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  • Sensitive Services – what matters most in end-of-life care? - Picker Institute Europe
    difficult topic And it s a good approach Patients should if they wish be able to express their experiences no matter how emotive and intricate the issue It is about encouraging real patient stories to be told freeing the individual s voice so that they feel comfortable to articulate in their own words what matters most to them To achieve this we must ensure people are able to share their stories in a way that makes them feel at ease and in control As researchers in this field we re all passionate about our research being more than just words on a page instead aiming for it to have a positive impact For me that means our work is used to drive better care All experiences matter But when looking at end of life care we must remember that this will be one of the last experiences a person may have It can and will have a significant impact on wider experiences for both the patient and the people around them Our work raises a key consideration when looking to deliver high quality end of life care Simply care services do not go far enough in understanding identifying and adapting to individuals emotional and support needs We have found upon diagnosis patients fell in to four categories each of which requires differing levels of support At peace and accepting of what was to come Unwilling to discuss but accepting Showing anger and sadness but understanding the diagnosis Denial of their diagnosis These cases more than any other highlight how health and social care is where the personal meets the professional where systematic processes meet individual emotions Better understanding and identification of these states will help care givers plan and deliver their approach in a way that better meets people s

    Original URL path: http://www.pickereurope.org/news/blog/sensitive-services-matters-end-life-care/ (2016-02-12)
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  • The NHS friends and family test rebooted: a vast improvement but it could be better - Picker Institute Europe
    been listening The further acknowledgement that the test s relative results shouldn t be used as a basis for performance related payments or publicly presented in a way that suggests comparability also goes some way towards addressing concerns about FFT s use in comparisons and restoring its credibility However critics of the existing headline FFT score based on the Net Promoter Score concept are unlikely to embrace the news that it may potentially be replaced by an even more contentious hospital star rating system akin to that used by Amazon and Trip Advisor Not only could this encourage patients to make direct comparisons between hospitals on the basis of a tool that is ill equipped to inform such insights but more worryingly it could be detrimental to provider reputation and staff morale as some hospitals inevitably become saddled with negative ratings and low rankings Similarly whilst the review acknowledges that FFT is best used for improvement and not direct organisation comparisons NHS England finds itself in the tricky situation of still having to justify how it may be sensibly used to inform patient choice Nowhere is this tension more clearly highlighted than in the following quote in order for its use for public choice to be maximised FFT data should be presented to the public in a much clearer and understandable manner albeit one that does not imply direct comparability of FFT data between trusts 1 This leaves us contemplating how exactly the test s incomparable data should inform our choice of provider How much impact has FFT had Next we re left musing on the incremental benefits of the FFT Some in the sector may raise an eyebrow at the factors identified in the review as determining the effectiveness of FFT as a feedback mechanism to drive local improvements including for example the leadership and culture of considering patient experience data prior to FFT Cynics may even raise the other eyebrow when reading that in wards and departments that previously lacked a culture of collecting and responding to patient experience data FFT may take longer to become embedded and used as effectively as possible 2 The review therefore raises big questions about the size of the FFT s benefits in comparison with its costs particularly when it acknowledges that more external support for larger scale data collection and analysis and potentially further technological investment may be required as the test is rolled out further Clarity appears to come on the subject of the weight of expectation on the FFT as NHS England suggests development of an information strategy which comprises the full set of complementary patient experience channels and tools However viewers of one of the videos that accompanies the review may be left with an uneasy feeling of deja vu when NHS England s National Director for Patients and Information tells us he believes the roll out of the FFT later this year will come to be seen as one of the most important turning points in the

    Original URL path: http://www.pickereurope.org/news/blog/nhs-friends-family-test-rebooted-vast-improvement-better/ (2016-02-12)
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  • Blog - Picker Institute Europe
    Maternity Survey Mental Health National Survey Programme NHS NHS England parents Partnerships patient experience Patient Experience Network Awards Patient feedback Patient Opinion PEN Person centred care Policy politics principles of patient centred care Quality Royal College Midwives Ruth Evans Safety self management service user feedback Shared Decision Making Sickle Cell Disorder Social Media Staff the King s Fund Transition Transparency Trends Waiting Times February 2016 January 2016 December 2015 November 2015 October 2015 September 2015 August 2015 July 2015 June 2015 May 2015 April 2015 March 2015 February 2015 January 2015 December 2014 November 2014 October 2014 September 2014 August 2014 July 2014 June 2014 May 2014 Dr Andrew McCulloch Giuseppe Paparella Steve Sizmur Bridget Hopwood Steve Bough Chris Graham Phil Stylianides Amy Tallett Vincent Coole Amanda Attwood Sir Donald Irvine CBE MD FRCGP FRCP FMedSci Previous 2 of 2 Next 5 November Dr Andrew McCulloch View Author Biog Close Dr Andrew McCulloch Chief Executive Officer Andrew has been CEO of the Picker Institute Europe since 2013 Previously Andrew was CEO of the Mental Health Foundation Director of Policy at the Sainsbury Centre for Mental Health and an Assistant Secretary at the Department of Health He has a PhD in Psychology from Southampton University He has been a Trustee Chair and Patron of a number of healthcare charities and a non executive Director in the NHS and education sectors Andrew has served on a number of Government advisory committees Andrew s areas of expertise include patient and service user empowerment comparative healthcare policy public health mental health learning disabilities and later life He has been awarded the President s Medal by the Royal College of Psychiatrists in recognition of his contribution to the mental health field Close See all by Author Tackling mental health stigma is a key piece of

