Patient centred care
things that we haven’t even considered important, for example decaffeinated coffee on the wards. They may highlight things that we are unaware of - we often think something is happening but maybe it isn’t, such as some patients not being referred on for certain services. Equally, they may tell us that the pathway is great and that provides authentic assurance and can be a real morale boost for the staff. Patients have a wealth of experience, and this approach is all about making sure we’re recognising that and bringing patients along on the journey. To date, the programme has held 29 Coffee
Catch Up events, eight of which were virtual sessions held during COVID, and we’ve seen over 1,500 in attendance. Gathering feedback in this way is invaluable and means we’re constantly improving and refining the experience for future patients. We get better insight into making effective change than if we ran surveys as we’re really getting to the root of things. An added benefit is patients feel engaged throughout the whole process. They also feel reassured as they’re able to hear about the experiences and recovery progress of their peers during these sessions. We’ve also heard from patients who felt they perhaps weren’t progressing as much as their peers, and the Coffee Catch Ups spurred them on to improve in their recovery.
Change with impact The material impact of these sessions is bringing in change with impact, based on the patient experience. For example, some patients advised us they would have liked more information around pain relief, what pain medication they might be given and the different side effects. We have a patient handbook and app as our central resource for patients going through the JointCare pathway and so we updated both with more information about pain relief. We also introduced pain medication cards on our wards, which explain a bit more about the different kinds of pain relief a patient may be offered and what side effects there may be. Another patient explained they had a
Deep Vein Thrombosis (DVT) after they were discharged and they weren’t able to be treated at ROH, as it’s not an acute hospital with an A&E. It was clear patients would rather be treated by the same team and so we developed a DVT- following discharge pathway. This is specifically for arthroplasty (joint replacement) patients with a suspected DVT, so they are able to return to the ROH for diagnosis and treatment. Other changes included introducing staggered admission times for patients who are scheduled for surgery in the afternoon, so they are not waiting in hospital all day for surgery, as well as
adding more information about sport and leisure activities for patients wishing for more advice on returning to activities after their operation.
Community and social facilitation While we have many ways to provide feedback across the Trust, the community setting of the Coffee Catch Ups provides the ideal environment for discussing feedback. Firstly, there’s the direct discussion with clinicians. We involve a range of clinicians involved throughout the JointCare pathway, from surgeons to physiotherapists and nurses. We’ll also involve our research team on some occasions to provide additional insight for their research projects. Having ready access to specialists means patients who may have questions about their progress can speak to a clinician directly and get in the moment responses. And for a patient who needs some inspiration from others before sharing their own feedback, we find directly hearing responses to their peers’ questions does prompt patients to raise their hand with a question of their own. Because it’s relaxed, people feel more inclined
to share their perspective, somewhat like the concept of social facilitation, which is the idea that people’s performance can improve when other people are present. In practice this could be a cyclist going faster in a group race, being pushed on by those around them, rather than cycling alone. The challenge with the social facilitation phenomenon is the setting can impact on productivity; sometimes people don’t want to put their head above the parapet. However, we’ve found the environment we create is conducive to active and engaging discussion. We hold the Coffee Catch Ups in a retirement
village’s activity hall, which is a relaxed space in itself, and we get people to sit at groups of small tables with tea/coffee and biscuits to chat with their peers. For some people who are feeling isolated, this is an opportunity for them to get out and engage with others who have gone through a similar experience. Our staff will chat to individuals throughout this part, again reinforcing the conversational nature of the session. Patients have fed back really positively. One patient said: “I thought it was extremely well organised, and the tone was just right to get feedback – both ways! Impressive turnout from ROH staff – surgeons, physios, pharmacists etc. Well done and thank you”, while another
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