Blacktown Mount Druitt Hospital (Blacktown Campus) added Carer Zones to 40 single rooms in its new Clinical Services Building, so carers can stay at the hospital overnight in comfort.
Aim
To improve the experience of carers who stay overnight at Blacktown Mount Druitt Hospital (Blacktown Campus).
Benefits
- Improves the hospital experience of patients, families and carers.
- Engages consumers and carers in the development of healthcare facilities.
- Empowers consumers with the ability to create meaningful change through their involvement in hospital decision making.
- Supports NSW State Health Plan: Towards 2021 (Providing World Class Clinical Care by Listening to Patients).
- Aligns with NSW Health’s responsibilities under the Carer Recognition Act 2010 to consult with carers, or organisations that represent carers, on policy that may affect them.
Background
As part of the Blacktown Mount Druitt Hospital Expansion Project (Stage 1), extensive consumer consultation was undertaken. It identified that many patients wanted a family member or carer to stay with them overnight while they were in hospital. This was particularly important for culturally and linguistically diverse and confused patients, who need help articulating their needs. Feedback showed that having a familiar person with them made them feel less anxious, while staff found the support of a person staying overnight improved patient experience and communication.
At the time, hospital rooms did not accommodate family members or carers, who often slept in a chair if they stayed overnight. There were also restricted visiting hours for families and carers, as well as difficulties with access to hospital facilities such as parking. The redevelopment of the hospital provided a valuable opportunity to address these concerns.
Implementation
A co-design process was undertaken in collaboration with consumers, to develop Carer Zones in 40 single rooms across the new facility. They are the first of their kind in NSW , featuring a defined space for the carer to sleep within the patient’s room, with direct access to bathroom facilities. This allows the carer to stay overnight in comfort, while retaining their privacy and not impeding the observation and care of the patient. During the day, this space acts as a sitting room for the patient and their carer.
To support the development of Carer Zones, a number of cultural and operational changes were implemented. These included:
- a new set of procedures for carers staying overnight with patients, developed in conjunction with patients and carers
- removing restrictions on visiting hours—entirely for carers and very significantly for other visitors
- a carer card that allows carers to take advantage of privileges such as concessional parking and improved hospital access
- a Carer Zone Education Program for staff, patients and carers, delivered by the Patient and Carer Experience Officer
- development of patient orientation and communication protocols, as well as agreed procedures to govern the program
- ongoing feedback and evaluation mechanisms (formal and informal) for staff, patients and carers, to ensure ongoing improvement of the program.
Each element of the program was designed, planned, implemented and evaluated in collaboration with patients, carers and consumers, as well as a broad range of clinical and non-clinical staff.
Project status
Sustained – The project has been implemented and is sustained in standard business.
Key dates
- 2014: Start of Blacktown Mount Druitt Hospital Expansion Project (Stage 1)
- April 2016: Opening of new Clinical Services Building, with ongoing evaluation of Carer Zones
Implementation site
Blacktown Mount Druitt Hospital (Blacktown Campus), Western Sydney Local Health District
Partnerships
- Health Infrastructure NSW
- Blacktown Expansion Project
- Jacobs Architects
- Consumers and carers
Results
Since the opening of the new Clinical Services Building at Blacktown Mount Druitt Hospital (Blacktown Campus) in April 2016, there has been significant use of the Carer Zone facilities. Qualitative feedback sourced in May 2016 was extremely positive, with patients who had carers staying overnight reporting reduced anxiety and improved satisfaction with their healthcare experience. The average length of stay for patients using Carer Zones is 6.5 days.
A patient survey conducted from April to December 2016 found that the familiar presence of a carer in the hospital overnight provided:
- comfort and reduced anxiety for the patient (94%)
- support in communication (93%)
- support in personal care activities.
In their feedback, one carer noted: “Every time I come here in the hospital with my mother I have to sleep on the chair but I thank God for whoever created this idea for I actually slept on a bed last night and I had a great, great sleep.”
While it was designed as a patient experience project, the Carer Zones had a number of unexpected benefits in relation to staff productivity and efficiency. In a survey of 143 staff conducted from April 2016 to July 2017, the following improvements were identified as a result of carers staying overnight with a patient:
- positively impacted staff workload (34%)
- reduced the need for nursing specials to provide additional care to the patient (45%)
- improved the ability to include the carer in rounding (43%)
- led to better communication between staff, carers and patients (94%).
There was also a 600% increase in the use of carer education resources in the Aged Care Ward over this time.
Incident Information Management System (IIMS) data collected from March 2015 to October 2016 showed a 40% reduction in falls over a 24-hour period in the Stroke and Rehabilitation Ward since implementation of the Carer Zones. Staff cite having a carer stay overnight, the ‘see and be seen’ design of the ward areas and Falls Huddles as the main contributors to this decrease. The data showed a 68% reduction in falls between midnight and 8am in the first six months of Carer Zones.
Representatives from dozens of organisations across Australia have visited Blacktown Mount Druitt Hospital (Blacktown Campus) to view the innovative design, with a number due to replicate the initiative. However, the initiative does not rely entirely on purpose-built Carer Zones. Many of the cultural and operational elements can be readily adopted into hospitals across NSW .
Lessons learnt
The project is a genuine example of co-design, where ongoing consultation is undertaken with staff, patients, carers and consumers. However, to ensure the consultation process leads to meaningful change, it is important to include these stakeholders in the multidisciplinary project team and involve them in decision making. All members of the project team should have a shared vision for the project and a willingness to adapt in response to feedback from patients, consumers and the community.
Resources
- Carer card
- Carer zone diagram
- Carer zone fact sheet
- Caring for carers poster
- Procedure for family members or carers staying overnight with patients at Blacktown and Mount Druitt hospitals
- Blacktown and Mount Druitt Hospitals Expansion Project
Contact
Wendy Cain
Patient and Carer Experience Officer
Clinical Governance
Western Sydney Local Health District
Phone: 0428 521 609
wendy.cain@health.nsw.gov.au