    Original URL path: http://www.pickereurope.org/blog/page/2/?tag=healthcare (2016-02-12)
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  • "Patients look for healthcare information online" - healthtalk.org on bringing the internet into the consultation room - Picker Institute Europe
    We have also started tracking how the website has influenced people s decision making during discussions with their doctors We get lots and lots of responses that allow us to not just have the lovely anecdotal individual stories that I have shared with you but also the key numbers to back up those sentiments It s important to know what s working and what isn t so we can deliver the best possible service to our users There are some areas where we are exceeding expectations that I think reflect how our users feel about the website 62 of our played videos are played from start to finish Which for the internet is amazing They aren t long 2 5 mins but people clearly stick around Why are engagement platforms like this so important One of the key reasons people come to our website is that they feel alone If you have just been diagnosed with something or are breast feeding for example you can feel really lonely and isolated It s the concept of it s your problem your issue everyone handles that differently One woman in one of the pancreatic cancer videos said I wanted to know every tube that was going into my body She literally wanted to know everything However there was a man in a similar video who had the polar opposite feeling I normally want to know everything that is going to happen but this time I don t want to know anything b ecause knowing was just overwhelming and upsetting I think whether you go to healthtalk org or find another online platform where you can express yourself or connect with us others in similar situations it s important to know those outlets are there to turn to We have lots of metrics that are impressive but the one I think we are proudest of isn t necessarily the highest number It s 70 70 of people say they leave our website feeling less alone and better prepared for the journey ahead To me that s excellent my favourite number and why I love what I do 85 say it is the best information they have found anywhere which is also great but perhaps more subjective What are some of the most common patient experience issues people share People often have something to say about the care they receive specifically their interactions with doctors Sometimes this is flagged on the website often people aren t just thinking of other patients they have direct messages for healthcare professionals They will speak to camera and say things like Doctors don t do this or stop doing that In other cases they will just want to say thank you And for staff that is massively encouraging The thing that I have found most impressive is the sheer diversity of experiences available There isn t necessarily a common issue that comes up over and over again We have roughly 25 000 videos so there is plenty of room for variation Everything is spoken about So if you want to see how pets are important to patients or how patients are interacting with the internet etc it s going to be there A healthcare professional could almost think of us as an archive of possible questions and as a research tool to understand what patients are saying in general There is no agenda it s not overwhelming negative or positive so there is always a balance of experiences which is important from a research point of view Do any specific videos or experiences stand out in your mind Some are really simple Little bits of advice that people want to give to others but they have massive impact My trustee Jane Kirk always remembers one with a cancer patient sharing her advice on chemotherapy She talked about how it makes your skin feel horrible and sensitive so buy the best bed linen you can afford because it will make such a big difference at the end of a day of chemotherapy So it can be as simple as that but the impact on someone about to start a course of treatment is immeasurable The one that really gets me was from a woman who had motor neurone disease discussing intimacy with her husband It was something I even find it difficult to think about and share without welling up Her lack of muscle control meant she wasn t able to be intimate with him physically he could cuddle her but she could no longer cuddle him back She was crying on the video and it s just deeply affecting We ve got lots of sad videos about really emotive subjects covering 93 health conditions such as pancreatic cancer self harm etc However it s not always sad It can be instructional and positive on subjects like breastfeeding and you will have mothers who talk about the difficulties they have had with it but there are also some where they share the sheer joy they felt from the experience The happy ones stick in your mind too Which videos do you have the highest user response to The most visited section of the website is actually symptoms of pancreatic cancer It s a condition that is very difficult to spot and though it s not massively common people worry You will see traffic at 3am from people searching for symptoms probably when they are lying in bed worrying and can t get to sleep at night Motor Neurone Disease tends to be the second most visited for similar reasons Patients are not the only people affected by conditions they have those around them also feel the knock on impact and the number of searches can be magnified by the patient s loved ones looking for answers and trying to help Are there any other ways that you think video communication and video platforms could support care improvement and knowledge sharing On the website the answer is probably no because

