Traditionally in times of pressure and escalation with rising attendances in A&E and reduced patient flow it was the clinical workforce who tried to cover off everything. Given that half of the trust employees are non-clinical this project set out to make full utilisation of the corporate workforce in times of escalation to improve patient experience and ensure patient safety was maintained. As a result the Patient Advise and Liaison Service (PALS) Customer Care team HR team and Finance team are now all part of the escalation response.
This initiative has been cost neutral but the value to patients and staff has been immense. The Trust’s Freedom to Speak up Guardian had received comments from staff during her walkabouts that they would like to be more pro-active in preventing complaints but that they required support at a local level.
The PALS Outreach Team was initially developed as a project for administrative staff to come out of their office and visit the wards and speak to patients on a daily basis. This led to a reduction in complaints received by the customer care team as when they are on the wards any issues identified are brought to the attention of the ward sister or nurse in charge and real time action is taken to improve the patient experience.
The initiative is supported by the NHS Constitution principle of “welcoming feedback from patients, families and carers” and by one of the Trust’s own values of “working together for patients”. The opportunity for non-clinical administrative staff to gain appreciation of front line patient experience has had other benefits in that ward staff now feel they personally know the staff in corporate departments and feel that when they are calling for advice they have improved relationships.
Once staff had become used to talking with patients on the wards it seemed a natural progression that in times of escalation they could help even more if trained to do so. The corporate governance team has over 30 staff who have now undertaken additional training to gain their food hygiene certificate and competency to practice which allows them to assist at meal times in times of escalation.
This has proved to be particularly helpful during winter pressures when the staff have been deployed to distribute meals and snacks to patients who have spent a long time in A&E after they have been seen but not admitted due to bed capacity within the hospital. The Human Resource and Finance teams have also helped considerably by acting as “runners” for A&E, the wards and pharmacy in times of escalation.
The members of staff within these departments are on a rota and if the Trust escalates to Opel Level 3 they leave what they are doing and report to Silver Command to be deployed appropriately. Having fresh pairs of eyes in clinical areas from non-clinical staff from other parts of the Trust has led to further improvements in patient and staff experience.
The PALS outreach team now see over 3000 patients a year in the ward areas and there has been a 29% reduction in ward based complaints compared to last year. From a qualitative perspective as well as the positive patient feedback received ward staff have been extremely pleased with the initiative (please seeattached presentations for individual comments received).
There is now a real sense of whole organisational team working not just during times of escalation as both clinical and non-clinical staff havea greater understanding of each others roles which has in turn fostered improved working relationships across the Trust.
The more the staff talked to their colleagues the more they wanted to be involved. The next department to volunteer to be “runners” for A&E were the HR department and the finance team quickly followed to join the initiative. The feedback from both patients and staff has been fantastic and we believe the initiative would be replicable in other organisations providing a “can do” and whole organisation team culture exists.