Abstract
Introduction
There are multiple national drivers promoting person-centered healthcare. In the face of competing pressures, patient experience is often compromised.
Aim: To increase the percentage of service users in our orthogeriatric rehabilitation ward rating experience as more than 6/10 to 90% by June 2024.
Methods
A multidisciplinary project using quality improvement methodology. Patients and carers were involved throughout. Patient, staff and carer interviews shaped improvement themes and change ideas. Broad themes identified:
• Communication
• Provision, and facilitation of, ward activities
• Environment
Several, cost neutral, tests of change were studied: weekly exercise class, mobile library, ‘activities trolley’, music concerts, volunteer recruitment, improved signposting and coordinating weekly relative update.
Run and SPC charts were used to study impact. Measures used:
• Outcome: Patient and carer satisfaction using 10-point Likert scale (1=poor, 10=excellent) in weekly, random cohort (P-chart). Mapping themes over time.
• Process: Minutes of physiotherapy delivered/week. Number of patients participating in activity other than PT/OT (C-chart). Percentage of relatives updated by MDT/week
• Balancing: Length of Stay (LOS). Readmission within 1-month. Staff Feedback. Inpatient falls.
Results
• The % of patients scoring experience >6/10 increased over the project but did not meet ‘special cause’ criteria. Feedback themes shifted positively.
• The median percentage of relatives receiving a weekly update increased (45% to 78%).
• Participation in activities improved, with special cause variation observed. The amount of physiotherapy delivered each week increased by 3 hours due to exercise classes.
• There was no significant change to falls, readmissions or LOS.
• Staffing, covid outbreaks and workload impacted negatively during the project.
Conclusions
‘Experience’ is individually unique and cannot be improved with a unilateral approach.
Using continuous feedback from patients and carers, we tested multiple interventions across several areas, demonstrating positive changes.
Patient experience is challenging to measure quantitatively but should not deter improvement work in this area