COMMUNICATION STRATEGY

1 / Context:
There are almost 180,000 admissions to ICU in the UK each year. More patients are now surviving ICU and being discharged from hospital, which will have a significant impact on healthcare utilisation as well as an increasing societal burden.
Research demonstrates that many patients have a poor quality of life following an intensive care admission, and it is now well recognised that families and caregivers of those patients who have been critically unwell, also suffer psychosocial morbidity in the years and months following intensive care discharge.
There is a small body of evidence emerging which demonstrates that patients and family members who have been through ICU appreciate meeting others with similar experiences. Historical trials focussing only on patient education, the use of ward rehabilitation assistant and one off follow up appointments have not shown quantitative improvement in outcome.
The InS:PIRE project 2014-2016 at Glasgow Royal Infirmary was funded by a SHINE grant from the Health Foundation. It trailed an intervention that included peer support and support for family members, and promoted self-efficacy and the utilisation of existing community services. This was successful in demonstrating an improvement in patients’ self-efficacy and how 'in control' they felt about their health and wellbeing, as well as a reduced cost per Quality Adjusted Life Year for participants.
In 2016, the InS:PIRE project was awarded an additional grant from the Health Foundation to scale the intervention to additional hospital sites in Scotland. These are Crosshouse Hospital (NHS Ayrshire and Arran), Monklands General and Wishaw General (NHS Lanarkshire), Victoria Hospital (NHS Fife) and the Golden Jubilee National hospital in Clydebank. The intervention will also continue at Glasgow Royal Infirmary.
This communication and engagement strategy and plan aim to support the delivery of the Health Foundation funded Scaling Up programme 2016-2018 by establishing clarity around the programme purpose and objectives, growing awareness and commitment, and fostering the capability for transformation change to be implemented and sustained.
This strategy and concomitant plan address the information and engagement needs of all stakeholders: both internal and external.
2. / Objectives:
  • To raise awareness and understanding of Post Intensive Care Syndrome, the InS:PIRE intervention, and the positive changes and benefits that InS:PIRE will bring to patients and their families / carers, healthcare professionals, NHS Boards, and society as a whole
  • To encourage patients and families who have experienced a stay in intensive care and potential volunteers to get involved in the work of the programme
  • To engage staff within the InS:PIRE implementation teams, keep them up to date with progress and to enhance implementation team capability with provision of information and materials
  • To manage expectations and perceptions by providing a realistic and consistent view of the work of the programme and of what will be happening and when
  • To foster collaboration and partnership within and across sectors around aligned objectives, develop devolved networks and disseminate the tools and knowledge necessary to sustain change
  • To ensure that InS:PIRE is viewed as a necessary and cost effective service that is strategically aligned locally and nationally, person centred, safe and effective
  • To ensure communication is focused, consistent, timely and effective

3. / Audiences
  • Implementation teams across NHS Greater Glasgow and Clyde, NHS Lanarkshire, NHS Ayrshire and Arran, NHS Fife, Golden Jubilee National Hospitals
  • NHS Board management teams and clinical leads within each of the implementation areas
  • Patient, family and carers who have experienced a stay in ICU in each of the implementation areas
  • Scottish Government clinical and policy leads
  • Scottish Intensive Care Society
  • Healthcare Improvement Scotland
  • Third sector partners
  • Volunteering managers across NHS implementation areas
  • Clinicians and academics within or aligned to critical care or having an interest in rehabilitation – UK and international
  • General public

