Informational leaflet for potential hospital participants

Background

With around 50% of all deaths occurring in hospital, have you ever thought what it is like for Carers (be they partners, family or dear friends) to come into an Emergency Care Department with their loved one who is dying?

What happens if such a visit ends in death whilst on the busy department or the short stay assessment ward? What is the Carer’s experience visiting their loved one in the viewing room for the last time or picking up the death certificate and the personal belongings?

We know that this is an everyday occurrence in hospitals, however for many people it is uncharted territory at a time of profound distress, grief and often bewilderment. The Carer’s needs can very easily and unintentionally be over looked. Perhaps this is the first time they have witnessed a death. They may have no idea about your routine procedure, such as collecting the death certificate. They may be very anxious about visiting their deceased loved one in the viewing room, yet so desperately want to say good bye and make sure that they are being well cared for.

So, what is the experience of the Carers who attended your unit or hospital today?  How confident are you that their experience is the best it can be during such a vulnerable time? Do you know what processes of care are working well and what could be improved?

 

Our Approach

‘Walking the Walk’ is a Quality Improvement initiative to improve the experiences of Carers whose loved one is dying and may have died in hospital.

The Walking the Walk (WTW) team comprises of two experienced Health Care Professionals with extensive experience of acute and palliative care, working with two Carers whose loved ones have been cared for whilst dying or have actually died in hospital.

We know that often for Carers it is the small things that matter and that can make the most difference. We know staff want to get it right, but that they don’t always have the insight to see what is really important and valued by Carers at such a time. This initiative has been welcomed by many acute hospitals as part of their user experience portfolio as it provides independent feedback and valued evidence for CQC inspections.

Using an experience-based approach adapted from two seminal programmes; The Fifteen Steps Challenge: Quality from a Patient’s Perspective (NHS England) and the Promoting Healing Environments (Kings Funds), we look for evidence and draw on experience through an end of life care lens.

To make effective change, observation is key. Lessons gained from ‘Walking the Walk’ approach offer a rich source of learning and can triangulate  with other data collected, such as audit, user feedback through complaints and ‘compliment’ and staff experience .

In addition to observation, ’Walking the Walk’ methodology utilises all the senses to capture key environmental features and processes of care across the journey, including signage, hospitality, information and responsive and real time support provided by staff in each care setting .

Walking the Walk incorporates both the personal experience of the Carers, and the professional insights of the Health Care Professionals on the team, distilled to offer a measured  perspective intended to be constructive and pragmatic.

‘The whole team is objective and intentionally non-judgemental with an eye on improvement not inspection or regulation….it’s different’ -  Hospital  Palliative Care Consultant

By walking the journey of a Carer and speaking with staff in each department, from the Emergency Department Reception to the Mortuary, we glean information on a range of levels. The findings are presented to the Host Team, detailing what we thought was effective and good  and what they may wish to consider for improvement. To date, using a similar process ,20 hospitals have undertaken such a process over the past two years. This has afforded the Team a wealth of tested experience, which we use to advise of possible solutions and suggestions to enhance the complete Carer’s experience.

 

What the Offer Entails

You will be linked with a Co-ordinator who will oversee the planning phase, the day of the visit and delivery of your report.

On the day

The approach involves walking the Carer’s journey through the hospital by the Walking the Walk team, and in discussion with you, we will include any specific areas you may want visited in this one day.

The Walking the Walk team will observe core areas as if they are a member of the public; unescorted by hospital staff. This commence in the car park and  will  include wide range of public areas which may be pertinent to the carer at such times

The Walking the Walk Team will be accompanied by a member of the Hospital Team for the second phase of the day as it will involve accessing clinical areas and speaking with unit staff . This has proven to be a great opportunity for the accompanying staff member to gain fresh insight  seeing the hospital from a different perspective as we all walk together and meet briefly with department staff.

The third and final phase  of the day is a 60-minute initial feedback meeting  to provide top-line insights.  This has proven to be an incredibly stimulating and motivating experience for Board Members, Medical Consultants, Nursing Directors, Heads of Facilities and Clinical Teams, with highly productive discussion ensuing.

 

"Same-day, high-level feedback to the hospitals. Very valuable and enabled really important cross-team discussion."

Palliative Care Nurse Consultant

 

Further quotes from the Carers who participated

 

‘"I thoroughly enjoyed my time on the walk thoughts, as well as getting a useful look into the many different areas of a hospital I was able to see the huge challenges many of them face and how the staff persevere to overcome them. I particularly enjoyed giving feedback to the staff, mainly because of the opportunity to actually be involved with people at the top of their fields, but also because I believe they found our observations and suggestions very helpful.’"

                                                             From Roberta whose  Daughter Louise died in ED aged 26

 

Within 3 weeks a draft written report is prepared which covers each area and department (supported by photographs) detailing what we observed to be valued aspects of practice or facilities which would be welcomed by Carers and what may be considered for improvement. This is sent to the Host Lead for any points of correction/clarification, before the final report is signed off.

 

 "The receipt of a written report within three weeks of the walkthrough highlighting what the team liked and areas the hospital may wish to consider for improvement…started work straight away after visit "

Hospital Care Hospital medical Consultant

 

 

6-9  months Revisit offer

The Walking the Walk team can offer (at an additional fee) to do a follow up visit to see what improvement has  been made  and

If you are interested in finding out more please contact us here

 

Claire Henry MBE