Written by Jo Harvey of Helen Sanderson Associates
In my first three training sessions at London Road Community Hospital (LRCH) in Derby I trained 10 staff each time. Last time I walked into the training room to find 22 staff packed in like sardines. There were nursing staff at all levels, healthcare assistants, therapists, ward receptionists and even the facilities manager. What a buzz. The day-long session was intense but incredibly rewarding.
I am mentoring two LRCH staff, Keith and Zoe, to be official trainers on site. They’ve both got a very easy way with them and during my sessions they contribute to the day sharing their examples. Last week Keith was leading the warm up and he kicked off by asking everyone to share one thing that no-one would know about them. Keith then neatly segued into his training patter. “So,” he said, “This is what personalisation is all about. It is just a case of knowing and understanding more about our patients as individuals, as whole people. We are really very good at the medical stuff here – but wouldn’t it be great to be good at this too?”
That’s my cue. It’s my job now to explain how we can put personalisation into practice by using a series of person-centred tools. I talk about one-page profiles and how they are used to understand what makes a person tick. I explain how patients and staff alike can use these profiles and about every aspect of the patient-centred journey we are creating at the hospital. By the end of the day my delegates have completed their own draft one-page profiles and also a short version which the patients will be able to see on notice boards around the wards. Importantly, I make sure everyone is clear on their responsibilities. Everyone is involved in the patient journey.
Yet, even with more than 50 staff trained, we still haven’t reached critical mass with the training. This hospital has 101 beds across four wards, staffed by a huge team. The time to really push forward with implementing the patient journey will be when enough people understand how it works and how it can help them.
Because we’ve known that implementation will take time, we’ve started with the easiest part of the patient journey. This is a tool we call ‘Good Day’ and it requires a member of staff to ask each patient, each day, what would make that day a good day for them. The question can be asked by any member of staff i.e. healthcare assistants, hostess, therapists not just nursing staff and the answer written on a white board above patients’ beds.
One of the first requests was that the patient would like to see the staff dance – so they did. It was a wonderful ice-breaker. But then another patient said that they wanted to die. We had talked in the training about this: how to explain to patients, very simply, that the team couldn’t help with that. Was there one little thing that would help them have a bit of a better day? Perhaps a hair wash or an extra cup of tea or a newspaper to read? It is about asking the question with confidence and responding to the answer with confidence too.
The implementation of patient one-page profiles will be a little more challenging. It has been agreed that admissions staff will start filling out the profiles – and that the ward receptionist will take photographs for the profile the day after admission. The good news is that a staff nurse, Amanda, has now been appointed as flow co-ordinator, in charge of admissions. She is based at the Royal Derby Hospital, where most of LRCH’s admissions come from. She has been developing one-page profiles as part of her admissions process and sending these with the patient to the London Road.
In the meantime I have one more training session booked at LRCH and after that I’m handing over to Keith and Zoe to carry on with the training. My role will change so that I pop in from time to time to help with any blockages in the implementation process. We’ve come a long way already, with much more work to be done – but we are making progress.