Summary of Patient Survey Resultsfor the
Inpatient Unit,DayHospice and Community Palliative Care Team
2011 –2012
Introduction
At St Barnabas House we welcome feedback on the service we provide in order for us to understand what is working well, and areas where improvements can be made. One system in place includes conducting an annual patient survey. This provides feedback in a more formal way from patients that use the services. As well as being a central requirement from our inspecting body – the Care Quality Commission – this structured process provides St Barnabas with a valuable insight into how we can improve the services that we offer.
Methodology
Questionnaires for the three main services – In-patient Unit, Day Hospice and Community Palliative Care Team were developed internally and disseminated to the three respective sample groups over a three month period. Sample group selection was defined by patients using these services at the time
The in-patient unit undertook this throughout January, February and March. A total of 35 questionnaires were given to patients discharged from the unit, out of these 20 were completed and returned (57%).
Day hospice undertook this throughout January February and March. A total of 60 questionnaires were given to patients attending the unit, out of these 46 were completed and returned (76%).
The Community Palliative Care Team undertook this throughout January, February and March. A total of 150 questionnaires were posted out to patients on the caseload, out of these 40 were completed and returned (27%).
Survey Results
The attached reports(appendix 1, 2 & 3), provide a summary of the surveys undertaken across the three main clinical services at St Barnabas House. These include specific questions and responses.Whilst feedback regarding services and facilities provided by St Barnabas House indicates that generally patients are extremely satisfied with care they received, specific areas highlight where we can progress change. The specific feedback we can address includes:
Inpatient Unit
“rooms are lonely and isolated at weekends”
Some patients found the single rooms lonely and isolated they would have liked more opportunity to interact with other patients. We plan to update the patient information so that patients are informed of this prior to admission and can ask family and friends to visit at weekends. Discussions have taken place with the voluntary services co-ordinator for ward volunteers to host afternoon tea in one of the ward sitting rooms for those patients who would like to attend. This will initially be piloted on weekdays to ensure the volunteers are well supported and then be extended to include weekends.
“did not know how to use the light switches”
The nursing team normally tell patients on admission how the nurse call and patient entertainment system work, this will be extended to include explaining how the light switches at the bedside work. The patient information on the patient entertainment and in-patient unit booklet will also be updated to include this information.
“more hot drinks would be nice”
The ward volunteers will be asked to offer patients extra hot drinks between the regular drinks round. The patient information on the patient entertainment and in-patient unit booklet will also be updated to explain that hot drinks are available at any time and advise patients to ask a volunteer or ring and ask a nurse.
“helpful if people were told they need to bring in toiletries”
The patient information leaflet for the in-patient unit will be updated to ensure this is explained. This will also be explained to health care professionals who are involved in requesting and organising admissions in order to allow them to ensure that patients are well prepared and informed prior to admission.
Day Hospice
“be nice to have a separate ladies toilet”
This is currently under review between clinical and facilities staff. It is anticipated that a decision will be made on this by Summer 2012. There are currently 3 mixed use toilets on the unit.
“helpful if you sold cards at Reception?”
This has been fed back to the Senior Management Team and is currently being looked into. It is anticipated that a decision will be made on this by Summer 2012
“hairdressing service would be useful”
After consideration it has been agreed to convert the existing shower facility in Day Hospice into a hair dressing facility. Work is due to commence on this in July 2012 and should be complete by September 2012
“could we have more Communion?”
This has been looked at with the hospice Chaplain and it is now possible for patients to have communion with the Chaplain on any day except Friday. This is not possible because of the weekly chapel service that is held. This has been reiterated to patient’s currently attending the unit.
Community Palliative Care Team
“more contact would be welcome”
For patients seen by the team a form clarifying the level of support for each patient is completed to ensure that patient expectations are balanced with specialist needs and priorities. Awareness within the team to clarify patient expectations is addressed at monthly team meetings.
“did not feel involved”
Whilst it is difficult to comment on this without assuming what the patient might mean they have not felt involved with, both nurses and doctors are aware of the critical need to involve patients in conversations regarding treatment, care and management plans.It is a requirement that staff give patients opportunities to discuss their preferences and that these are documented in the patient’s file. This will be discussed within the team meeting to confirm that this is happening.
