What is person-centred care?. ?. ?. HOSPITAL. Smiles everyone!. Whats the problem?. ?. Everyone aims to do a good job, but. The subliminal message? More, more, more....... Faster, faster, faster...... with less. Whats our priority the system or the people?. - PowerPoint PPT Presentation
What is person-centred care??
Smiles everyone!HOSPITAL?Whats the problem??Everyone aims to do a good job, but......The subliminal message?
More, more, more.......
Faster, faster, faster......
Whats our priority the system or the people?Comprehensive systematic measurement infrastructureNHS Board18 wks RTTHSMR4 hour A&ENHS BoardNHS BoardNHS BoardNHS BoardNHS BoardNHS Board4 hour 18 wks HSMR4 hour 18 wks HSMR4 hour 18 wks HSMR4 hour 18 wks HSMRBut, where is care experience? The voice of the service user?Current StateStaff ExperienceTeamvitalityPulse surveysComplaintsBi-annualsurveySystemOutcomesPeople FocusedOutcomesPatientGroupsBetterTogetherLocal surveys4 hours18 wksFinanceAccessTargetsEtc Too much focus on the system outcomesActivity tends to be a bit siloeda lot of its about assurance and performancesome is about improvement, but we need more measurement for improvement and more triangulation between related areas of activity.In our current culture what we are led to believe is measurement for improvement actually turns into measurement for assurance! Why are we still measuring reliable processes on a weekly or monthly basis 4 yrs down the line?Measurement for improvement is exactly what it says for improvement not for-ever! Once an improvement has been made and the process is reliable then frequency can be reduced to quarterly or 6 monthly and efforts focused on the next area for improvement.
7Obs ofCareSystem OutcomesStaff ExperienceReal-timeFeedbackTeamvitalityPulse surveysSystemMeasuresPersonalgoalsStaff wellbeingCare ExperienceReal-time feedbackLovedOnesComp-limentsMust doWith MeMeasurement for ImprovementValues basedReflect.Nothing aboutmeSystemMeasuresSystemOutcomesSystemoutcomesSystemoutcomeSystemoutcomesFuture StateFuture state. A more balanced joined up approach underpinned by measurement for improvement with care experience right up the middleMore focus on people and pathways and what adds value in their eyesMore real-time measurement generated and owned by teamsMore effective triangulation of data collect once use many times8Are 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...
In some cases this means we need to put new structures in place. Where is your comprehensive, system-wide, real-time listening? As far as PCC goes, If we dont listen we cant improve.10
The first indicator of something going wrong at Mid Staffs was the voice of pts & families and the voice of staff. But they werent heard or they were ignored. Voice of the customer is THE best early warning system of harm that we can have do our listening system in place?11Overall, 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 CsCaring & Compassionate staff & servicesClear Communication & explanationEffective Collaboration between clinicians, patients & othersClean and safe care environmentClinical excellenceWhat 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?To re-establish the core values and behaviours of health & care servicesIts all about people.
Carol19Aims of the collaborative?To re-establish the core values and behaviours of health & care servicesTo design processes of care that focus on the needs of the people, not on the needs of the system or the professionBy December 2015 people using services will have a positive experience and get the outcomes they expectServices are delivered in active, collaborative partnership with peopleTechnical care is delivered reliably and based on person-centred principlesPhysical & cultural environments support the delivery of person-centred careAimPrimary DriversSecondary DriversTechnical 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 checklistWalk-rounds & Observations focus on:People & interactions (conversations with people using & delivering service, observations of care, etc)Environment of care (signage, way-finding, etc)
Person-Centred Health & Care: Care ExperiencePerson-centred care is everyones businessDistributed, values based leadership culture from the point of service delivery through to support staff, middle management and senior executivesValues & behaviours form basis of recruitment , development & management of staffReliable use of recognised tools to promote optimal team functioningPerson-centred values & behaviours are evident in words & actions at all levels of leadershipSee also Leadership change package for key interventions & structuresReliable application of the five Must do with Me elements: What matters to you? finding out whats important to people and using this info to collaboratively plan careWho matters to you? making it easy & routine for people to involve their personal support network if they chooseWhat information do you need? - information is timely, full and understandable & decisions are collaborativePersonalised contact as much as is possible timing & method of contact with services is flexibleNothing 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
We believe form the evidence available that these 5 Must do With Me elements are the nodal points in the system where we have opportunity to create real value for the people who use our services, whilst at the same time enhancing system outcomes such as safety and efficiency
21Aims of the collaborative?To re-establish the core values and behaviours of health & care servicesTo design processes of care that focus on the needs of the people, not on the needs of the system or the professionTo measure person-centredness as systematically & comprehensively as we measure HAI or financial performanceHow to Measure Person-Centredness?
Listen 3 times 1.Before (expectations) 2.During(POC experience) 3.After (objective reflection)In Real-timeListen in different waysSurveyStoryUnsolicited feedbackAdvisory councilsObs of carePeople with first-handexperienceMulti-method
Multi-traitSystematically & Comprehensively25
Sir Winston Churchill 1874-1965 By 2015All health and careservices are centred around peopleAim Primary Drivers Secondary DriversImproved Care ExperienceImproved Staff ExperienceCo-Production
Co-designing with NHS, Local Authority and 3rd SectorLeadershipThe separation into work streams is artificial. All inextricably linked, but this helps us to identify and understand what to do and helps us to get started. Senior leadership crucial to set drive the culture and create the structures that will enable PCC to flourish. By 2015All health and careservices are centred around peopleAim Primary Drivers Secondary DriversLeadershipCare Experience Staff ExperienceCoproductionCo-designing with NHS, Local Authority and 3rd SectorAll of these things combined will help us to work towards our aim.
Next learning Session...May 30th-31st SECC, GlasgowRegistration now open at www.eventage.co.uk