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Patient involvement in improvement: Worthing’s emergency floor project

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Patricia Peal has been Worthing Emergency Floor project’s patient representative since 2014. In this Future Hospital blog, she discusses four key principles for successful patient involvement.

A core aim of the Future Hospital Programme (FHP) is improving health services for patients with patients at the centre of how those services should be designed and delivered. For this to be successful, clinicians and patient representatives need to understand what patient representation and involvement entails.

The FHP works with eight development site teams across England and Wales and supports them in leading local, clinically-led improvement projects. While each project is different in its scope and objectives, all teams are working with patient representatives and volunteers from the Royal College of Physicians' (RCP’s) Patient and Carer Network.

Patient involvement in improvement

When I joined Worthing’s emergency floor project team, patient representation was not a fully established concept for the team and the trust. Patient involvement is not easy and there have been challenges along the way.

Before one team meeting, I received materials only a few hours before the meeting was due to take place, leaving me insufficient time to familiarise myself with the key issues for discussion, and in another meeting, the shortage of ‘cows’ was raised several times. I had to ask for an explanation and found this referred to ‘computers on wheels’.

    ... it is important to foster an inclusive atmosphere where all project team members are able to contribute to discussions and decisions

    Patricia Peal, Worthing Emergency Floor project patient representative

    Being an FHP patient representative

    In my experience with the Worthing Emergency Floor project I have found that good leadership, team cohesion, a clear remit and open communication will go a long way to help create lasting and effective working relationships and achieve successful outcomes. Here are some of my thoughts on each topic:    

    Establish project leadership

    Improvement projects are complex; strong, overall leadership is essential for achieving success.

    • Identify who will lead the improvement project.
    • The project lead should have a clear idea of who they want in the team and why.

    Build a cohesive team

    In order for patient involvement to be effective and valuable, it is important to foster an inclusive atmosphere where all project team members are able to contribute to discussions and decisions.

    • The project lead and its members are responsible for building a cohesive and inclusive team.
    • Everyone involved in the initiative should be introduced to the patient representative(s).

    Identify a remit for the patient representative

    Patient representatives bring their own unique expertise, experience and skills to project teams. The remit of their involvement in the team should be clearly identified from the outset.

    • There must be a clear remit for the patient representative role.
    • Ideally, a role description and time commitment should be agreed and delivered by the clinical lead and/or project manager.
    • A patient representative champion should also be identified to provide support to the patient representative during their tenure.

    Use clear, plain language

    Bear in mind that patient representatives may be unfamiliar with common medical terminology. In order for patients to fulfil their roles to the best of their abilities, the language used in team meetings and correspondence should be written in plain English. Any unclear terminology or abbreviations should be explained and clarified.

    • Patient representatives may be unfamiliar with medical detail and terminology.
    • Patients should be supported by the whole team and given time and opportunity to ask any questions.

    Patricia Peal is the patient representative for the Future Hospital Programme’s Worthing Emergency Floor project.