“plenty of chat but they cannot do much in between”
Engaging with patients and forming rapport is an important part of the specialist nurse role. In supporting patients there needs to be identified reason/specialist need for contact to be made. This should be clearly documented in patient records. The way the service responds to more urgent needs is currently under review as part of a service review programme.
Conclusion
We have used internal questionnaire tools for our annual surveys, and we have purposely focused on gaining more information from the people that we serve. It isencouraging to receive such positive feedback through this undertaking but we are also aware that there is room for improvement. It is only through maintaining an on-going focus on feedback from people that use our service that we can remain in touch with understanding what people actually want from us. As diverse as this feedback may be, we need to be confident that our aspirations are needs led and patient centred.
APPENDIX 1
INPATIENT UNIT PATIENT QUESTIONNAIRE 2011
The questionnaire was given out to 35 patients discharged from the Inpatient Unit. There were 20 (57%) questionnaire returned. The results are summarized below.
1. How long did you have to wait for admission to the Inpatient Unit once a bed had been requested?
1 day 7(35%)
2-3 days 6(30%)
4-7 days 4(20%)
1 week > 3(15%)
2. Was this wait acceptable to you/your family?
Yes 17(85%)
No 3(15%)
3. Was there any information that would have been useful to you on your arrival?
- What to bring in – soaps, towels, etc
- Whether there is Wifi access
- How to use the light switches
4. Were you able to speak to a nurse or doctor easily
Yes 20(100%)
No --
5. Did staff involved in your care introduce themselves when they met you for the first time?
No---
Some of the time---
Most of the time 5(25%)
Always 15(75%)
6. Did staff involved in your care explain what they were doing?
No---
Some of the time ---
Most of the time 5(25%)
Always 15(75%)
7. Overall, did you have confidence in the staff who were caring for you?
No---
Some of the time---
Most of the time 6(30%)
Always 14(70%)
8. Did you feel you were involved in planning your care?
No---
Some of the time---
Most of the time 7(35%)
Always 13(65%)
Can’t remember---
9. Did you feel fully supported in any decisions you had to make?
Yes 13(65%)
No---
Not sure---
Never had to make any 7(35%)
10. Do you have any suggestions on how we could involve you more?
No 4(20%)
Information on activities 1(5%)
Activities in the sitting room 4(20%)
More to do at weekends 5(25%)
11. How effectively did you feel the Inpatient Team responded to your individual medical and nursing needs? (1 = poorly, 5 = very well)
1 ---
2---
3 ---
44(20%)
5 16 (80%)
12. In general, did you feel you were treated with respect?
No ---
Some of the time---
Most of the time---
Always 20(100%)
13. Do you feel your privacy was respected, for example, when being examined or during discussions with staff?
No ---
Some of the time---
Most of the time4(20%)
Always 16(80%)
14. Did you have the opportunity to ask questions whenever you wanted to?
No ---
Some of the time---
Most of the time5(25%)
Always 15(75%)
Can’t remember---
15. Did you have enough time to make decisions about your care?
No ---
Some of the time2(10%)
Most of the time8(40%)
Always 10(50%)
Can’t remember---
16. Are there any improvements to existing activities/therapies or any additional ones you would like to see?
More complementary therapy 5(20%)
17. How has being in the Inpatient Unit made you feel?
- Less stressed that drugs are now right
- More confident
- Safe
- Meds sorted
- Relaxed, happy and well looked after
18. What has helped and what hasn’t?
- The staff have helped
- Peace and quiet
- Able to relax
19. How did you feel about the room you were in?
Best
fridge 2(10%)
clean, good outlook and comfortable 5(25%)
Worst
loneliness 5(25%)
light switches
20. Please comment on the catering service, menu offered and how well the catering staff responded to any special requests
- Appetising
- Excellent 8(40%)
- Responsive
21. What improvements, if any, to the catering service would you like to see?
- Another hot drink in the morning
- More hot drinks
22. Please comment on the standards of hygiene in the Inpatient Unit
- No complaints
- Very good 2(10%)
- Wipe switches more often would be good
23. Were you told how to make a complaint, if you needed to?
Yes 8(40%)
No---
Can’t remember12(60%)
24. While in our care, were you told how to call for help?
Yes 20(100%)
No---
Can’t remember---
25. If you needed to call for help, were you satisfied with the response?
No ---
Some of the time1(5%)
Most of the time7(35%)
Always 12(60%)
Did not call for help----
26. Did you find the patient information helpful?
No ---
Some of the time---
Most of the time8(40%)
Always10(50%)
Which?2(10%)
27. Can you suggest any further information which would have been helpful?
No suggestions
28. Do you have any more comments or suggestions to help us develop our services?
- Better signposting from the road
- Wish I could stay
- Not have to move on
- A trolley selling toiletries, sweets, etc
Conclusion/action points
The feedback was very positive overall but a few areas need to be improved moving forward.
