The Musgrove story Our journey towards excellent

patient experience

Martine Price, Head of Patient Experience

Dr Robert Whiting, Consultant Stroke Physician

Our story …

Our journey

A CLEARCLEAR ambition

• Patient safety To achieve zero avoidable harm to patients

• Patient experience To ensure that 95% of patients rate their care as excellent

• Making the most of Musgrove To achieve a reference cost index below 90

Improving patient experience

Learning for improvement

- Patient Safety

- Patient Experience

- Making the most of Musgrove

Zero avoidable harm to patients

95% of patients rate their care as excellent

Reference cost index below 90

Improvement workstream groups

Pathway improvement

groups

The Dunkery Chapter

The Dunkery chapter …

Identifying the problems:

Pathway mapping

Patient shadowing

Staff shadowing

Patient user focus groups

Feedback questionnaires

Key issues:– Getting patients to

stroke unit– Co-ordination of care – Information provision

for patients & families– Discharge planning– End of life care– Staff wellbeing

Patients spending more time in the right place!

Proportion of patients spending 90% of their stay on stroke unit

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Apr-09

May-09

Jun-09

Jul-09

Aug-09

Sep-09

Oct-09

Nov-09

Dec-09

Jan-10

Feb-10

Mar-10

Apr-10

May-10

Jun-10

Jul-10

Aug-10

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

% Achieving

Improvement across key quality indicators

Antiplatelet Therapy within 48 hours

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Swallow Screening within 24 hours

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Physiotherapy Assessment within 72 hours

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Rehabilitation goals agreed by MDT

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Mortality rate

Treated with dignity & respect

Would recommend…

7-day mortality

0%

5%10%

15%

20%25%

30%

35%

40%45%

50%

May-10

Jun-10

Jul-10

Aug-10

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

Mortality rate30-day mortality

0%

5%10%

15%

20%25%

30%

35%

40%45%

50%

May-10

Jun-10

Jul-10

Aug-10

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

Mortality rate

• “What makes a good or bad day?”

• Building “resilience”

• “Snorkel” exercise– Generating new ideas

for service improvement

Staff engagement day

Looking to the future…

What have we achieved

April 2009 May 2009 June 2009 July 2009August 2009September 2009

October 2009 November 2009 December 2009 January 2010 February 2010March 2010 April 2010 May 2010 June 2010 July 2010

August 2010September 2010

October 2010 November 2010 December 2010 January 2011 February 2011March 2011 April 2011 May 2011 June 2011 July 2011

August 2011September 2011

80.0%

85.0%

90.0%

95.0%

100.0%

Target: 95%

April 2010: Point ofCare Project

February 2011: ImprovementNetwork launched

Patient Experience: Always treated with respect & dignity

Our learning

•What’s it like to be a patient at Musgrove•Have a plan – Driver Diagram•Measurement •Leadership•Staff engagement

What next ...