Last April my mother had to be cut out of her car by the fire service. A car had slammed into hers when she was turning right and a policewoman at the scene said she was surprised mum had survived the accident.
Mum was rushed to the nearest A and E with a smashed femur and a fractured pelvis. They operated the next morning to pin her leg but she then had to spend longer in intensive care with chest complications. Mum spent a week in the hospital and was then transferred to the orthopaedic ward of her local hospital for more intensive physiotherapy.
My mother is 78 and her name is Carolyn Aston. She is warm and loyal and is deeply loved by her friends and family. She is also one of the most determined people I know and is fiercely independent – so it was a shock to discover that she did not feel safe in hospital. She felt she was treated like ‘the broken leg in the far bed’, not like a person at all. She said that sometimes no-one answered her bell when she wanted to go to the toilet. When she did get to the toilet it felt like she was just left there. Meals were ‘dumped on her tray without a word and the person went away, sometimes not even leaving a spoon’. “Have you ever cut up porridge with a knife and fork?” she asked me, a commentary on the quality of the food.
She said that not many nurses smiled or asked how she was. “They behaved like they were doing me a big favour. They were not interested in me as a person at all,” she said. “I remember one of the night staff who took my blood pressure. She was so surly, you would not believe it, and she constantly chewed gum.”
Mum was upset and a little frightened but she was also worried about her treatment. She never knew which physiotherapist was turning up or what time they would come. Mum was in hospital over a bank holiday and therefore did not get physio for three days. This made her worry that she was not making as much progress as she could. “I was just processed, as a number, not a person. It felt as if there was no-one there looking out for me and I wasn’t aware whether I had a named nurse,” she said.
The transfer to the orthopedic ward of her local hospital happened at midnight. At the new hospital, she was asked all the same questions – name, age, GP, details of her injury. And the wrong name was put on her door – Caroline not Carolyn. When she finally left hospital and was wheeled past the nurses’ station, no-one even looked up or waved goodbye. It was if she had never been there at all.
Mum’s experience may not be unusual. It made me think about how a patient’s experience could be different: how could be patient-centred.
What if hospital care was delivered as if patients mattered as people?
- What if you only told your story once and every time a nurse or professional asked you more questions, they were building on what you had already told them?
- What if you were known as a person and people knew a little about what mattered to you as an individual?
- What if you knew a little about the nurses and staff, so that they felt like people as well?
- What if you knew who your ‘team’ was and when they were coming each day, as well as a nurse who was responsible for making sure you were comfortable and had as good a day as possible?
- What if you had an opportunity to tell people safely how your hospital experience was going for you, whilst there was still an opportunity to make it better (rather than a questionnaire after you have left?)
- What if night staff saw their role as helping you sleep well?
- What if you were part of the planning and decision-making about when you transferred or were discharged home?
- What if you were contacted after you arrived home to see how you were getting on?
These are the questions we are exploring with the senior management team, nurses and health professionals at a hospital in Bispham, Blackpool. Here, we have developed a process, our vision of what a truly patient-centred experience could look like, based on my mum’s experience and how it could have been different. We’ll be implementing and refining this process over the next few months.
This hospital in Bispham has made a start. Already, profiles of the nurses and health professionals’ are up on the walls, so new patients can learn about their team and understand more about them as people. Staff have started to ask each patient what is working/not working and what is important in the future. We are still at the beginning of this work but one thing is certain: every single patient who walks through the doors of Bispham hospital will be treated like an important, valued human being – not just a patient with a condition.