Meeting Patients Needs
As part of the Compassion in Practice Strategy (2012) Action Area Two has been working with the Institute for Healthcare Improvement (IHI) and Picker (Europe) to look at how the NHS organisations in England can develop consistent ways to meet the individual needs of patients to ensure that care is patient centred and delivered in partnership with them and those close to them.
Always Events®, initially conceived in the United States by the Picker Institute and now led by the Institute for Healthcare Improvement (IHI), laid the foundation for the development of IHI’s trademarked Always Events framework. This framework provides a strategy to help health care providers identify, develop, and achieve reliability in person- and family-centred care delivery processes.
More information on the IHI work around always events and developing patient and family centred care can be found: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=146
An Always Event is a clear, action-oriented, and pervasive practice or set of behaviours that:
- Provides a foundation for partnering with patients and their families;
- Ensures optimal patient experience and improved outcomes; and
- Serves as a unifying force for all that demonstrates an ongoing commitment to person- and family-centred care.
Always Events are aspects of the patient experience that are so important to patients and family members that health care providers must aim to perform them consistently for every individual, every time.
These can only be developed with the patient firmly being a partner in the development of the event, and the co-production is key to ensuring organisations meet the patients’ needs and what matters to them.
An Always Event must meet four criteria:
- Important: Patients and family members have identified the event as fundamental to improving their experience of care, and they predict that the event will have a meaningful impact when successfully implemented.
- Evidence-based: The event is known to contribute to the optimal care of and respect for patients and family members (either through research or quality improvement measurement over time).
- Measurable: The event is specific enough that it is possible to determine whether or not the process or behaviours occur reliably. This requirement is necessary to ensure that Always Events are not merely aspirational, but also quantifiable.
- Affordable and Sustainable: The event should be achievable and sustainable without substantial renovations, capital expenditures, or the purchase of new equipment or technology. This specification encourages organizations to focus on leveraging opportunities to improve the care experience through improvements in relationship-based care and in care processes.
NHS England, IHI and Picker (Europe) have been working with provider organisations within England to test out the Always Events methodology and will soon be enrolling other organisations for phase two of the project that will test out a toolkit on how to develop Always Events within the NHS.
Great work has been done and this has happened as staff members have engaged with patients and carers as partners, not just a token patient in the room, but when developing their always event, the pioneer Trusts have had 50% staff and 50% patients/carers in the room to work this through. This has led to so great ideas that have ensured care is focused on what matters to the patient.
- We will always support you in your transitions of care
- We will always support you in moving on in care
Asking the service users
These always events were developed by asking the service users who accessed the community learning disability team, what was good, what was bad, what needed improving and how could they improve. Some great ideas came from the co-production workshop including the use of photographs on letters so service users could actually see who was sending the letter or who was going to be providing their care next.
Blackpool Teaching Hospitals NHS Foundation Trust are working with patients who have accessed stroke treatment to develop and always event to ensure their discharge is safe and in the words of their patients “I always know what to when I get home or, if not, I know who to contact.”
As we move forward with his exciting programme NHS England, IHI and Picker (Europe) will be developing and testing an Always Event toolkit on how the NHS should co-produce always events; this will be tested over and over again and will be published in 2016.
For me the development of always events truly is the development of partnership care, changing the culture of organisations to enhance the care they deliver to their patients ensure what matters to them is the priority within the relevant systems and process of care delivery.
This week’s blog was by @pauljebb1 (Paul Jebb), Experience of Care Professional Lead, Patient Experience Team, NHS England