Historically, patients and care providers have been coming at the experience from two very different directions. Hiro Tanaka, Consultant Orthopaedic Surgeon at Aneurin Bevan Local Health Board, illustrated this point with a moving story about his mother, who was admitted to Hiro’s own hospital. Hiro described how proud he was that she had received the best possible care – and how shocked he was to later hear her describe her stay as ‘the worst two days of my life.’ Through this powerful experience, Hiro discovered that even between two people who are very close, empathy is not necessarily innate. His experience focused on hospital processes; hers focused on her state of mind – extreme anxiety and uncertainty about what was happening to her.
So we need to gather information about the patient experience, and we need to act on it. In an NHS for which this is starting to move into mainstream thinking, the prospect of creating the necessary cultural shift can be overwhelming. But it is possible, and who better to demonstrate this than Julie Hendry, Director of Quality and Patient Experience at Mid-Staffordshire NHS Foundation Trust? At a hospital where public trust had been eroded, Julie and her colleagues used a range of methods to encourage people to feel ownership of their trust. To help the board remain focused on what is best for ‘real’ patients, every board meeting opens with a patient speaking about their experience of care. To ensure transparency, meetings are open to the public and the press. Whatever action the trust takes, it checks back with patients to ensure that they feel listened to.
Julie also spoke of the power of the ‘small things’ to transform experiences, and this was a common theme. For example, one patient described the lack of dignity afforded by having to wear a backless gown. Most of all, patients talk about the desire to be listened to and treated with courtesy and compassion. These lessons are emerging from a number of structured methods of engaging patients and using their experiences, including observation, shadowing and experience-based co-design (EBCD). See the revised EBCD toolkit, also launched last week, for a step-by-step guide to the approach.
Many speakers had also found that what benefits patients also benefits staff. Where staff morale is low, patients suffer too, and vice versa. But the very act of listening can make a difference. Many teams talked about how shifting the focus to the experience of the patient had helped staff reconnect with the reasons they started working in health care in the first place. And a growing number of trusts are using values-based interviewing to ensure that they are recruiting people who share the organisation’s views about what matters most.
It was clear that all the teams and individuals speaking at the conference had had to persevere. Turning around a culture of care cannot be achieved through a quick fix. It takes courage, because you can’t start to improve things without first admitting that you could have been doing things better, and without relinquishing a little control. But those who have done it are finding that it pays dividends.