Sharon Kidd has managed The Friends and Family Test (FFT) at United Lincolnshire Hospitals NHS Trust since its conception in May 2012. As FFT celebrates its 2 year anniversary we ask Sharon about the implementation journey and patient experience improvements.
1. When the Friends and Family Test was first introduced in April 2013, did you think it would be an effective measurement of patient experience?
The 42 Midlands & East Trusts implemented The Friends and Family Test in April 2012, a year before the national timeline. So in April 2013, we were still quite new to FFT, but beginning to realise it was an actual quantifiable way to measure patient experience. There was a lot of hype and publicity surrounding its entry so this helped build momentum.
The best example I can think of to support this is when CQC identified an underperforming ward flagged through FFT and a new Matron was hired to improve the situation immediately. From feedback, changes were made and the ward went from receiving the lowest response rates to 100% recommend feedback and winning a staff award. This also led to all other key measures significantly improving.
2. What has been the biggest challenge with FFT implementation across the Trust?
Reading the guidance it seemed easier than what it was, but theory in to practise, it was a massive and daunting undertaking!
Staff buy in was really low, actually they hated the admin burden and across 70 wards and 3 A&E’s this was immense! Ownership of FFT implementation at ward level was also a struggle and who was going to collect the responses and enter the data.
3. How did you overcome these challenges?
Initially, we used paper surveys and 3 part time staff were hired to help with the administration and collating data. However, considering the human resources required to reach CQUIN targets this way, paper just wasn’t going to cut it.
Firstly, postcard inputting was outsourced to Healthcare Communications to relieve admin overload and we then looked at other communication channels to increase response rates in a cost effective way with less reliance on internal resources.
4. Your Response rates are above targets, what methods do you use to collect data and is this influenced by demographics?
As the fourth largest acute Trust and the upcoming rollout to Outpatients, Day Case and Paediatrics in August 2014, it was clear we had to move forward with technology to capture quality data despite initial resistance.
We worked with Healthcare Communications who recommended SMS and Interactive Voice Messaging (IVM) to boost response rates cost effectively and this is how we reached our first CQUIN. These channels immediately freed up staff time spent on paper and collating was automatic. Now all patients that provide a mobile number receive an SMS survey and over 75’s automatically get an Agent call.
Patients that provide a landline number receive an IVM. We still use paper, but that combination was how we achieved this quarter’s target and gave every patient the opportunity to provide feedback. Buy in significantly improved with the relief of staff time spent using paper alone.
5. Feedback is overwhelmingly positive, has this had an impact on staff morale?
FFT has improved staff morale immensely and created a friendly internal competitiveness. Staff take the feedback personally and feel proud to receive positive feedback. They question when scores are lower, take it on board and strive to improve next month.
6. How do you collate all that information from so many different communication tools?
Healthcare Communications Envoy Messenger collects data from all communication channels and feedback is shown in real time. We encourage our clinics to routinely login in and check, especially Outpatients and pick up on any data trends.
Monthly ward reports are sent out to Ward sisters and business managers who then decide what actions to take, this is also a vehicle of getting information out to all staff involved.
7. What stands out as some of the best ‘You said, we did’ actions to you?
These actions happen at a ward level and every month each ward displays a poster with response rate percentages and 3 areas of improvement. These plans are visible on noticeboards to keep patients up to date with service development.
Sometimes it’s the small actions that make a big difference. Inpatients feedback flagged tea was always cold when it came to serving the last patients. To overcome this, two pots were used and the tea run was split, meaning everyone now receives hot tea in half the time it took originally.
8. How to you intend to further use data to impact on patient experience?
FFT can’t be the only measurement and themes across a variety of spectrums are required. I’m working with Healthcare Communications combining different measurements to get an overall picture. More effective actions from this information will show we are listening to all patients and acting upon the information received.
9. Any advice to new Patient Experience staff?
To be thick skinned and tenacious, three years on there are still pockets of staff that won’t engage. We focus on the vast majority who are involved and motivated by the feedback.
Over the 3 year journey we still come across unexpected issues such as ways of identifying sensitive patients and it’s a continuous learning process. Sometimes you can only change something as a result of a feedback, you can’t foresee everything.