3. / Key Messages
  • After an Intensive Care Unit (ICU) admission, patients often experience persistent physical, psychological and social symptoms commonly referred to as Post Intensive Care Syndrome (PICS). PICS increases healthcare costs and causes significant burden to individuals, their caregivers and society.
  • InS:PIRE is a five week rehabilitation programme aimed at patients and caregivers who have experienced a stay in ICU: focussing on patient education, peer support and facilitation of self-management. A learning and reflecting session is held at the end of every five week cohort, allowing the intervention to be continually improved using participant feedback.
  • InS:PIRE was successfully prototyped at Glasgow Royal Infirmary 2014-2016 and demonstrated an improvement in patients’ self-efficacy and how 'in control' they felt about their health and wellbeing, as well as a reduced cost per Quality Adjusted Life Year for participants.
  • Between 2016 and 2018, the intervention will scale to additional hospital sites in Scotland. These are Crosshouse Hospital (NHS Ayrshire and Arran), Monklands General and Wishaw General (NHS Lanarkshire), Victoria Hospital (NHS Fife) and the Golden Jubilee National hospital in Clydebank. The intervention will also continue at Glasgow Royal Infirmary.
  • The programme will produce the following key deliverables:
  • 37 five week rehabilitation cohorts over a 2 year period (2017-2018) across six hospital sites in Scotland
  • 5 national quality improvement learning sessions and an evolving InS:PIRE community of practice
  • Materials to raise awareness of PICS and to support patients and families who have experienced a stay in ICU
  • InS:PIRE Pack containing the information required for the intervention to be implemented elsewhere
  • Evaluation report including health economic assessment
  • A service blueprint for the west of Scotland
  • Anticipated benefits of the programme are:
  • Patient and families – feeling more in control of health, improved psychological and physical outcome measures and reduced carer strain leading to improved overall health and wellbeing
  • Reduced unnecessary / over treatment and increased linkage of patients and families with community sources of support
  • Reduced harm / risk of harm as a result of inappropriate medication
  • Improved awareness of Post intensive care syndrome among health and social care staff and the general public
  • A reduction in unnecessary variation in practice and outcomes across the west of Scotland region
  • The programme aligns to the following national policies and strategies:
  • Realistic medicine (Chief Medical Officers Annual Report 2014-2015), The Healthcare quality strategy for NHS Scotland 2010,
Health and social care integration:
  • Shared decision-making – multi-disciplinary and integrated cross sector (health, social care and third sector) teams work together with cohort participants to co-create personal outcomes goals and support decision making about sources of support, diet, exercise, and strategies for self-management.
  • A personalised approach to care – components of the programme are tailored to meet individual needs and preferences, based on what matters to each participant.
  • Reducing harm and waste – team pharmacists conduct a medication review, thereby reducing the risk of harm from continuing unnecessary medication or adverse incidents due to interactions between prescribed drugs. Iterative quality improvement cycles refine the overall intervention to maximise efficacy and efficiency.
  • Reducing unnecessary variation in practice and outcomes – Taking an evidence based approach, the InS:PIRE intervention is continually improved with support from quality improvement fellows. National learning sessions allow teams to share best practice, reducing unnecessary variation between team sites while allowing for necessary variation due to local population requirements.
  • Becoming improvers and innovators – teams are supported to continually improve by quality improvement fellows, and encouraged to develop local improvements to the intervention according to need. Capacity is built across teams to create and sustain improvement.

4. / Communication Tools and Activities Approaches
 Face-to-face: Boards and sub-committees, user groups/public forums, team and individual meetings, conferences, seminars, learning sessions, presentations, inductions and training sessions.
 Print-based. Leaflets, posters, pop up banners, website cards, branded post-it notes
Electronic and audio-visual: Programme board papers, staff newsletter, press releases, films, blogs, periscope, tweets, stories and stakeholder quotes, learning journal, storify, documentary, academic publications, patient opinion feedback
Information push –presentations/briefings, newsletter, emails, tweets
Information pull – InS:PIRE external website with staff secure area and local Board intranets
Standardise formats/style – InS:PIRE logo on all programme communications and materials
5. / Evaluation & Amendment
An external formative and summative evaluation will be carried out by a team from the University of Aberdeen.
The communication strategy and plan will be monitored and amended by the programme manager based on feedback from implementation teams and stakeholders and formative reviews by the external evaluation team.
Author / Jane Ankori, InS:PIRE Programme Manager
Date / 22 December 2016
Version / 1.0
Template / Health Foundation