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PET is an enabler. Live feedback is incredibly valuable!

Claire Tripp Director of Nursing

Putting patient insight to work

Already ranked among the top 20 per cent of England's hospitals, Papworth Hospital NHS Foundation Trust is investing a lot of faith in the opinions of its patients. Claire Tripp, Director of Nursing, says that the patient experience programme is being developed to attain even higher levels of accuracy.

The trust's comprehensive programme of involvement and feedback has been in place for a number of years and under Tripp's direction for the last two. She believes the programme has been a success "because of the energy from the ward sisters and the patient experience panel." No matter how long the programme has been running, it is always "a sobering reference to get real, honest responses," Tripp continued.

The patient involvement programme at Papworth revolves around the use of the Patient Experience Tracker (PET) handsets. These enable the team to gain detailed patient feedback, using this insight to identify which areas need improvement and how this can be achieved.

Solution:

PET is used to ask questions in all areas of the trust. Questions are rotated every six months; they are planned well in advance and often revolve around compliance with national policy, such as the essence of care benchmarks, as well as specific local questions.

Last year, the trust wanted to look into issues surrounding privacy and dignity. Because of the age of the hospital, there are no single-sex bathrooms available, an issue that has frequently made the news. The PET questions were therefore tailored to address this issue in the context of privacy and dignity.

Four months into a series of questions, the ward sisters and Tripp discuss issues they would like to address, creating a pool of questions to work through.

"The ward sisters all use PET in different ways because they know what works best in their area," said Tripp. "PET is an enabler. It allows nurses on wards to really understand, as it happens, what is happening. If there is a problem, they can correlate it with staff absence or illness and easily track changes."

She said, "The completion goal for the PET project is now at 60 per cent. Some wards are above that rate; others are below. Our average hovers around 50 per cent, which, when considering our case load of 25,000 patient episodes a year, isn't bad."

Part of Tripp's work on the project involves continually examining ways to optimise completion of the questions. There is a handset on each ward, and one ward sister has found success by putting hers on the evening drinks trolley.

Another way the trust achieves a high rate of success with the programme is by utilising the time and skills of the Patient Experience Panel (PEP), which helps the trust learn far more about its overall performance. "PEP is the roving, non-managerial eyes and ears of the trust, and they pick up a lot of helpful comments and concerns," said Tripp. The panel decides its own sets of questions and has two handsets that panel members can use wherever and whenever they are at the trust.

Outcome:

"Live feedback is incredibly valuable," said Tripp. "We use it to focus on areas needing improvement and to identify the areas we are doing well in." For example, all the results from the privacy and dignity survey questions were over 95 per cent positive. The trust now feels confident in defending its decision to leave the bathrooms the way they are and spend resources on other matters more pressing to patients.

Teams are always eager to look at their satisfaction scores, and monthly reports are distributed to the board of directors, managerial executives, ward sisters, nurse advisory board, PEP, the Patient and Public Involvement membership committee, commissioners and the board of governors. This keeps everyone across the trust informed and involved, and also lets them see that their work and decisions are recognised and validated by the people they serve every day - the patients.

The board of governors meetings are open to the public, which means that satisfaction results get a wide airing across the local community. "PET gives rapid, real-time affirmation of [hospital staff's] hard work," Tripp said, which "is invaluable in keeping everyone motivated, focused on their goals and aware of the value their work has to patients."

Survey analysis has been done monthly, but will likely become weekly or bi-weekly. However, analysis is used weekly if a very specific problem crops up and needs immediate attention.

"Knowing that this data is there makes everyone's life a lot easier. No one stresses as much about a problem because we know we can swiftly identify it and put it right," said Tripp.

Ward nurses are already looking to the next stage of the patient engagement programme and are researching ways to use PET to drive further improvements in quality. They are currently considering care for the elderly and nutrition.

Tripp and her team are also examining performance data reports and starting to plan ways to make them easier to read, use and understand; PET may be used as part of the solution. They may also use the PEP's handsets to check potential bias to answers given on wards - where patients may feel bad about making certain judgements in front of a nurse.

"The feedback and comparison we get from PET helps us improve the use of information and the quality of clinical data across the trust," Tripp said. "This is an excellent way for us to cross-examine other areas of work, whether they are problem areas or areas of excellence. The information gives us an extra point of reference."

Tool or service

Patient Experience Tracker