    Original URL path: http://www.pickereurope.org/news/blog/around-half-of-the-british-population-are-looking-for-healthcare-information-online-so-lets-work-with-it-luis-carrasquieiro-ceo-of-healthtalk-org-discusses-working-towards-bringing-th/ (2016-02-12)
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  • "We need to change the concept of professionalism, to really keep moving in the right direction." - Picker Institute Europe
    feedback research every five years and draw from only a small sample just does not allow you the opportunity to improve or get a true reflection of the experience that patients are really having Proactive feedback research should be ubiquitous and carried out on an appropriately sized sample continually That way you will be able to extract a summary of that data and learn from it in terms of best practice and it will still feed into annual appraisal and five yearly revalidation I think it is excellent that NHS England now accept that measuring quality of care is important I do not discount the value of this getting measurement on the agenda is the first hurdle But next we have to get better at using that measurement how we do it how frequently we do it and whether we are asking the right questions Which is why I think the Picker Institute Europe are such a fantastic organisation and why I think they are playing a key role in transforming the healthcare service available through measurement They understand that patients should be at the heart of everything a doctor does and deliver the materials and programmes to get that understanding back at the top of the priority list I also think that Sir Donald Irvine has been absolutely instrumental in getting ICF the recognition it deserves Although no longer in practice he has campaigned and worked tirelessly to get the initiative acknowledged and improve understanding of just why it is so important Other than him and Professor Bruce Keogh I am not really aware of many people who have gone to the lengths we have to embed this initiative into practice In your opinion what are the main flaws in the NHS in general Obviously we are up against very challenging cost constraints but we are also living in transformative times and as a health service going through a significant transition phase As a service we have gone from a system of complete non management where doctors can almost do exactly as they chose to one that is now very actively and heavily managed in terms of both individual and organisational performance This dramatic shift inevitably creates difficulties as we are seeing now I also think that as a result of this active management culture some of the targets and priorities that have been put into place and interpreted as being in the patients interest are actually not necessarily and they are to a degreedistorting our view of the profession and the service we give The acknowledgement that being a good doctor starts with core professionalism and the desire to provide a good service that puts the patients needs first making for quality care has actually been lost This lack of individual ownership a reluctance to be the advocate of patient quality while being the interface with patients and ensuring high quality performance is a real problem If you look at the Mid Staffordshire Report it lists the failings

    Original URL path: http://www.pickereurope.org/news/blog/need-change-concept-professionalism-really-keep-moving-right-direction/ (2016-02-12)
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  • Patients everywhere want to be sure they have a good Doctor – and they have a right to! - Picker Institute Europe
    doctors have to follow the same code of conduct and consider what it is patients actually want from them For me Osler s best practice prescriptions are is relevant now as they ever were Being a doctor is not simply about working hard to qualify and then making your own rules standards have to be maintained and where they fluctuate improved How would you describe current patient expectations Like the principles of being a good doctor the principles of patient care have not changed with time Patients have just become more vocal and have more platforms available to them to express them Unlike doctors patients do not and have never talked about professionalism as an entity Instead they see being professional as consistently good doctoring For them good doctors are up to date competent respectful courteous kind empathetic and honest people who will listen to them relate to them do their best to find out promptly what is wrong with them prescribe the right treatment and care for them in a manner which makes them feel that their interests come first Patients want their doctors to be good team players when teamwork is needed All these qualities are essential elements of a trusting doctor patient relationship Trust is imperative You mentioned there being more communication platforms for patients than ever before what are the key ones in your opinion With time comes change and over the course of time the world we live in has simply changed this has naturally effected the way patients gain information There are more healthcare regulations in place to protect patients now and more sources of information both in terms of organisations and general outlets The internet is heavily imbedded in everyday life and for most people social media is as normal as receiving a letter possibly even more so Social media is an instant and effective communication exchange that is gradually helping patients to take control of their healthcare experience When you think about it they now have access to more information than ever about the results of care given by individual clinical teams and clinicians For example today anyone can access the knowledge base of medicine directly without mediation by a doctor just at the click of a button they have access to total transparency about their doctors performance and track record There is more power in patients hands than ever before and because of that they have more choices available about the kind of care they choose There is more power in patients hands than ever before and because of that they have more choices available about the kind of care they choose How do you think Picker Institute Europe and the work conducted by the organisation has impacted patient expectations I think Picker Institute Europe and the like has played a massive role in the transition of patient experience and the doctor patient power exchange Thanks to our late great founding father Harvey Picker the tools and research now exists to

