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Reality: NHS patients using the web to call a nurse from their hospital bed

November 22, 2013

…nurses respond in minutes and (most unlikely) it’s all thanks to the Prime Minister’s Friends and Family Test.

I’ve just spent the most incredible morning in Cumbria with the brilliant senior nurses and ward managers from the University Hospitals Morecambe Bay Trust. I travel to many hospitals both in the UK and abroad – indeed that’s how I spend most of each week – and I can honestly tell you I’ve never met a more inspiring, passionate or dedicated group of NHS professionals. As you may be aware, due to the failings of a tiny number of their predecessors (not to diminish for one moment the tragic seriousness of those failings), the nurses in the Trust’s hospitals face huge extra pressures and responsibilities – on top of those shared by their colleagues in hospitals across the country.

But you wouldn’t know it when you meet them. Unless of course that is part of the reason they are so passionate and determined that a) all patients and their families will get the very best possible experience, and b) that staff performance in this respect should be 100% openly and transparently shared with patients and the public: just like TripAdvisor, ratings and reviews from all their patients are published on the internet.

 What this means is that every patient is asked to rate and review their experience, whether on paper forms, online or using their own phone or iPad. All these comments are monitored in real time, as well as being fully shared (without editing or censorship) on the web at iWantGreatCare

Each week staff on the wards carefully review all the patient feedback for their teams – what patients and families said about them in the last seven days, as well as checking their “star rating” compared with other wards in the Trust’s hospitals, and soon (through iWantGreatCare’s “National Experience Tracker” – or NET) how they compare with similar wards across the UK.

 And this goes way beyond box-ticking or comparing scores. Nurses today told me what an incredible difference it is making to be able to read the words and personal accounts of their patients, not occasionally, but every week. How it enables them to reconnect with what really matters to them as professionals, reminds them of the impact of their hard work, and enables them to respond rapidly when things are not as they should be. Indeed the midwives described how in just a few months this has helped build morale and has rapidly become a central part of their shared vision to be not just good, but actually aspire to be the very best for each and every patient. This is not about merely measuring patient experience, it is about transforming it. (Interestingly – and perhaps not unconnected – sickness/absence rates for these midwives has fallen by nearly 70% in the same period, saving the Trust money on expensive bank staff.)

 

But in addition to all the benefits described above, the iWantGreatCare solution being deployed across the whole Trust (and indeed at hospitals across the UK and now into Canada and New York) goes further than needed by the basic Friends and Family Test, actually enabling patients to provide truly instant feedback, and for staff to be able to respond in minutes, meet the patient’s immediate need and fix things instantly to ensure improvements for the next patient.

Now this is all fine in theory and we’ve been promised “an innovative, paperless NHS” for what seems like decades, but what totally humbled me this morning was to hear from the frontline teams in Morecambe Bay that they have made this a reality – and that both patients and staff find it “completely amazing”. The senior nurse from the surgical unit recounted to her colleagues how last week an elderly patient had used his iPad, from his hospital bed, to provide feedback on his care, highlighting a problem and concern he had using the iWantGreatCare pages for the hospital.

The nurses on the wards are able to receive instant alerts if there are concerns that need addressing for their ward – and thus the nurses were instantly made aware of a problem. Interestingly, in his comment the patient said something along the lines of “this needs sorting at some point, but I don’t want to interrupt anyone now”. Whilst the comments on iWantGreatCare are anonymous there were not many elderly patients sitting in bed with iPads! Thus the nurse was able to go directly to the patient and say “Let’s solve that problem now”.

I am told that the patient (who is still in the hospital) was completely amazed, not really expecting anybody to do anything ever, let alone seconds after he had given his feedback – this was not what he had come to expect from the NHS! Not only was the problem fixed, but the patient has been telling all his visitors and family about the incredible hospital and how the staff really listen, really care and get things fixed. His confidence is high, as is the morale of the staff who see people talking about the great care they deliver.

And of course a hospital where staff care enough to listen to every piece of feedback from patients, where they see every patient comment – good or bad – to be truly valuable and as a chance to improve quality, is the sort of hospital we should all want to be treated in, or indeed to work in as a healthcare professional. The evidence is clear (and is one reason why the CQC, Bruce Keogh and Don Berwick all highlight the need for hospitals to actively listen to patient experience as a fundamental metric of quality) – deliver excellent experience and you will deliver better, safer, cheaper clinical outcomes.

 

[I’d like to put on record my profound personal thanks to the fabulous staff I met today for sharing their vision and passion with me – and to all the patients across the country who every day use iWantGreatCare to improve their NHS by rating and reviewing their doctors and hospitals. You really are improving the care for the next patient.]

 

 

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