Engaging Patients as Partners in Care

Aim

By July 2019 there will be a reduction of 25% in the number of complaints relating to communication and treatment within the medical ward of South East Regional Hospital (SERH).

Benefits

• Patients and families are empowered to drive care outcomes
• Reduced risk to patient safety
• Care is patient-centric and recognises the role of carers and families
• Improved results in experience based surveys of staff and patients
• Improved communication across healthcare teams
• Better collaboration in preparing for discharge

Background

The executive leadership team at SERH identified that the patients’ experience of care impacted their clinical outcomes. This was evidenced by three sentinel events and nine clinical reviews relating to communication and treatment. These occurred within the medical ward of SERH.

Feedback received from patients, families and carers indicated that communication, treatment and access (timely care) did not meet their expectations. Data (patient surveys) showed that patients were not actively involved in care planning.  This resulted in 89 complaints directly related to communication, treatment, and access (timely care) between March 2016 and March 2018. The analysis of these complaints relating to communication, treatment, and access (timely care) was consistent with the previous data collected.

Your Say staff survey results for the same period (March 2016 to March 2018) highlighted poor staff culture and a disconnected team that lacked leadership and refined work processes. This led to impaired performance and a loss of organisational reputation.

Implementation

The project team will be implementing two solutions.

1. The use of patient communication boards by staff and patients, families and carers to encourage communication and shared partnership in care
2. Interdisciplinary team rounding at the bedside, where the patients, families and carers are key partners in the process.  These routine ward processes were previously identified as being poorly executed and communications rarely included patients and families.

Both solutions will be co-designed and implemented with patients, families, carers, and staff. This includes co-designing key principles, establishing ways of working, education, and execution.

The project team collaborated with other ward project initiatives (including PwC’s PERFORM program) that were seen to have a common purpose. As a result the executive sponsor and project team re-evaluated the efficacy of the solutions and adjusted the implementation process and timetable accordingly.

Implementation has been adjusted to complement the PERFORM program. The patient communication board implementation will commence in February 2019, and completed and evaluated by April 2019.  The interdisciplinary team rounding implementation will commence in March 2019, and will be completed and evaluated by June 2019.

Status

Implementation – The project is ready for implementation or is currently being implemented, piloted or tested.

Dates

Project Timeframe: February 2018 to June 2019.

Implementation sites

Medical ward of South East Regional Hospital.

Partnerships

Centre for Healthcare Redesign

Evaluation

The evaluation of both solutions will run from 5 April 2019 through to 24 June 2019.

Lessons learnt

• The competing priorities of the medical ward staff with other projects happening within the ward, contributed to the reluctance of staff to engage.
• The introduction of PERFORM during the diagnostic phase has meant that the solutions and implementation plan needed to be adjusted.
• The varied work schedules of the project team, without dedicated project time, caused unavoidable delay throughout the process. Having ongoing support for the project is imperative, never stop talking about it.

Further reading

• Braithwaite J, Herkes J, Ludlow K, et al. Association between organisational and workplace cultures, and patient outcomes: systematic review. BMJ Open. 2017:7(10);1-11.
• NSW Health. Multidisciplinary Ward Rounds. A Resource, Sydney: NSW Health; 2011.
• Sehgal NL, Green A, Vldyarthi AR, et al. Whiteboards as a communication tool in the hospital setting: A survey of practices and recommendations. Journal of hospital medicine. 2010:5(4);234-239.
• Walton V, Hogden AaGD. Ward rounds, participants, roles and perceptions: literature review. International Journal of Health Care Quality Assurance. 2016:29(4);364-379.

Contacts