Download Experience of Maternity Care - Christine Armstrong

Experience Led Commissioning
Experience of Maternity care
January 2015
Christine Armstrong, Regional Lead 10,000 Voices
Overview of 10,000 Voices
 Context of Patient/Client Experience in NI
 Central to strategic drivers – A Strategy for Maternity
Care in Northern Ireland 2012 - 2018 /Quality 2020
 Response to high profile inquiries
“The patient voice should be heard and heeded at all
times” (Berwick 2013)
Aim of 10,000 Voices
 Improve patient experience
 Influence how services are commissioned
Experience-Led Commissioning
A new model of commissioning
Core Principles of Experience-based Design
 Partnership approach between patients, staff and carers
 Emphasis on experience rather than attitude or opinion
 Narrative and storytelling approach to identify ‘touch
points’
 Emphasis on co-design of services
 Systematic evaluation of improvement and benefits
Experience-Led Commissioning
A new model of commissioning
Experience-based Design is about: 



Capturing the experience
Understanding the experience
Improving the experience
Measuring the improvement
Listening
Regional action plans
and commissioning
priorities
Influencing
Patient stories
Person and
their
experience
Trust action plans
Learning
“Working together to
make positive change”
Improving
Phases of 10,000 Voices
 Phase 1 – Unscheduled care
 Phase 2 – Care in Home
 Phase 3 – Staff experience
Experience of nursing and midwifery care
(regionally agreed Key Performance Indicators)
Experience of Nursing and Midwifery Care Key Performance Indicators (KPIs)
 Consistent delivery of midwifery care against
identified need
 Confidence in the knowledge and skills of the midwife
 Sense of safety whilst under the care of the midwife
 Involvement in decisions about midwifery care
Experience of Nursing and Midwifery Care Key Performance Indicators (KPIs)
 Time spent by midwives with the woman
 Respect from the midwife for the patients preference
and choice
 Midwives support to care for themselves, where
appropriate
 Midwives understanding of what is important to the
woman
Listening to experiences of maternity
care
A Strategy for Maternity Care in Northern Ireland 2012 2018
 A quality maternity service is one which is both safe in
terms of the physical and emotional needs of women
and their babies, takes account of their opinions and
experiences
 Any quality monitoring must include patient
experiences.
10,000 Voices
Experiences of Maternity Care
• Stories collected across all 5 Trusts
• All areas of maternity care
• Experience of MLUs to inform regional guidelines
• Data collected in a variety of settings, for example:
clinical settings/community groups/roadshows
How safe did you feel while being
looked after by the midwife…
I felt safe all the time
I always felt vulnerable and unsafe
It depended on who was looking
after me
How the overall experience of
maternity care was rated



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Strongly positive/ positive – 92%
Neutral/not sure – 5%
Strongly negative/negative -2.5%
Missing data – 0.5%
Stories rated as strongly
positive/positive
Theme – Feeling safe
•
•
•
•
Safe in a crisis situation
Keeping woman and her partner calm and relaxed
Understanding anxiety of first time parents
Providing reassurance
“At all times I felt safe and in a controlled environment”
Stories rated as strongly
positive/positive
Theme – confidence in the skills of midwives
• Professionalism of staff
• Highly experienced staff
• Excellent clinical knowledge
“Professional and personable staff with excellent
clinical knowledge”
Stories rated as strongly
positive/positive
Theme – Communication with women and
their partners
• Introductions and explanations of what was
happening
• Listening to concerns and answering questions
• Keeping woman and partner informed
• Respectful of choices of women
“For each person it is a unique experience , so no
question felt too silly to ask”
Stories rated as strongly
positive/positive
Theme - Providing compassionate care
• Staff going the extra mile
• Dedication of staff to work
• Very helpful and friendly staff
• Made to feel very welcome
• Good teamwork
“We had total trust in the hands of the professionals,
who showed empathy, clarity, integrity and teamwork”
Stories rated as neutral/not sure
Theme – Staffing levels
• Staff overworked
• Staff have a lot of paperwork to complete
• Staff staying on after shift was finished
“Felt that the staff had no time to spare”
Stories rated as negative/strongly
negative
Theme – Staff attitude
• Staff appeared rude and abrupt
• Made to feel uncomfortable
• Not offering enough support
“I experienced a lack of empathy and care that left me in
tears”
Stories rated as negative/strongly
negative
Theme – Communication
• Mixed messages from midwives
• Women felt that they were not being listened to
• More information needed, for example miscarriage,
consent for theatre
“ I wish now that I had been more forthcoming and
demanded that my voice be heard”
Next steps
 Regional workshop and further analysis
 Development of local and regional action plans
 Further period of story collection
Contact details
Christine Armstrong, Regional Lead 10,000 Voices
Email: [email protected]
Telephone: 07711002069