PFCC toolkit glossary

This glossary explains some of the technical terms in the PFCC toolkit.

Administrative champion

Within PFCC, the administrative champion is someone at board level, who can champion the initiative across the organisation. They chair the guiding council, and promote PFCC to the board.

Balancing measures

Within a measurement dashboard, balancing measures reflect what is going on in the wider system – particularly unintended consequences of an intervention. For example, when attempting to reduce the length of stay, a balancing measure might be whether emergency admissions increase.

Care experience

In PFCC, the focus of the work is a ‘care experience’: care viewed from the patient’s perspective rather than that of the organisation. It may cross different wards or departments.

Clinical champion

A senior clinical member of staff who will be part of the guiding council and will promote PFCC to clinical colleagues.

Driver diagram

A structured logic chart used to identify the ‘drivers’ or the main influences on patients’ experiences.

Experience-based co-design (EBCD)

An approach that enables staff and patients (or other service users) to co-design services and/or care pathways, together in partnership, usually using filmed patient stories.

Guiding council

The key group responsible for initiating PFCC and maintaining senior oversight of the work. It will establish the working groups and support them and the project teams. Members of the guiding council include the administrative champion, a clinical champion, a PFCC co-ordinator, and a scribe.

Institute for Healthcare Improvement (IHI)

The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organisation based in Cambridge, Massachusetts. It is a leading health and health care improvement agency.

Improvement teams

Small teams of staff appointed by the care experience working group, to take forward specific improvement projects within PFCC. They are time-limited.

Key contact

A general manager to organise the care experience working group, bring them together, and ensure that action notes, plans and reports are completed.

Model for improvement

A well-established approach to improvement developed by the Associates in Process Improvement. It consists of three questions: what are we trying to accomplish? how will we know change is an improvement? and what changes can we make that will result in improvement? This incorporates Plan, Do, Study, Act (PDSA) cycles.

Outcome measures

Within the PFCC measurement dashboard, outcome measures will capture the extent to which the ultimate aim is being achieved. How is the system performing? What is the result? (Was the patient’s experience better?)

Patient-centred care

This is care delivered with reference to those elements that are critical to patients’ experience. The Department of Health definition includes: respect for patient-centred values, preferences, and expressed needs; co-ordination and integration of care across the health and social care system; information, communication, and education; emotional support; welcoming the involvement of family and friends; attention to transition and continuity; and access to care.

Plan, Do, Study, Act (PDSA)

Rapid improvement cycles that form part of the Model for improvement. The steps in a PDSA cycle are Plan, Do, Study, Act.

PFCC co-ordinator

An administrative member of staff who is on the guiding council, the PFCC co-ordinator is responsible for managing the shadowing process, booking meetings, maintaining details of all the change projects, and overseeing communication between all group members. Role may be combined with that of the scribe.

Process map

A visual representation of what happens to the patient at each stage of their care experience. Process mapping allows us to ‘see’ and understand the patient’s experience by separating the management of a specific condition or treatment into a series of consecutive events or steps (activities, interventions, or staff interactions, for example).

Process measures

Within a PFCC measurement dashboard, there are likely to be both outcome measures and process measures. Outcome measures will indicate whether the ultimate goal is achieved, while process measures will indicate the extent to which steps in the system are performing as planned. They also gauge whether the care was better – for example, compliance with a care bundle or checklist that indicates good care.

Relational care

Often described as the ‘how’ as opposed to the ‘what’ of health care. It concerns relationships and interactions between staff and patients, including how nurses and doctors communicate with the patient and being treated with dignity and respect. Research shows that some patients view relational care as more important than transactional aspects of care.

Run charts

A graph that displays observed data in a time sequence and enables assessments to be made of trends over time.

Scribe

An administrative member of staff who is a member of the PFCC guiding council and who keeps action notes of meetings. The role may be combined with that of the PFCC co-ordinator.

Shadowing

The most important part of the PFCC methodology, shadowing requires staff to accompany patients throughout their care experience to gain an experience of what it is like for them, and the meaning of the experience for patients.

Snorkelling

A group activity that enables a wide variety of health care staff to think creatively and develop their own ideas for changes that will improve patients’ care experiences. The origin of the idea came from the Deep Dive approach within the design industry.

The Deep DiveTM

An approach to generating innovative ideas from the design company IDEO. This approach was the basis for the less intensive ‘snorkelling’ approach to generate ideas for improvement. It is an informal, non-hierarchical approach which generates a large volume of ideas, then evaluates and hones them down to arrive at a preferred option.

Touchpoints

A term widely used in experience based co-design to identify moments in a care experience which have a particular emotional impact on patients.

Transactional care

Sometimes called ‘functional’ care, it is the process of care, of what happens (rather the manner in which it happens).

Transforming care at the bedside (TCAB)

Improvement initiative originating in the United States, and now applied in Wales, which aims to transform patients’ experience of care, predominantly relying on frontline nursing staff to bring about change.

Ward or clinic champion

A clinical member of staff who is part of the working group and who champions PFCC with frontline staff in the setting where it is being applied. It is often a matron, clinical nurse specialist or ward sister.

Working group/care experience working group

A sub-group within PFCC that develops from the guiding council to include a wider variety of staff – typically, clinical leaders, leaders from particular wards or departments where improvements are taking place, a manager to act as a key contact to oversee the work of the group, a scribe, and team members from across the care experience.

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