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Patient & whanau centred care standards

Patient & whanau centred care standards

What are 'Patient and Whanau Centred Care Standards’?

The Patient and Whānau Centred Care Standards have been set up to ensure we provide consistent high-quality patient care. The programme provides a framework to monitor, measure and evaluate key 'fundamental' components of patient care within our hospitals.


What are we trying to achieve?

We want to make sure that patients have the best experience possible when in our hospitals to support their recovery. This means getting the basics right, such as:

  • making sure patients feel safe
  • having consistently clean environments
  • making sure patients get enough rest
  • making sure patients are well fed
  • making sure patients are comfortable and their pain is well-managed

This ward led programme aims to support staff to deliver a consistently high standard of care and allow us to monitor how well we provide care, particularly the fundamental aspects of care.


What have we done?

The PWCCS framework was developed over 2014-2015. To define the standards of care and identify priorities for improvement we undertook a literature review, staff interviews, thematic analysis of patient/family feedback, a stocktake of current activity, and a baseline audit. A multi-disciplinary Steering group with independent Chair and cultural and consumer representation oversaw the staged development of standards.

This work enabled us to identify nine fundamental areas of care (called Care Standards) which provide the overarching framework for the programme. The table below shows the nine Care Standards and the care we aim to deliver for each aspect of care:

 

Care Standard

Care Statement

1

Communication

Patients/Whānau and carers experience effective communication

2

Clinical monitoring and management

Patients receive care in an environment that allows safe, effective monitoring and timely care

3

Care Environment

Patients/Whānau experience care in a safe, clean, tidy, and well maintained environment that meets their needs and preferences

4

Comfort and Pain management

Patients experience care in an environment that demonstrates compassion, promotes comfort and rest, and manages pain in an optimal manner

5

Respect, Privacy and Dignity

Patients experience care and a care environment that respects each individual, and protects and supports privacy and dignity

6

Nutrition & Hydration

Patients receive appropriate nutrition and hydration to meet personal needs and preferences

7

Safety & Prevention

Patients and whānau feel safe, secure, and protected

8

Personal care

Patients personal care needs and preferences are met in a safe, comfortable, and timely manner

9

Self Care

Patients and their whānau receive care that promotes self care and independence


Evaluating the Patient and Whānau Centred Care Standards

We set up a regular 6 monthly ‘Care Standards’ process to review the standard of care on all inpatient wards.

Care Standards review process

  1. Pre-review questionnaire for the Charge Nurse Manager
  2. Talking to patients and staff
  3. Interview with the Charge Nurse Manager
  4. Observing practice on the ward
  5. Reviewing audit and performance results with the wards
  6. Panel meetings with senior team
  7. Celebrating success and improvement

This process provides us with a broad view of our patients' and staff care experience. Ward teams then use these results to plan their practice development and improvement activities.

Since June 2015, we have completed three rounds of Care Standards reviews. We have also extended the programme to include all inpatient wards across North Shore Hospital, Waitakere Hospital, Wilson Centre and Mason Clinic.

Ward Participation Care Standards 2015-2016

PWCCS participation

Jun-Jul 2015

Dec 2015

Jun 2016

Wards

27

35

43

Patients interviewed

134

178

248

 

Did we make a difference?

The Patient and Whānau Centred Care Standards programme is still in its infancy however the results are encouraging with an overall improvement in 7 of the 9 standards across the organisation for wards who have participated in all three reviews.

Patient and Whānau Centred Care Standards Review results  2015-2016 (excl. Mental Health)
Patient and Whānau Centred Care Standards Review results 2015-2016 (excl. Mental Health)


Improving care

The Care Standards PWCCS reviews have helped us to identify and target areas for improvement at a ward and organisational level. Below is some of the improvement activity arising from this programme:

Organisational improvement activity

  • e-Vitals electronic monitoring
  • Focus on food quality
  • Sleep promotion/noise reduction on wards
  • Nurse led ward round in acute stroke units
  • Streamlining of organisational audits

Local improvement activity

Local improvement activity


Sharing our programme

We have shared our experience of establishing this unique programme in a number of forums this year including:

  • International Learning Collaborative, Oxford, UK
  • APAC 2016 (healthcare conference), Sydney, Australia
  • New Zealand Medical Journal

Where to from here?

  • Our next 6-monthly Care Standards review will take place in December 2016.
  • The programme and process continues to be refined at each review. Longer term, we plan to include community and outpatient settings.
  • The programme is being expanded into a ward accreditation programme. Ward teams who demonstrate sustained excellence in the care standards and ward leadership will become an accredited ward.