Patient & whanau centred care standards

Patient and Whānau Centred Care StandardsWhat are 'Patient and Whanau Centred Care Standards'?

The 'Patient and Whānau Centred Care Standards’ have been set up to ensure we provide consistent high-quality patient care. The programme provide a framework to monitor, measure and evaluate key 'fundamental' components of patient care within our hospitals.

What are we trying to achieve?

We want to make sure that patients have the best experience possible when in our hospitals to support their recovery. This means getting the basics right, such as:

  • having consistently clean environments
  • making sure patients feel safe
  • making sure patients receive appropriate observations and monitoring
  • making sure patients get enough rest
  • making sure patients are well-fed
  • making sure patients are comfortable and their pain is well-managed To achieve consistent high-quality care, we want to develop clear standards of care that we expect all patients to receive during their hospital stay. The standards will be measured by observing practice as well as talking to patients and families / whānau and staff, so we will have a broad view of our patients' and staff care experience.

What did we find?

We reviewed feedback from patients, families / whānau and staff and this generally indicated that we do not consistently get the basics right. Some of the key areas of concern identified were:

  • nutrition and hydration
  • environmental cleanliness
  • patient observation and monitoring
  • management of pain
  • communication

In April we conducted a Care Standards audit on 27 wards where staff were observed providing patient care, and the ward environment was assessed. In addition 108 patients completed a survey about the care they received. Here are some of the results from the audit and survey:

Results from Ward Audits:

Fundamentals of Care Audit Observations of General Ward Environment

Results from observations of the general environment of our hospitals' wards conducted by nursing staff showed that:

  • 96% of ward areas were observed to be clean and tidy
  • 96% of staff looked smart and professional in their appearance
  • 89% of wards were observed to be calm and noise was kept to a minimum
  • 89% of wards' patient toilets were observed to be clean

Results from Patient Satisfaction Survey:

Fundamentals of Care Audit Observations of General Ward Environment

Results from our patient survey on categories of care showed that:

  • 88% were satisfied that their personal care needs were met
  • 86% were satisfied with the food and fluid service and the maintenance of their privacy and dignity
  • 85% were satisfied with the level of communication and information provided
  • patients were least satisfied with the management of their pain and comfort and their ability to rest

Below are some of the comments used by patients to describe their experience in our hospital wards:

Comments from Patient Satisfaction Survey

What have we done?

We convened a multi-disciplinary steering group, chaired by the head of department of nursing in the Faculty of Social and Health Services at Unitec, Auckland.  The group helps prioritise work, reviews and tracks progress and reports on progress to our Clinical Governance Board.

We have completed a broad review of our current practice to identify priorities for improvement, including:

  • interviewing staff
  • analysis of patient and family feedback from the Friends & Family Test survey [view more about Friends & Family Test]
  • analysis of complaints
  • developing and carrying out a 'Care Standards' audit across Waitakere and North Shore Hospitals
  • carrying out stocktake of current projects that relate to the care standards

We also completed a review of literature to:

  • define the care standards
  • identify hospitals with similar programmes
  • learn about the factors that affect the delivery of care standards and what is needed to make the programme successful

Areas of Focus

As a result of the literature review and a review of current practice we have identified nine key areas of focus:

Nine key areas of focus for Care Standards

Where to from here?

The nine areas identified for improvement will be the basis of the standards of care that we are establishing. Once the expected standards are defined, in place and improvements made, we will conduct audits within our wards and we will continue to survey our patients to measure results over time.

We will provide an update on progress in next year’s quality account.