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From faults to flawless – make the Friends and Family Test really work

October 22, 2012
The Friends and Family Test (FFT) has to be fully functional in every hospital from April 1st, 2013. This is a significant undertaking and – if done badly – could cost Trusts a lot of time and money, yet deliver only minimal benefits in terms of improving the quality of care delivered.
On the other hand, it is possible to put in place a solution that not only exceeds the requirements of the FFT, but does so in a way that delivers significant benefits to Trust boards and senior management, increases morale of frontline clinical staff, and builds unprecedented trust amongst the public and patients using the hospital.
Rather than being yet another tick-box, data-collection exercise that has little impact on patient care, the FFT has the potential to transform the culture across the NHS and lead to unprecedented improvements.
iWantGreatCare has been delivering variants of the FFT for UK healthcare providers for over four years and has identified the following critical success factors that will enable Trusts to achieve all the benefits described.
1. Patient experience has to be important right at the top of the organisation – this requires leadership and real engagement from the chief executive and non-executive members of the board. Rather than being an add-on at the end of the board meeting, patient experience – and the FFT – has to be a fundamental metric of quality; reported using robust, comparative metrics, with a specific board-member held to account for targets and performance.
2. The single “would you recommend?” question has to be accompanied by the collection of free text to better understand the issues underlining the scores provided by patients. Whilst the FFT guidance currently requires a single question to be asked, the best organisations will also give every patient the opportunity to provide free-text asking the question, “what was done well and what could be improved?”. The insight attained when this is a standard part of practice makes it simple for organisations to highlight excellence as well as pinpointing the causes of dissatisfaction, whilst also giving the critical human and emotional stories so essential to engage staff with the FFT.
3. The FFT performance of individual departments, wards, and clinics has to be fed directly back to the staff on a weekly basis. But how best to do this in a way which isn’t just another email amongst many others? How to provide feedback to staff in a format and style that truly engages and changes attitudes and behaviour to build a culture of excellence? This sounds ambitious, but what iWantGreatCare has learnt over four years is that it is possible to deliver concise, engaging, graphical reports that transform how doctors and nurses think of patient experience feedback. Using innovative techniques proven in other sectors, and using excellent graphic design it is possible to build a culture that focuses – and actually delivers – continuous improvement in patient experience.
The best thing about these benefits is that they are neither complex, nor expensive to realise. It takes just a few weeks to put the system in place with data being delivered almost immediately. And best of all for most NHS Trusts there is absolutely no cost to use the FFT solution from iWantGreatCare.
(Along with colleagues from TripAdvisor, I will be giving a seminar tomorrow  at #FTN2012 on how NHS Trusts can use feedback to go “from faults to flawless”. Looks like it is over-subscribed, so get there early.)
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