courage to listen and to implement patient feedback pamela taylor ward manager ward am3
TRANSCRIPT
Courage To Listen And To Implement Patient Feedback
Pamela TaylorWard Manager
Ward AM3
About The Ward
23 bedded female gastroenterology ward
Array of medical conditions affecting GI tract
Complex dependencies to drugs and alcohol
Quality Dashboard Data
Question Text Apr-11 May-11 Jun-11 Jul-11
Has the patients pain score been documented on the TPR chart along with routine observations since admission?
100.0% 100.0% 100.0% 100.0%
If pain score >4, is a pain care plan in place documenting ongoing management and evaluation of pain? 50.0% 66.7% 66.7% 66.7%
For patients with a pain score >4 has appropriate action been taken for each episode? 100.0% 100.0% 100.0% 100.0%Was the effectiveness of the intervention reviewed for each episode of pain score>4? 33.3% 33.3% 0.0% 100.0%If pain scores >4 on more than two occasions in the last 24 hour period is regular analgesia, other than paracetamol, prescribed?
100.0% 100.0% 100.0% 100.0%
Are you satisfied with how your pain has been managed? 33.3% 33.3% 66.7% 33.3%
Did you wait longer than 15 minutes for the last dose of pain relief you asked for (excludes drug round) 100.0% 100.0% 0.0% 66.7%
Is an appropriate pain assessment tool being used? 100.0% 100.0% 100.0% 100.0%
How would you assess the pain score of a patient who was unable/difficulties communicating verbally? 100.0% 100.0% 100.0% 100.0%
Presenting the
Quality of Care For
AM3 Part of the
PatientExperienceMetrics
Delivering the Best Patient Experience in the NHSCentral Manchester University Hospitals NHS Foundation Trust.
Brown - Safeguarding IncidentsGreen - PALS Compliments, Blue - PALS Complaints and Red - Complaints
QualityCampaign.co.uk Reported Distributed on 16/01/2011 December 2011
Black - MRSAGreen - Median Length of Stay Purple - CDIFF
Providing Good Nutrition
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Ensuring Patient Safety
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Ensuring Patient Satisfaction
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Achieving Good Communication
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Ensuring Pain is Managed
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Respecting Privacy & Dignity
40%
50%
60%
70%
80%
90%
100%1
2/1
0
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Achieving a Clean Environment
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Ensuring Infections are Controlled
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
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Involving Patients & Carers
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Monitoring Medication Errors
0
5
10
15
20
25
30
35
40
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Total Reported Incidents
0
10
20
30
40
50
60
70
80
90
100
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Monitoring Patient Falls
0
5
10
15
20
25
30
35
40
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
KEY: Scored by… Blue - Patients via Tracker Turquoise - Ward Managers via MWR/QCR (New QCR started April 2011)
Monitoring Pressure Sores
0
2
4
6
8
10
12
14
16
18
20
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Average Length of Stay
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Reducing Complaints
0
2
4
6
8
10
12
14
16
18
20
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Monitoring Infection Rates
0
2
4
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Safeguarding Patients
0
2
4
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Overall Quality
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
KEY: By Severity…Teal - Low/Grade 1 Green - Minor/Grade 2 Yellow - Moderate/Grade 3 Orange - Major/Grade 4 Red - Catastrophic (L5)
Meeting Equality & Diversity Needs
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
Meeting Personal Hygiene & Care Needs
40%
50%
60%
70%
80%
90%
100%
12
/10
01
/11
02
/11
03
/11
04
/11
05
/11
06
/11
07
/11
08
/11
09
/11
10
/11
11
/11
12
/11
85% Lower Threshold - 95% Upper Threshold
*Grades refer to Pressure Sores only
Effective Pain Management?
Main issues in Quality Care Round were: • Use of pain care plans,
• Evaluating effectiveness,
• Patient satisfaction,
• Waiting longer than 15 mins
Total Pain Management score was below 80% between March-June 2011
Effective Pain Management?
Main issues in patient feedback on tracker device:
Did staff give medicine quick enough?
Did medicine work?
Results as low as 60% in some months
Patient Focus Group
Invited inpatients over previous week and on day of event
Established ground rules
Ensuring everyone had a voice
What Patient Told Us
It sometimes takes ages for me to get my pain
killers after I’ve asked for them
The staff work really hard
Staff don’t ask me if my pain killers have worked, or how my pain is after they have given me my
tablets
Sometimes when I ask for pain killers, I might be told I have to wait because the nurse is
busy with a sick patient or is on her break
The ward is very busy
Staff Involvement
• Greater Job Satisfaction
• Increased Productivity
• Improved Patient Safety
• Improved Customer Focus
• A flexible approach to meeting new challenges
Awareness Raising Sessions
A number of events were held so the majority of staff could attend with the purpose of:
Helping staff to understand the problem
Ensuring staff to take ownership of the problem
Agreeing A Way Forward
All analgesia will be given with 15 minutes of being requested by the patient (if prescribed)
Patients will have their pain and effectiveness of analgesia assessed during each shift or after any intervention
Staff will demonstrate continuous positive regard for their patients
Self administration of analgesia
Impact For Me As Ward Manager
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11
PET
QCR
The Next Steps
• Thinking Differently
• Foundation of Nursing Studies
• The benefits for our Patients
Thank You
Pamela TaylorWard Manager
Ward AM3