Look Closer See Me Dignity in Care Denise

“Look Closer See Me” Dignity in Care Denise Llewellyn Executive Director of Nursing Aneurin Bevan Health Board

Background… Growing concern reported about care provided to (older and vulnerable) people in NHS settings: - • Patients Association & Community Health Council • NHS Complaints Ombudsman in England • Care Quality Commission/Health Inspectorate Wales • Comments from the nursing profession – RCN/NMC • Increasing media, public and political concern and comment • Awaiting Francis review

What the Commissioner said… Fundamental change is needed. Patients need to know what quality care is, and staff need to be supported by systems and resources to empower them to meet patient’s expectations. Poor practice should not be tolerated. The attitudes, behaviour and emotional intelligence of staff on the wards are crucial. We need strong, positive leadership at all levels and a system which builds in dignity and respect as the cornerstone of high quality care’’

Dignity in Care in ABHB • • High on the agenda Board commitment Staff commitment Seeing results, feeling results with evidence of improvement • ABHB Patient Experience Framework (2011)

Key Areas being addressed • • • Leadership Culture Safe Dignified Care Workforce Listening to the Patients Voice

The ‘Fundamentals of Care’ (2003) ( FOC) is a Welsh Assembly Government initiative which aims to improve the quality of aspects of health and social care for adults. The standards are monitored annually by the Welsh Assembly Government, with quarterly internal reports on progress to the Nurse Director. The Fo. C initiative grew out of concerns regarding the following: • • • Inconsistency in standards across services and areas Common themes in complaints and compliments Increasing expectation of the service user Lack of clarity for service users Increasing focus on regulation and performance Ward Sister empowerment and ownership

The table below shows % compliance with the 12 Fundamentals of Care Standards from 2009 2011 Operational Score % compliance User Experience % score Standard 2009 2011 1 Communication & Information 75 85 93 96 2&5 Respecting People & Relationship 70 80 88 94 3 Ensuring Safety 88 90 93 95 4 Promoting independence 83 82 91 94 6 Sleep, rest and activity 78 83 87 91 7 Ensuring comfort, alleviating pain 79 83 94 96 8 Personal Hygiene and appearance 70 76 91 95 9 Eating & Drinking 83 89 90 94 10 Oral Health and hygiene 62 70 74 87 11 Toilet needs 87 93 93 95 12 Preventing pressure ulcers 82 87 82 91 78 83 89 94 Overall Average Score

“Transforming Care” (NLIAH 2009) is the vehicle to improving the patients’ experience of care To increase the time nurses spend in direct care to 70% (average is 35%!) To increase patient satisfaction to at least 95%. To increase staff satisfaction to at least 95%. To reduce adverse events by 50% AN AMBITIOUS CHALLENGE!

“Transforming Care” Dignity Outcomes Knowing How We Are Doing is critical…. . • St Woolos Hospital in Newport – 10 months without a Hospital Acquired Pressure Ulcer • County Hospital in Torfaen – 3 months without a Hospital Acquired Pressure Ulcer • Direct Patient Care Time has increased from 48% to 56% in Ebbw Ward, YAB • Ward B 3, RGH have had 365 days without a Medication mis-administration Incident • Ward C 4 West, RGH have had 235 days without a case of MRSA • Ward 4/1, NHH have had 71 days without a V&A Incident

WAY FORWARD • Patient Stories • Patient & Family Centred Care Programme (Kings Fund & IHI) • Patient experience Improvement Work (Kafka Brigade UK)

“Look Closer See Me”