Privacy and dignity champions from across your workforce can enhance the patient experience, explains Alison Moore
Dignity and privacy are often seen as issues for acute hospitals; but community settings also struggle with them, especially in older buildings.
Staff have ownership of it. It’s not just management telling them what to do
One primary care trust’s provider side has tackled numerous dignity and privacy issues using a network of 40 dignity champions based in six community hospitals to promote change and embed new attitudes among staff. It is now getting very high scores for dignity related issues using a “real time” patient experience tracker system which asks patients for feedback.
The PCT - NHS Eastern and Coastal Kent - is now planning to repeat a privacy and dignity audit it carried out last November. This showed that, although patients had a generally positive experience, there were areas of concern such as the confidentiality of telephone conversations and the availability of appropriate bathing facilities.
Of its six community hospitals, two are new and purpose built but the other four are 1920s war memorial hospitals. Although improvements have been made over the year, the fabric of the buildings can be a limiting factor.
PCT head of quality improvement support service Jane Bromwich describes the approach as both top-down - there is high level support and commitment to the dignity agenda - and bottom-up, in that many of the initiatives come from staff. She says the dignity champions, who come from across the workforce and are not just nurses, are “the collective conscience of the organisation”.
Raising dignity issues
These champions are proving extremely vocal in raising dignity issues with other staff.
“It’s really good seeing a housekeeper say can you knock before you enter to someone like a doctor,” says clinical service manager for community hospitals Gillian Sainsbury.
The changes they are promoting are often small scale but can make a difference to patients quickly. Examples include: notices on bathrooms saying they are occupied and additional privacy measures in toilets; dignity and privacy boards in each ward with information about the campaign; purple pegs saying “do not disturb” hung on curtains around beds; and posters asking staff to ensure sensitive conversations on ward telephones can’t be overheard.
The purple pegs idea was not only initiated by staff but dignity champions sourced the pegs through negotiations with a high street retailer.
Ms Sainsbury says: “Staff have ownership of it. It’s not just management telling them what to do. It comes from them and is much more sustainable.”
Whitstable and Tankerton Hospital staff nurse Rieta Mugford was one of the first dignity champion volunteers and has attended several national study days, feeding this back to other staff through training sessions. She says stopping and listening to what patients want is central to the dignity approach.
“In the beginning we had a little bit of resistance, but we showed by example, shutting curtains and so on. We have also done two roadshows and drop-in sessions for staff,” she says.
“It is working: people are changing.”
The PCT has also been able to get a small amount of central funding which has provided better privacy screening for single sex bays on wards.
Recent work has included converting some store rooms to provide additional bathrooms at one site, which addressed some of the concerns raised in the dignity and privacy audit.
Other actions have included a DVD on dignity used in induction training and a “top tips” leaflet. Public input has been important: a lay member of the PCT health reference group helped develop a questionnaire and sat on an Essence of Care steering group (dignity and privacy issues often overlap with the Essence of Care initiative for nurses).
The PCT is now taking patient feedback a step forward and has piloted the patient experience tracker system. This is being introduced across the community hospitals and its results, as well as being used to flag up problems instantly, will be presented to the board.
“It gives us some real indicators of where to focus and it is real time, rather than waiting for an annual patient survey,” says Ms Sainsbury.
Although the system has only recently been introduced, initial results from the tracker suggest more than 96 per cent of patients feel staff are supporting them and more than 99 per cent feel their ward is clean and tidy.
Meeting patients’ expectations on privacy and dignity is likely to become more important. Ms Sainsbury says as provider sides gain autonomy from PCTs, evidence of high standards will be important in meeting commissioners’ requirements.