Case study: The New Victoria Hospital
Improving and maintaining quality is at the heart of everything at the New Victoria Hospital in Kingston. As an independent organisation with about 240 staff, Quality Manager, Kath Dobson acknowledges that their job might be an easier one than at other, larger hospital trusts.
However, the building blocks of constantly communicating with patients and ensuring all staff have the patient experience and quality improvement at the centre of everything done requires full commitment from all staff.
Soon, the organisation, winner of the CHKS quality improvement award, will have a new day surgery unit, increasing bed capacity by a third. Kath and the team are determined that their standards will be at the very least maintained, if not improved, despite the expansion.
Kath says: “A staff survey revealed that 100 per cent of staff believe that the patient comes first. People go out of their way to achieve excellent customer service. They have a strong sense of commitment and loyalty to the organisation.”
To ensure involvement throughout the organisation, all patient feedback and other performance measures and outcome data are shared with all staff. Any negative comment or complaint is taken very seriously, followed up and investigated. Everyone takes ownership and a steering group, which is primarily clinical, however representative of all departments, will work through quality, professional and regulatory standards and best practice guidelines.
In October 2013, patient feedback questionnaires were redesigned to include Friends and Family Tests. The stats are reported back on a monthly basis and circulated to all staff. While it means that any negative feedback can be addressed it also means that if a member of staff is mentioned for doing good work, that can be seen too.
Kath says: “We are constantly monitoring what is going on. We also have a quality executive team which meets quarterly and we are constantly looking for ways to reach patients to find out what matters most to them.”
Direct communication with patients is a vital part of their success. Jane Harris, Ward Manager, said the team embraced the RCN Principles of Nursing, which were worked into an improvement audit tool. The principles incorporated the RCNs six Cs: care, compassion, competence, communication, courage and commitment. Jane says: “We chat to a patient who has stayed with us for more than 24 hours, typically three to four days. We got really good feedback about how our patients felt. We turned it into a chat with the patient and that way we got to hear whether there were other areas of care they were not happy with. We were conscious that we didn’t want it to be just a paper exercise and that we acted on our findings. It was embraced by all the teams of staff.”
Feedback from patient questionnaires is collected and validated by an independent company which also does the same for other independent hospitals in the area. Where more targeted evaluations take place, for example looking at a particular service area eg catering, this enables New Victoria to benchmark itself against other similar hospitals.
Any “poor” ratings from the questionnaires will be flagged up to the hospital as a red alert so that they can act on it immediately. Every situation where a patient feels the organisation could have done better, will be followed up and carefully considered.
The organisation makes its data collection as robust as possible, ensuring they have as large a number as possible of surveys returned. On admission each patient is given a feedback form to fill in. The national average of forms returned is about 25 per cent, but after introducing a post-discharge phone call, where patients are reminded about the form, the organisation now has a 28 -30 per cent return rate. Plans to make it easier for patients to provide feedback electronically are underway with the questionnaire being accessible on the website.
Technology is also coming into play to ensure they get feedback from their outpatients. Twice a year, 50 patients are picked at random and are given an iPad to fill out the survey. The results are collated by Survey Monkey and entered into an audit log.
Staff wellbeing is a big focus at the hospital. More than 40 per cent of their staff have worked there for more than ten years. Good staff working conditions are a help, but the organisation also has an emphasis on training and professional development.
Kath says: “We do a lot of training. We are able to be proactive with identifying new training as we are a private organisation. We recently identified the need for more dementia training and all members of staff who had attended the training became a dementia friend. We have also incorporated this training into the mandatory adult safe guarding training for all staff. It was a key line of enquiry for CQC when they visited and we were able to demonstrate our compliance with this requirement.”
For the last four years, an annual externally collated staff survey has been carried out which has helped to improve patient experience. There is a thorough governance review process in place and information from all sources is always discussed, evaluated and fed back to all teams from department to Board level, whether negative or positive.
Kath says: “It’s all about feeding back to the teams so the lessons learned can be implemented into service delivery where appropriate. Maintaining and seeking ways to improve the quality of care and service delivery is essentially at the core of everything we do.”
Quality accreditation has helped the hospital improve care to its patients as it supports service delivery and defines a framework within in which we work, improving it’s processes and organisational procedures.
Pam Newsham, director of clinical services says: “Winning the Quality Improvement award is a huge achievement and reinforces the commitment of the entire team in a quality driven organisation. This reassures our patients that they are at the centre of everything we do and that the service and care they receive will be of the highest standard.”
