Comment

Listening to feedback

As the revalidation process makes clear, staff who are willing to discuss services with patients can improve care outcomes.

As the revalidation process makes clear, staff who are willing to discuss services with patients can improve care outcomes.

Focusing on the experience of patients and carers, and ensuring people are treated with compassion, dignity and respect in a clean, safe and well-managed environment, are crucial to good practice.

Senior nurses are well placed to ensure that they and the staff they manage continually reflect on, and learn from, practice, and thereby ensure that patient outcomes are improved and the NMC code of conduct is upheld.

Patient Experience in Adult NHS Services (National Institute for Health and Care Excellence (NICE) 2012) is a valuable framework that underpins reflection. It states that high quality care should be clinically effective, safe and person centred. As registrants, we should ask ourselves how the care we deliver brings this NICE quality standard to life.

A National Quality Board (2015) paper on patient experience builds on the NICE standard, setting out a common approach for healthcare professionals to improve patients’ experiences of care.

These experiences begin with a patient’s first contact with the health and care system, and continue to his or her final contact, which may be years after the initial treatment and may include end of life care.

Patients may have good experiences of care when they are involved in decisions about it and when professionals communicate with them effectively. If they do not feel involved or understand their treatments, their outcomes may be poorer and health resources may be wasted.

The meaning of patient experience in this context is set out below:

What ‘experience’ means

  • Patients’ experiences of receiving care or treatment. For example, did they know who to contact about their problems?
  • Processes that patients are involved in, such as booking appointments.
  • How a contact made a patient feel, for example, was he or she treated with dignity and respect?
  • Whether information, such as diagnoses, is given sensitively

It is important that nurses reflect on how they can create a culture in which staff are given feedback and can take action on what they have learned.

When teams receive information from surveys, conversations, user narratives, compliments, complaints and focus groups, they can work with patients, families and carers to produce solutions. This can be especially important in situations where patients are scared, confused or worried.

'Always events'

One way to respond to feedback is to develop ‘always events’, which focus on the things that should always happen.

Measuring patient experience can also demonstrate improvement. In this context, the Health Foundation (2013) review and the Care Quality Commission (2015) National Inpatient Survey 2014 are useful resources for practitioners.

There is a strong correlation between staff engagement and the experience of service users. Research shows that, when staff lack support from managers, are subject to bullying, are under too much pressure or have a poor work-life balance, the experience of patients is of a lower quality. Organisations should therefore support staff to deliver a good experience of care.

Revalidation requires nurses to seek out feedback, highlight common themes and work with the public to identify areas that can be improved.

Senior nurses in leadership roles are ideally placed to encourage and enable reflection on experiences of care during the revalidation process.

About the authors

Kath Evans is experience of care lead (maternity, infants, children and young people) at NHS England.

Paul Jebb is experience of care professional lead at NHS England.

References

Care Quality Commission (2015) National Inpatient Survey 2014. (Last accessed: March 9 2016.)

Health Foundation (2013) Measuring Patient Experience. (Last accessed: March 9 2016.)

National Institute for Health and Care Excellence (2012) Patient Experience in Adult NHS Services. (Last accessed: March 9 2016.)

National Quality Board (2015) Improving Experiences of Care. (Last accessed: March 9 2016.)

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