On the Point of Care programme we have been working with NHS staff and others to identify interventions that could help to address this inconsistency and bridge the gap between knowledge and practice. We have been testing aspects of a methodology called patient and family-centred care (PFCC) – devised by Dr Tony DiGioia from the University of Pittsburgh Medical Center. It is a low-tech approach to improving services, based on the fundamental premise that care givers need to see care through patients' eyes if they are going to improve the patients' experience. As Tony reminded us at a recent event on patient experience, 'no industry has ever survived without considering the needs of its end users'.
It seems so obvious to look at care through the patients' eyes – surely as caregivers we know about our patients' needs and our own services? But as the PFCC method shows, sometimes we see only our part of the bigger picture, and often, it is only the patient or their family that can see the whole situation. The PFCC method involves caregivers shadowing patients so they can truly experience care through the patients' eyes. With this knowledge it is possible to design better health care experiences for patients.
Last week, we heard from Tony at a workshop that brought together leaders in the patient experience field with NHS staff who have been working to improve patients' experiences across a range of care pathways. A number of NHS doctors, nurses and managers at this event told us that shadowing had enabled them to look at care in a different way. How long must a night shift seem to a patient waiting anxiously, without sleep, for the next phase of her clinical assessment; the same shift that flies by for a nurse, who is run off her feet? How baffling must it be for a patient, who is moved from one waiting room to another for no apparent reason with no explanation? What feels like a sense of progress through the system for hospital staff may feel pointless or confusing for a patient.
In Pittsburgh, where PFCC has been in use for more than five years, it has helped to identify examples of duplication and waste – often the greatest frustration for staff. As a result, significant changes in clinical practice and care processes have improved patients' experiences and reduced delays and lengths of stay in hospital.
For the NHS staff at the workshop, the message was clear: simple approaches can achieve rapid and meaningful change for patients. They agreed that patients and frontline staff are the place to begin making improvements. The progress made by their Pittsburgh colleagues galvanised their efforts to make the small changes in care that can make a big difference to patients, challenging the often expressed notion that the system is too hard for frontline staff to change.
Find out more about the Patient and Family-centred Care programme