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Improving Patient and Staff Experience Program (IPSE)

Summary

The Improving Patient and Staff Experience (IPSE) program enabled managers and staff to create a culture of better practice through a supported intensive six-month program.

A growing body of evidence shows that patients’ experience of care has a direct correlation to their health outcomes and that staff experience affects the performance and efficiency of the whole system. Patients often use different measures to health care workers to assess their health experience. For example, patients measure the quality of care provided against the level of dignity and respect they received, whereas staff may use how well they worked together as a team to judge their coordination of care.

The IPSE program has currently been rolled out to over 80 units across NSW. Each partner hospital received:

  • Dedicated and facilitated coaching that includes six days of site visits
  • Tailored executive coaching
  • Three development days
  • Online resources 
  • Near real time measurement of patient experience to provide feedback to staff.

The expectation was to create a culture of better practice and excellence. Managers supported staff in utilising the tools and tactics, and all staff in the identified ward/ units were involved in implementing the Program.

Delivering the program

The IPSE Program was delivered to over 80 units across 20 hospitals with support from Studer Group Australia New Zealand and Customer Feedback System (CFS) Australasia.

StuderGroup Australasia provided coaching to the leaders, managers and staff of healthcare organisations by providing a detailed framework and practical instructions that create and sustain change. StuderGroup uses a model called "Evidence Based Leadership". This model focuses on 6 core components:

  • Alignment of purpose with clear and objective accountability system
  • Leadership skills to carry out the organisational goals
  • Use of proven tools and tactics to change behaviours and performance
  • Managing the performance gap of people
  • Standardisation of process, policies and procedures
  • Accelerators that quicken and/or automate processes.

Evidence Based Leadership Model

As part of the IPSE program a set of discrete tools was implemented over six months. The tools have been specifically aimed to improve:

  • The health experience for both for staff and patients
  • Quality of service
  • Safety
  • Clinical outcomes.

The tools implemented are:

  • Leader Rounding with Staff for Outcomes
  • Reward and Recognition – Thank You Notes
  • Values Clarification and Above and Below the Line Behaviour
  • Leader Rounding on Patients
  • Key Words at Key Times and A.I.D.E.T.
  • Hourly Patient Rounding.

Rounding for Outcomes

Rounding is a standardised way for staff to engage other staff or patients. The first component of Rounding for Outcomes is Leader Rounding with Staff. This is where leaders held regular brief individual meetings with all staff.

Aim of the Tool:

  • Build relationships between managers and staff
  • Improve staff satisfaction
  • Get staff more involved in identifying things needing improvement and in contributing to improve services
  • Retain staff
  • Assist managers to develop leadership skills and build teamwork in their departments
  • Identify role models and feeds into reward and recognition systems
  • Implement staff peer and manager recognition and reward system
  • Reinforce high performance and desired behaviour.

Staff Recognition Systems

The IPSE program encouraged Staff Recognition Systems to improve staff morale, commitment and involvement. The system provided timely and effective recognition of jobs well done both from peers and from managers and was used to encourage high performance and desired behaviour.

Aim of the Tool:

  • Face to face recognition and delivery of a "thank you" by the manager to a staff member directly
  • The manager writing a personalised "thank you note" to a staff member recognised by a peer
  • Higher levels of management receive advice from a manager and personally express their appreciation for the behaviour of a staff member 2-3 levels below them
  • Recognition of the efforts of a staff member in a staff meeting
  • Post staff recognition information on notice board.

Values Clarification and Above the Line Behaviours

Values Clarification and Above the Line Behaviours is where leaders worked with staff to identify team values and behaviours so that everyone understands what a particular values means to the team. The purpose of the standards was to:

  • Establish clear behaviour guidelines for staff to follow
  • Involve staff to identify appropriate behaviour within their own service – what does that look like for us
  • Improve staff satisfaction and morale
  • Ensure staff have a way they can safely challenge each other on behaviour that contradicts the agreed Above the Line behaviours.

Leader Rounding with Patients

Leader Rounding with Patients validates the care being provided by staff and is where leaders briefly talk to a selection of patients and carers.

Aim of the Tool:

  • Improve patient safety
  • Improve patient health and clinical outcomes
  • Improve patient satisfaction and patient and carer experience
  • Identify issues early and allows corrective action and service recovery
  • Ensure key service strategies are in place – always, for; every patient, every staff member and every time.

AIDET – the Five Fundamentals of Patient/Customer Communication

AIDET – the Five Fundamentals of Patient/Customer Communication is a structured way to communicate with patients and clients which reduces anxiety and increases compliance. The mnemonic A.I.D.E.T. stans for:

  • Acknowledge the patient
  • Introduce yourself
  • Duration of procedure/ test/ interaction
  • Explanation of procedure/ test/ interaction
  • Thank the patient for their cooperation

This tool is highly effective in both inpatient and outpatient settings.

Aim of the Tool:

  • Improve patient safety, improved patient health and clinical outcomes
  • Improve patient compliance and reduced anxiety
  • Improve patient satisfaction and patient and carer experience
  • Implement good patient communications – always; every patient, every time
  • Standardise communication approach to all patients and carers
  • Improve staff morale – Happier patients make it a better place to work

Hourly Patient Rounding

Hourly Patient Rounding is then introduced and builds upon the foundational activities of the Must Haves and AIDET. This tool allows for regular proactive clinical service and care.

Aim of the Tool:

  • Improve patient health and clinical outcomes
  • Improve patient safety
  • Reduce clinical incidents
  • Improve care planning
  • Improve patient compliance & reduced anxiety
  • Improve clinical outcomes
  • Improve patient satisfaction and experience
  • Decrease length of stay
  • Improve nurse time efficiency.

Patient Experience Tracker

Customer Feedback System (CFS) Australasia provided the Patient Experience Tracker or PET. The PET system provided near instantaneous feedback to a specific ward, clinic or service outlets and showed the progress of implementation. Each morning the leadership team received a report via email on patient/ customer experiences for the previous 24 hours. The system enabled frontline staff to understand patients or customers’ needs, and more specifically, enabled the team to celebrate where they do well and encouraged critical questioning on how to improve their service.

Read the PET Fact Sheet (PDF File pdf - 1.6 MB) for more information.

Contact

Lucy Thompson
Patient and Staff Experience Manager
Agency for Clinical Innovation
pse@aci.health.nsw.gov.au 
Ph: 02 9464 4658

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