Using Discovery Interviews to Improve Care

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• Using Discovery Interviews to Improve Care
• AMI/ACS national conference 10th June 04
• Vanessa Lodge
• National Manager (London and SE) - CHD
  Collaborative

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Ways of involving patients

• Patients as teachers
• Focus groups
• Patient representation
• Expert patient
• Citizens panel
• PPI forum
• Patient survey
• Comment cards/audits/questionnaires
• Website
• Patient diaries
• Infiltrating other public forums

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Goal of the CHD Collaborative

• To improve experience and outcomes for patients
  with suspected or diagnosed CHD by optimising
  care delivery systems across the whole integrated
  pathway of care.

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Aim of the Discovery interview

• To identify realistic and manageable
• ways for clinical teams to learn directly
• from their patients and carers about
• their needs so that they
• can be met better.

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Power of the story
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DISCOVERY INTERVIEWS Semi-structured interviews
of patients and their carers. Based on key
stages of their journey through their illness.
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CHD DISCOVERY INTERVIEW SPINE Thinking
something was wrong Seeing someone in the
NHS Having tests to find out what was
wrong Being told what was wrong Receiving
treatment Getting better Living with your
condition Being followed up
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Possible responses to hearing a story

• A change that is so small and obvious that it can
  be immediately implemented.
• A change that requires more attention by the team
  providing care, and for which using the Nolan
  framework as a guide will enhance the chances of
  learning and success.
• A question that requires more investigation
  before any change is made.

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Patients and carers needs CHD

• Ability to recognise symptoms.
• Receive appropriate information - timing,
  delivery, quality, consistency.
• Involvement in the care process and decision
  making, including carers.
• Financial burdens.
• Treated with courtesy and kindness.
• High levels of anxiety - need for psychological
  support.
• Impact on peoples lives - patients and carers.

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Implemented changes from patients and carers
stories

• Carers support group established.
• Patient booking into one stop follow-up clinic.
• Cardiac Rehab Nurse contacts patients 4 days
  after discharge -someone to talk to.
• Drop-in Clinic.
• Cardiac Navigator role.
• Development of buddy/befriending service.

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Putting the patient at the centre
Power of the story
Value judgement free
Patient inspired improvements
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• Any Questions
• Vanessa.lodge_at_npat.nhs.uk
• www.modern.nhs.uk/chd