets
Etc
Obs ofCare
System Outcomes
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
Are we serious about improving person-centred care?
Then we need to measure the right stuff!
“Every system is perfectly designed to get the results it gets...”
Overall, we found that the service: provided very good care, which was tailored to meet the individual needs of people who used the service supported people through a committed, caring and dedicated multidisciplinary team
ensured people were being consulted about the quality of their care and the development of the service ensured people were treated with dignity and respect, and
was valued by the people who used it and everyone we spoke with spoke of the care and treatment being excellent.
“The focus of all their activity is on the patient, families and carers.”(Healthcare Improvement Scotland inspection report of Strathcarron Hospice March 2013)
Its not just about getting
the measurement culture right...
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?
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, Edinburgh physician and author
“The secret of caring for the patient, is caring for the patient”
Francis Weld Peabody 1881-1927
Aims of the collaborative?
1. To re-establish the core values and behaviours of health & care services
Its all about people…….
…….and relationships
Aims of the collaborative?
1. To re-establish the core values and behaviours of health & care services
2. To design processes of care that focus on the needs of the people, not on the needs of the system or the profession
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 care
2. Who matters to you? – making it easy & routine for people to involve their personal support network if they choose
3. What information do you need? - information is timely, full and understandable & decisions are collaborative
4. Personalised contact – as much as is possible timing & method of contact with services is flexible
5. 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
Aims of the collaborative?
1. To re-establish the core values and behaviours of health & care services
2. To design processes of care that focus on the needs of the people, not on the needs of the system or the profession
3. To measure person-centredness as systematically & comprehensively as we measure HAI or financial performance
How to Measure Person-Centredness?
Listen 3 times
1.Before (expectations)
2.During(POC experience)
3.After (objective reflection)
In Real-time
Listen in different ways
• Survey• Story• Unsolicited feedback• Advisory councils• Obs of care•People with first-handexperience
Multi-method
Multi-trait
Systematically & Comprehensively
By 2015All health and
careservices are
centred around people
Aim Primary Drivers Secondary Drivers
Improved Care Experience
Improved Staff Experience
Co-Production
Co-designing with NHS, Local Authority and 3rd
Sector
Lea
de
rsh
ip
By 2015All health and
careservices are
centred around people
Aim Primary Drivers Secondary Drivers
LeadershipCare Experience Staff Experience
Coproduction
Co-designing with NHS, Local Authority and 3rd
Sector
Next learning Session...
• May 30th-31st SECC, Glasgow• Registration now open at www.eventage.co.uk
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