Friends and Family Test (FFT) – a journey

Theresa Hegarty, Head of Patient Experience, Royal United Hospital, Bath, NHS Trust

Contents

Personal aspects Process used Changes made

Patient feedback matters / context

Tidal wave of reports and public interest in patient experience; Francis; Keogh; Berwick

“The patient voice should be heard and heeded at all times … even when that voice is a whisper” Don Berwick

Since 2008 RUH has led the way with real-time patient feedback: PET and Meridian – increasing use of Meridian alongside FFT

On-going Patient Feedback: FFT; Meridian; PALS; complaints; patient stories; See it my way

Personal reaction to FFT

Patient experience needs a simple focus How do we provide this? Huge task / huge effort This is about a shift in culture Patient experience is on the map

RUH monthly process

Cards used and Internet surveys Data inputted onto Meridian system Two staff: Band 1 and Band 3 employed Reports on Staff; Food and Environment sent to key leads Sister, Matron, FFT Lead, Ward Clerk on each ward/area are

sent for their area only: all patient comments; FFT score; You said We did; report sheet; FFT whole trust report for the month

Monthly summary of comments sent to Divisional Managers; Clinical Leads; Specialty Managers; Executive Team members

Dashboard access to results

FFT – Quarterly results Response rates: Q1 = 23%; Q2 = 27%; Q3 = 23% of

eligible patients FFT scores: Q1 = +70; Q2 = +66; Q3 = +76 In October 2013, RUH ED/MAU/SAU scored the third

highest of all Trusts in England:

WEST MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST 356 2,102 16.9%93

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 219 5,919 3.7%83

ROYAL UNITED HOSPITAL BATH NHS TRUST 495 3,326 14.9%82

NORTHERN LINCOLNSHIRE AND GOOLE HOSPITALS NHS FOUNDATION TRUST 33 5,382 0.6%82

THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST 868 5,172 16.8%80

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 585 4,077 14.3%80

ST HELENS AND KNOWSLEY HOSPITALS NHS TRUST 441 4,008 11.0%79

MOORFIELDS EYE HOSPITAL NHS FOUNDATION TRUST 1,345 7,018 19.2%79

YEOVIL DISTRICT HOSPITAL NHS FOUNDATION TRUST 166 1,815 9.1%78

UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST 637 6,707 9.5%77

FFT results benchmarked

Patient comments

“Brilliant care from the most amazing staff”

“The smoking at the main entrance must be addressed for patients and nurses especially given that it is right next to the breast care cancer unit”

“Staff absolutely first class especially ‘X’. I would also like to mention ‘X’ in recovery. I was there for 7 ½ hours and he couldn’t have done more for me”“Staff were extremely

professional and treated me with dignity and respect. I felt completely safe and well cared for”

“Care can’t get better. Food adequate and hot. Heat unacceptable for staff – they struggled to work in it”

“Excellent care and attitude – these workers are worth their weight in gold. However the food is abysmal and needs revamping”

“Dr X and team have been brilliant! This time the nurses have been great cleaning bed and on top of drugs. Last time was laid in very dirty bed for days and nurses were not helpful or caring”

“Staff were very caring at all times”

Patient comments

We have been asking patients for their feedback on the RUH as part of the ‘Friends and Family Test’. Here is an example of the feedback, and how we’ve used it to make improvements.

You said We did

“Felt a bit lonely at times” We have art supplies and books on the ward. We have links to befrienders, Pat a Pet and music therapy, please talk with us if you feel lonely

“More shelves in bathroom” We have added extra shelves in the bathroom

Strategic changes made

£168,000 extra investment in patient meals Lost property policy; signs reminding

patients/families to look after property; new practices

Quiet closing bins

Next steps

Focus on supporting practice change using QI methodology

Implement FFT in Maternity (new contract) and Outpatients

Pathway Project and partnership working