1)Respite patients feel lonely and bored in their rooms at times, particularly at weekends.
2)Patients do not know how to use light switches.
3)Signposting from the road needs to be re-examined.
4)There is a lack of confectionary for patients.
5)Patients do not know what to bring in.
6)Patients would like more hot drinks
Sam Bennett, Ward Sister
April 2012
APPENDIX 2
DAY HOSPICE PATIENT QUESTIONNAIRE 2012
The 2012 Day Hospice Survey was evaluated in January, February and March 2012 with patients receiving support from the service. The approach taken involved nursing staff from the Day Hospice team giving the survey form to patients thought to be well enough to complete it. Where patients were unable to complete the form themselves, carers were asked to give their views.
A total of 60 survey forms were given out to patients, with 46 of these completed and returned.With the form, patients were given an envelope addressed to the Day Hospice Team Leader. Patients were made aware that they could answer confidentially thus ensuring complete anonymity.The overall results are extremely positive and show how much the patients value the services offered by the Day Hospice department.
Results
The total number of responses from patients and carers throughout the three month period was 46. The following answers detail the breakdown of responses given.
- AgeGender
18-30 (0)Male – 22
31-50 (3)Female – 24
51-70 (7)
71-85 (25)
86+ (11)
- Before your first visit to the Day Hospice, were you given a Day Hospice leaflet?
Yes – 37
No – 4
Can’t remember – 5
- Did you find the leaflet helpful?
Yes – 38
No – 1
Didn’t look at the leaflet – 4
- Did you feel anxious at the start of your first visit to the Day Hospice?
Not anxious at all – 30
Extremely anxious – 11
Can’t remember – 2
- Did you feel anxious at the end of your first visit to the Day Hospice?
Not anxious at all – 42
Extremely anxious – 1
Can’t remember – 2
- Was there anything we could have done to relieve your anxiety?
No – very friendly. Time was a good way. To be introduced to other people attending. It was a bit like first day in a new job. Nothing can get better than this. I was a little unsure about the routine of the Day Hospice but I think that was a normal feeling. Everyone welcomed me and put me at my ease. I felt comforted on my first visit to the Day Hospice with the kind care received.
- Have you used the transport organised by the hospice?
Yes – 41 No – 3
a)Was the journey comfortable?
Yes – 42
No – 2
b)Did you feel safe?
Yes – 42
No – 0
- Do you have any other comments on the hospice transport?
I’m very grateful that it’s available, as it gives my carer the whole day to himself. Very satisfactory. Drivers are all first class. Some drivers have air fresheners, which could have an adverse effect on some people. Good service. Excellent. Very good careful driver, always helpful. Driver courteous and helpful. Driver’s very kind. Wonderful driver – very attentive, always on time.
- Whilst you were in the Day Hospice, did the staff involved in your care introduce themselves?
Never – 0
Sometimes – 2
Always – 43
- Do the Day Hospice staff explain what they are doing?
Never – 0
Sometimes – 5
Always – 41
- Overall, do you have confidence in the staff who care for you?
Never – 0
Sometimes – 1
Always – 45
- Overall, how satisfied were you with your involvement in planning your care?
Dissatisfied – 1
Satisfied – 14
Very satisfied 31
- How supported did you feel when a group member died?
Unsupported – 1
Supported – 11
Well supported – 17
No-one in my group has died – 15
- Did you feel you were treated with respect during your visits to the Day Hospice?
Never – 1
Sometimes – 0
Always – 45
- Did you feel staff made an effort to meet your individual needs and wishes?
Never – 1
Sometimes – 3
Always – 42
- Did you feel confident there were enough staff and volunteers to offer help if needed?
