HSE ACUTE HOSPITAL SERVICES 2019 Listening, Responding and Improving The HSE response to the findings of the National Inpatient Experience Survey Thank you Thank you to the people who participated in the National Patient Experience Survey 2019 (NPES 2019) and to their families and carers. Without your support, this survey would not have been possible. The findings of NPES 2019, tell us what matters to you as patients and about the important improvements that can be made to improve hospital services across Ireland. The NPES 2019 allows us to explore how the patient voice has helped to change and improve hospital care for patients in the last year and the quality improvement priorities for 2020. Thank you to all of the staff of the participating hospitals for encouraging patients to participate in the survey, and for their participation in the discussions and review of the feedback received and the development of the quality improvement response which is presented in this paper. The survey was overseen by a National Steering Group, a Project Team and a Project Board. We acknowledge the direction and guidance provided by the members of these groups. The Quality Improvement Response, presented in this paper, was developed by an Oversight Group for Improving Patient Experience-Acute Hospitals, together with staff and managers from each participating hospital. We acknowledge the dedication and commitment of all participants to work in partnership and to develop meaningful plans designed to improve patient experience across all participating hospitals. Contents Foreword 4 Introduction 5 Message of Support 8 The HSE: Listening, Responding, Improving 9 • Improving patient experience of Emergency Departments 10 • Improving care on the ward 16 • Improving communications and information for patients during examination, treatment and diagnosis 29 • Improving patient information and communication at discharge 35 • Improving organisational culture in healthcare 39 Using the findings of the National Patient Experience Survey to design healthcare systems 44 Conclusion 49 Saolta University Health Care Group 53 RCSI Hospital Group 67 UL Hospitals Group 74 South/South West Hospital Group 85 Ireland East Hospital Group 108 Dublin Midlands Hospital Group 125 Acknowledgments 139 New initiative Existing initiative continues Responding to the results of the National Patient Experience Survey Programme | 2019 | Page 3 Foreword from CEO of the HSE The National Patient Experience Survey (NPES) 2019 will be published on 25th November 2019. This is the third such report. It provides us with important insights about patients’ perspectives on how they experienced treatment in our public hospitals. We need to take the time to understand and to reflect critically on what patients have told us, so that we can continue to improve our services. There are many aspects of health and social care services in Ireland that we can be very proud of. Our healthcare staff are routinely praised for their hard work and empathy. NPES 2019 reported improvements in patient experience across all hospitals and Hospital Groups. While also describing areas were further attention is required, 84% of patients expressed satisfaction with the services that they received. Learning is a core component of delivering safe and effective healthcare. Learning is achieved by, amongst other things, ‘listening, responding and improving’ – which are the areas of focus of this HSE report. We are constantly working to improve a patient’s experience. Included in the report are examples of improvement initiatives and all of our hospitals now have quality improvement as part of their core work and purpose. We are currently embarked upon a major change process in our healthcare system through Sláintecare. Our approach to reform will be defined by the adoption of a more participate approach. Over the coming years there will be many opportunities for patients, advocates and staff to become involved in co-designing the kind of health service that is required to meet the needs of our population. I am pleased that we are continuing to register improvements in the delivery of acute care and that patients are positively responding to this. However, our acute hospitals are still under pressure and this too is reflected in the NEPS 2019. In order to alleviate this pressure, we need to generate additional capacity in the community. During the course of 2020 we will begin the process of moving towards a more regional healthcare structure which will devolve more authority to six new health regions and empower frontline staff to make more immediate decisions. Using a population-based approach will ensure that we focus relentlessly on preventing sickness, keeping people healthy and at home, and, when it is necessary, providing the highest quality hospital care. On behalf of the HSE I wish to again acknowledge and thank the patients and families for their generosity in completing the survey which will be used as a learning platform for improvement in future years. I also thank the Oversight Group for Improving Patient Experience – Acute Hospitals, together with staff and managers from each participating hospital for developing this response, designed to improve patient experience across all acute hospital services in Ireland. Finally I would like to acknowledge the initiative and collaboration of colleagues in the Health Information and Quality Authority and the Department of Health for partnering with us in the development of the National Patient Experience Survey Programme – a partnership which will flourish in the years ahead to the benefit of patients and our health services. Mr. Paul Reid Chief Executive Officer, Health Service Executive (HSE) Responding to the results of the National Patient Experience Survey Programme | 2019 | Page 4 Introduction Improving the hospital experience for patients and loved ones is at the heart of everything we do as individuals and as a collective working in acute hospital. The Results of the National Patient Experience Survey (NPES 2019) provide acute hospital services in Ireland with tangible evidence about what matters to patients, about their journey through Irish hospitals and real practical examples of areas for improvement. For our patients, being treated with dignity and respect and being fully involved and treated as shared experts in the decision making about their care, are key factors for a positive experience. A true partnership between a patient and a healthcare professional means that a patient’s values and preferences are understood and respected. Healthcare professionals, learn so much about health and illness, by listening to patients in an authentic way. Patients, their families and/or carers want to feel enabled and empowered, listened to and involved in the decision making about their healthcare. Improved communication, together with clear information, being treated with dignity and afforded privacy, to discuss their care and treatment in at every stage of their journey, from admission to discharge, results in improved experience and outcomes of care. Embracing a culture which promotes the importance of patient experience and patients as partners in their care, requires a deliberate and focused effort by management and leadership. Driving patient experience as a key priority into the day-to-day life of individual hospitals and the Corporate HSE, requires a commitment and a plan which informs us whether or not the plan is making an actual measurable difference for patients. I have established a team in the Acute Operations, whose role it is to actively engage with the findings, review each and every patient story and work in partnership with hospitals and Hospital Groups to oversee the implementation and advancement of this work. As National Director of Acute Operations I am committed to ensuring that: a. the findings of the National Patient Experience Survey are used systematically to inform quality improvements priorities, at every level of the organisation; and b. leadership and support is provided for the implementation and resourcing of improvement initiatives across acute hospitals. The HSE Acute Operations in 2019: c. Worked in partnership with the Department of Health to introduce the new Independent Patient Advocacy Service across acute hospital services; d. Demonstrated our commitment to listening and responding to patient feedback, through the publication of the quality improvement response, developed at hospital, Hospital Group and at corporate level 2019; e. Worked in partnership with patients, carers and families, to codesign improvement initiatives at a corporate and local level; and f. Ensured that the priorities of the NPES are aligned with work streams at a corporate level. I welcome this opportunity to meaningfully engage with findings of the National Patient Experience Survey 2019. I am excited about building real and meaningful partnerships with patients and our community and I am committed to supporting the implementation of a programme of work designed to improve patient experience across acute hospital services. An action plan and a reporting structure supporting its implementation, will give us at the corporate acute hospital management team level the assurance required that we are making a real difference for patients across Ireland. Liam Woods National Director, Acute Operations, HSE Responding to the results of the National Patient Experience Survey Programme | 2019 | Page 5 Acute Operations, HSE Listening, Responding, Improving