    Original URL path: http://www.pickereurope.org/news/blog/patients-everywhere-want-sure-good-doctor-right/ (2016-02-12)
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  • Informed consent is more than a box ticking exercise – it is a necessity that takes time, consideration and skill to be achieved properly - Picker Institute Europe
    the consequences of not acknowledging or adhering to the principles of person centred care In brief Nadine Montgomery a diabetic mother who gave birth by vaginal delivery experienced a complicated labour which was caused by shoulder dystocia when the baby s head has been born but one of their shoulders becomes stuck Resulting in her son experiencing oxygen deprivation and consequently being born with Cerebral Palsy Shoulder dystocia is acknowledged as having a risk of 9 10 in diabetic mothers particularly those of small stature however the mother involved had argued that she had not been told of the significant risks surrounding her son s birth and the implications of having a natural birth versus a caesarean As a result of her appeal against Bellshill Maternity Hospital Lanarkshire and the subsequent judgement Mrs Montgomery received significant compensation Both the case and its impact have come to be seen as a healthcare milestone and a potential turning point in the physician patient relationship Following the judgement doctors must now ensure that patients are aware of the material risks involved in any proposed treatment and of reasonable alternatives Previously doctors followed the Bolam test which asked whether a doctor s conduct would be supported by a responsible body or medical opinion Though that test will still apply to other areas of medical negligence it will no longer do so for the issue of consent Within the Montgomery judgement no less than five key person centred care principles were violated patient information choice and respect for patient values safety involvement and communication showing both the role each plays in the care process and how they work in unison The high profile nature of the judgement and consequent events put the issue of decision making and service user autonomy firmly under the spotlight and into the consciousness of healthcare professionals at all levels But how are we going to embed good practice around consent more firmly in our healthcare system According to this week s 2015 NHS National Maternity Survey findings only 72 of women responded that they felt they were always involved enough in decision about their care during labour and birth down 7 on 2013 results This result shows that in maternity care specifically involvement and decision making remain an area in need of urgent improvement As outlined in the judgement itself service user consent amounts to much more than a signature at the end of a promptly filed form and actually takes a lot of time consideration and skill to be done properly Getting it right starts with acknowledging that person centred care is the only way to effectively provide quality treatment and subsequently taking responsibility for providing it by building and driving a culture that enables it Like anything viewed with hindsight learning from and changing behaviours based on past events and experiences allows a tragedy to become an opportunity and for a negative situation to have a positive outcome If used and understood in the right way Nadine Montgomery

    Original URL path: http://www.pickereurope.org/news/blog/informed-consent-is-more-than-a-box-ticking-exercise-it-is-a-necessity-that-takes-time-consideration-and-skill-to-be-achieved-properly/ (2016-02-12)
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  • Blog - Picker Institute Europe
    Filter by author A E Age UK Oxfordshire Always Events care coordination Care quality charity Children and Young People Circles of Support collaboration Commissioning communication Community Mental Health Survey Cultural Change Dementia Election 2015 End of life care families Friends and Family Test Health and Social Care health and social care policy Healthcare Healthtalk org Healthwatch Oxfordshire Individual Clinician Feedback informed consent Inpatients Survey Internet Involvement ISQua Jeremy Corbyn Labour Labour Party Conference learning disabilities Long term Conditions maternity Maternity Survey Mental Health National Survey Programme NHS NHS England parents Partnerships patient experience Patient Experience Network Awards Patient feedback Patient Opinion PEN Person centred care Policy politics principles of patient centred care Quality Royal College Midwives Ruth Evans Safety self management service user feedback Shared Decision Making Sickle Cell Disorder Social Media Staff the King s Fund Transition Transparency Trends Waiting Times February 2016 January 2016 December 2015 November 2015 October 2015 September 2015 August 2015 July 2015 June 2015 May 2015 April 2015 March 2015 February 2015 January 2015 December 2014 November 2014 October 2014 September 2014 August 2014 July 2014 June 2014 May 2014 Dr Andrew McCulloch Giuseppe Paparella Steve Sizmur Bridget Hopwood Steve Bough Chris Graham Phil

    Original URL path: http://www.pickereurope.org/blog/?author_guest=Veena%20Raleigh,%20Senior%20Fellow%20at%20The%20King%27s%20Fund (2016-02-12)
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