Some of the time – 2
Most of the time – 10
Always – 31
- Overall quality of catering (1 = poor / 5 = excellent)
Choice
1 – 0
2 – 0
3 – 3
4 – 12
5 – 25 / Presentation
1 – 0
2 – 0
3 – 3
4 – 6
5 – 31
Portion size
1 – 0
2 – 0
3 – 3
4 – 7
5 – 34 / Taste
1 – 0
2 – 0
3 – 2
4 – 10
5 – 28
- Please comment on the range of activities available
Good range – busy in the mornings. Good though varies on different days. Excellent –something to suit everyone. I enjoy being with other people, whatever activities I may be able to take part in is a bonus. Activities are entertaining. Felt happy and included. Love dominoes and word puzzles. On the whole very good. I would like more activities that involve patients. Enjoy photography with Stevan’s help. More crafts and involvement games. Very varied. Very good at keeping the brain active. Nice to be with people in the same boat. Photography, reflexology, chapel service, group activities – especially general knowledge quizzes have all proved very helpful and enjoyable. Good but it doesn’t give enough time to read the paper and chat.
- Please comment on the general environment and surroundings
Very good. Excellent. Tasteful. Very comfortable, relaxing and accessible. Wonderful. Warm and friendly. Splendid surroundings. Looking forward to seeing spring blooms in the garden. A very happy place. Restful and quiet. Very comforting and comfortable. Cannot be faulted. Good but lounge is like being in a corridor, would have been better if group were in a circle. Dining area ok. Excellent – like a club. Clean and tidy. Pleasant and well planned. Cannot fault staff or Day Hospice. Would be nice to have a separate ladies toilet. Do feel all the security restrictions limit us. In the old hospice we could wonder about without needing staff to be available to let us in and out.
- Did you have the opportunity to ask questions when you wanted to?
Yes – 41
No – 1
Didn’t need to – 2
- Do you think your attendance at the Day Hospice has been beneficial to you?
Yes – 44 No – 0
a)If so, why?
Helps to mix with other patients in similar circumstances. I live alone and it’s nice to meet people. Good company. Met some lovely people, beautiful environment, great atmosphere. My trips to the hospice give me something to look forward to, as my time at home is spent sitting in the same chair all day. It breaks up lonely days at home. Gives us plenty of opportunity to chat to other people and to discuss problems with our nurse. Excellent lunch. Feel supported. Helps to take your mind off your problems. Gives my husband a little rest. Makes me feel really good and confident. Sleep better at night and feel more relaxed and rested. Enjoy refreshments and meals. Positive atmosphere. Family happy I am looked after. It helps me switch off from thinking and planning. Gives my mind, body and soul complete relaxation. Reason for being motivated. Being monitored how I’m progressing. Given me support and understanding of my illness and knowing someone cares. Kindness of nurses and staff. Even more beneficial in winter.- Did you find the Complimentary Therapy service beneficial?
Yes, very good. Best bit of the day. Helps greatly with my peripheral neuropathy. Very therapeutic and relaxing. Very comforting. No - do not want any. Much enjoyed – very relaxing atmosphere. Massages give me relief from stress. Therapy helps me to relax.
- Did you find the Chaplaincy service helpful?
Yes – I attend every week. Stephen is so easy to talk to and he is a good listener. Much enjoy my visit with Stephen – very comforting and peaceful. Have not been. Very helpful. Stephen and Ros are so good. Giving me a greater understanding to life. Have found it comforting. Yes ‘cos no pressure re religion but thought provoking.
- Did you find the Physiotherapists input useful?
Yes, I have degenerative/arthritic ankle – so very useful. Very good but not quite enough. Very soothing and helpful relief. Exercises are very helpful. Excellent. Was very worth it. The exercises are helpful in keeping us as supple as we can be and to keep our mobility as best we can. Yes – given exercises to help with painful knees.
- Do you have any suggestions about how we could improve the Day Hospice service?
A hairdresser would be really useful. The service could not be better. Could be more adult. Turn the heating down – too hot. Reinstate the hairdresser and sell cards again. Tee must be an organisation which could provide cards at a price, which would provide a profit for the hospice. No – very content. Would be nice to have communion, as I can’t get to church – our vicar not very supportive. More speakers. I find it hard to get to know people, as visitors seem to sit in the same seats. Possibly a little more choice in menu e.g. soup or salad. More toilets. More handrails for us with bad balance.
Findings