15 Steps Challenge toolkit reveals what NHS patients think about their care: In the lead up to the implementation of the NHS friends and family test, a toolkit created by the NHS Institute for Innovation and Improvement offers new insights into how patients feel.
Getting an insight into patients' perspectives is vital if we are to improve their experience of care. Understanding how patients feel about the care they receive can only truly be achieved by looking through their eyes.
In 2010-11 the NHS Institute for Innovation and Improvement held a series of focus groups with patients and relatives; these groups included ethnic minority groups, older people and parents. Several also included staff from different teams and service areas. The focus groups discussed what "good" looks like to patients. Do first impressions count? What is it staff do that makes patients feel confident and valued?
During one of these workshops a mother who often had to take her daughter to a hospital ward told us: "I can tell what kind of care my daughter is going to get within 15 steps of walking on to a ward". This led us to ask "how did she know?", and sparked the development of the 15 Steps Challenge toolkit, which was launched last year for acute organisations.
While this mother's statement referred to her acute hospital experience, many service users and relatives told us the principle was also true for mental health inpatient settings and community care. As a result we developed the 15 Steps Challenge for mental health inpatient care and 15 Steps Challenge for community services, which have just been launched.
Co-produced with patients, carers and staff, they provide a series of questions and prompts to guide users through their first impressions of a care setting. Organisations gain an understanding of how patients feel about their care and how high levels of confidence can be built. It can also help them understand and identify the components of high-quality care that are important to patients.
The toolkit helps pinpoint potential improvements that matter to patients. For example, in community services teams often ask patients for information in two ways, via a questionnaire sent to their home (often not very effective or engaging), or through a questionnaire on an iPad that staff take to a patient's home (which can be intimidating for them to fill in with the staff member in the same room).
The 15 Steps Challenge is different because it has a team of people asking open and engaging questions to the patient/carer so that they can express their thoughts and not just tick a box. The discussion provides qualitative information that helps teams learn what works and what does not. The team who ask the questions are independent of the care team, which helps the patient be more open in their responses.
The 15 Steps Challenge is not an audit or a performance management tool. It provides an opportunity to spread good practice and puts the emphasis on patient stories, impressions and feelings about patient care. It is designed as a listening tool, not an audit or questionnaire; the main objective is for patients to tell you about their experiences so they can be improved upon.
With the NHS friends and family test coming into effect from April 2013, publishing details of the best performing hospitals in England, this initiative will drive other hospitals to raise standards in patient care. The 15 Steps Challenge supports the friends and family test by allowing organisations to go into patients' opinions and experiences in more depth, and identify changes that can help improve the care they receive.
Many organisations are using the toolkit to strengthen the work they are already doing to improve the patient experience. It is available free of charge to NHS organisations in England and can be accessed here.
Lynn Callard is national lead for the productive care QIPP work stream at the NHS Institute for Innovation and Improvement Guardian Professional.
Getting an insight into patients' perspectives is vital if we are to improve their experience of care. Understanding how patients feel about the care they receive can only truly be achieved by looking through their eyes.
In 2010-11 the NHS Institute for Innovation and Improvement held a series of focus groups with patients and relatives; these groups included ethnic minority groups, older people and parents. Several also included staff from different teams and service areas. The focus groups discussed what "good" looks like to patients. Do first impressions count? What is it staff do that makes patients feel confident and valued?
During one of these workshops a mother who often had to take her daughter to a hospital ward told us: "I can tell what kind of care my daughter is going to get within 15 steps of walking on to a ward". This led us to ask "how did she know?", and sparked the development of the 15 Steps Challenge toolkit, which was launched last year for acute organisations.
While this mother's statement referred to her acute hospital experience, many service users and relatives told us the principle was also true for mental health inpatient settings and community care. As a result we developed the 15 Steps Challenge for mental health inpatient care and 15 Steps Challenge for community services, which have just been launched.
Co-produced with patients, carers and staff, they provide a series of questions and prompts to guide users through their first impressions of a care setting. Organisations gain an understanding of how patients feel about their care and how high levels of confidence can be built. It can also help them understand and identify the components of high-quality care that are important to patients.
The toolkit helps pinpoint potential improvements that matter to patients. For example, in community services teams often ask patients for information in two ways, via a questionnaire sent to their home (often not very effective or engaging), or through a questionnaire on an iPad that staff take to a patient's home (which can be intimidating for them to fill in with the staff member in the same room).
The 15 Steps Challenge is different because it has a team of people asking open and engaging questions to the patient/carer so that they can express their thoughts and not just tick a box. The discussion provides qualitative information that helps teams learn what works and what does not. The team who ask the questions are independent of the care team, which helps the patient be more open in their responses.
The 15 Steps Challenge is not an audit or a performance management tool. It provides an opportunity to spread good practice and puts the emphasis on patient stories, impressions and feelings about patient care. It is designed as a listening tool, not an audit or questionnaire; the main objective is for patients to tell you about their experiences so they can be improved upon.
With the NHS friends and family test coming into effect from April 2013, publishing details of the best performing hospitals in England, this initiative will drive other hospitals to raise standards in patient care. The 15 Steps Challenge supports the friends and family test by allowing organisations to go into patients' opinions and experiences in more depth, and identify changes that can help improve the care they receive.
Many organisations are using the toolkit to strengthen the work they are already doing to improve the patient experience. It is available free of charge to NHS organisations in England and can be accessed here.
Lynn Callard is national lead for the productive care QIPP work stream at the NHS Institute for Innovation and Improvement Guardian Professional.
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