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Patient and whanau centred care standards

Patient and whanau centred care standards

This is an update on our story about Care Standards featured in our Quality Account 2013/2014 [view previous story about our Care Standards].


What are 'Patient and Whānau Centred Care Standards’?

The Patient and Whānau Centred Care Standards have been set up to ensure we provide consistent high-quality patient care. The programme provides a framework to monitor, measure and evaluate key 'fundamental' components of patient care within our hospitals.


What are we trying to achieve?

We want to make sure that patients have the best experience possible when in our hospitals to support their recovery. This means getting the basics right, such as:

  • making sure patients feel safe
  • having consistently clean environments
  • making sure patients get enough rest
  • making sure patients are well fed
  • making sure patients are comfortable and their pain is well-managed

We aimed to introduce a programme that would support staff to deliver a consistently high standard of care and allow us to monitor how well we provide care, particularly the fundamental aspects of care.


What have we done?

The first stage of the Patient and Whānau Centred Care Standards project involved reviewing current practice to identify priorities for improvement. This included:

  • interviewing staff
  • analysing feedback and complaints from patients and families
  • auditing care across both North Shore and Waitakere Hospitals
  • carrying out a stocktake of current projects that relate to the care standards
  • conducting a literature review to define the standards and evaluate similar programmes

Development of Care Standards

This work enabled us to identify nine fundamental areas of care (called Care Standards) to provide the overarching framework for the Patient and Whānau Centred Care Standards programme. Together, these nine Care Standards describe the care we want all our patients and whānau to receive. For each of these nine areas of care, we then:

  • defined the standard of care expected based on local and national guidelines
  • described the practice needed to meet those standards of care
  • developed a review process to regularly assess patient and staff experience of how well we were doing

The table below shows the nine Care Standards and the care we aim to deliver for each aspect of care:

 

Care Standard

Care Statement

1

Communication

Patients/Whānau and carers experience effective communication

2

Clinical monitoring and management

Patients receive care in an environment that allows safe, effective monitoring and timely care

3

Care Environment

Patients/Whānau experience care in a safe, clean, tidy, and well maintained environment that meets their needs and preferences

4

Comfort and Pain management

Patients experience care in an environment that demonstrates compassion, promotes comfort and rest, and manages pain in an optimal manner

5

Respect, Privacy and Dignity

Patients experience care and a care environment that respects each individual, and protects and supports privacy and dignity

6

Nutrition & Hydration

Patients receive appropriate nutrition and hydration to meet personal needs and preferences

7

Safety & Prevention

Patients and whānau feel safe, secure, and protected

8

Personal care

Patients personal care needs and preferences are met in a safe, comfortable, and timely manner

9

Self Care

Patients and their whānau receive care that promotes self care and independence


The Care Standards were launched in June 2015 and we conducted the first review of all inpatient wards in June-July 2015 to understand our performance against the standards. The review process involved:

  • talking with patients and staff
  • interviews with the ward charge nurse managers
  • observing practices on the ward
  • reviewing results of existing ward audits and other performance measures

This process provides us with a broad view of our patients' and staff care experience and will be conducted on a six-monthly basis. Ward teams will be able to use the results from the review to plan their practice development and improvement activities.


Did we make a difference?

The first ‘Care Standards’ review involved 27 wards/units across the organisation. The results of this review showed a high standard of care and a high level of patient satisfaction with care overall. The table and chart below shows the overall results for the organisation:


Areas of Success

Some areas of success we identified were:

  • From ward observations:
    • patient dignity and modesty maintained
    • staff are courteous and polite to patients
  • From patient responses:
    • staff treated them with respect
    • their culture and beliefs were acknowledged
    • they were able to eat meals without interruption
  • Review of existing ward audit results:
    • staff completing patient assessment of risk of falls

Areas for Improvement

Some areas for improvement we identified were:

  • offering patients assistance with personal cares such as shaving, teeth-brushing
  • providing patients with less interrupted sleep
  • involving patients in plans about leaving hospital
  • staff providing explanations to patients about falls and injury prevention
  • completion of clinical documentation

Where to from here?

The next Care Standards review is planned for December 2015. This will enable us to measure improvements implemented over the 6 months since the first review.

We are also in the process of expanding this to a ward accreditation programme. The aim of the Accreditation Programme is to set an aspirational pathway to excellence for wards. The Care Standards would form the basis of this programme and we plan to extend this to other service areas (eg outpatients and community services); to engage ward teams consisting of doctors, nurses, and allied health professionals; and to reward achievement.

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