Going for gold in Calderdale

Many people experience care that they are happy with because it meets their health needs and personal choices. However, sometimes health care might not meet all of these expectations and needs. To ensure the Trust always meets people’s needs it works hard to ensure improvements are continually sought after inline with the national Essence of Care benchmarking.

Here we look at how services in Calderdale are approaching Essence of Care to ensure a gold standard of practice and care.

Essence of Care, which was first introduced in 2001, is a national initiative aimed at improving the fundamental and essential aspects of care that are crucial to a patient’s experience.

The intiative aims to support localised quality improvement by providing a set of established and refreshed benchmarks supporting frontline care across care settings at a local level. There are 12 benchmarks for all frontline staff in health and social care settings to follow.

What is a benchmark?

A benchmark is an example that shows what care should be like. They are a tool to help healthcare practitioners take a patient-focused and structured approach to sharing and comparing practice.

Care currently being provided by the Trust is compared to the set of benchmarks outlined in Essence of Care to ensure that they match. If they don’t, then the Trust makes on-going improvements to ensure they do.

Following a consultation exercise in 2009, Essence of Care has been refreshed and now contains 12 benchmarks that have been identified by patients, carers and clinical professionals as crucial to a patient’s experience. These are:

• Self care
• Communication
• Personal hygiene
• Bladder, bowel and continence care
• Safety
• Promoting health and wellbeing
• Food and drink
• Prevention and management of pressure ulcers
• Care environment
• Respect and dignity
• Record keeping
• Prevention and management of pain

The Trust has also developed its own benchmarking tools or adapted those above to ensure that they meet the specialist needs of the services provided.

The benchmarking process outlined in Essence of Care 2010, helps practitioners to take a structured approach to sharing and comparing practice, enabling them to identify the best care and to develop action plans to remedy any deficits in patient care.

Calderdale senior nurse manager Grahame Peace added, "People who use our services rightly expect high-quality care and support. Those who are responsible for the provision of this care need to be able to assure themselves that the care and support they give is the best it can be wherever services are provided. Essence of care is used by the Trust’s frontline staff to assess the quality of care we provide and to highlight areas where there is room for improvement."

To help highlight the work that is ongoing around Essence of Care in Calderdale the Dales Unit at Calderdale Royal Hospital in Halifax, held a special information event. Staff from the inpatient wards, crisis team, recovery services, older people’s service and LD services were all part of the event designed to showcase work. It also gave staff the opportunity to talk about the work covered in these areas and to discuss benchmarks that have already been met.

The benchmarks covered by the unit so far are the care environment, which ensures people are confident that that the care environment meets their individual needs and preferences; promoting health and wellbeing, which ensures everyone will be supported to make healthier choices for themselves and others; and respect and dignity, which makes sure patients benefit from care that is focused upon respect for the individual.

Through monthly Essence of Care meetings staff in Calderdale are able to share good practice. Ideas are shared on how benchmarks can be met and staff look at what other wards might already be doing that could be put into practice elsewhere.

Staff can see if they are meeting benchmarks by giving indicators within each benchmark a rating of green, amber or red. Green means the points are being met and successfully carried out and evidence has been sort to ensure this is the case. Amber and red means there is still work that needs to be done to pass the individual indicators within the benchmark and in these situations an action plan is established to see what work can be done to improve.

Staff on the wards have found Essence of Care works alongside their existing work and gives them the chance to view their work in a different light. Sometimes it’s easy to do the day-to-day tasks on auto pilot without looking too much at how the process could be improved. But Essence of Care requires all staff to evaluate what they are doing and how they are doing it. The monthly meetings ensure no one gets complacent with meeting the benchmarks and that the process is on-going and if a green outcome is achieved that they strive for an even higher standard of care. The clinical areas are now looking to incorporate Essence of Care into the ‘Productive Ward’ initiative that is being rolled out across the Trust. (Read more about the productive ward programme)

Speaking about the event Sharon Burgoyne ward manager said. "Essence of Care is already having an impact within Calderdale services and this event was a great opportunity to reflect on the work that has taken place so far. I think everyone involved will agree Essence of Care is having some great results on the wards and both staff and service users are benefiting from the initiative. We will continue to have our monthly meetings to look at what work can be done next to improve patient experience and to work through the next benchmarks."

How Essence of Care can be used

Essence of Care is a very versatile tool that can be used in a number of ways and at different levels.

For example, it can be used as:

• a quality assurance or benchmarking tool
• a reference document or checklist
• an audit tool – as a foundation and focus for audit data collection
• a dissemination tool – to spread current good practice
• a root cause analysis tool – when examining incidents and complaints
• an education tool – to educate and train staff
• to provide evidence of compliance with registration criteria for the Care Quality Commission
• to provide evidence of achievement and best practice and care – for example, to the regulator or Health Service Ombudsman

When using Essence of Care staff identify how they can make it work for people who use services and their carers, focusing on their areas of concern. It can be used flexibly to make improvements and to ensure there is involvement from people, carers and all staff concerned with the delivery of care. To save time and effort it can be integrated into other projects and initiatives and used with commissioning assurance work.

Staff in Calderdale and across the Trust are encouraged where possible to share and compare best practice to ensure good ideas can be disseminated across an organisations. Where possible its is also encouraged to use evidence already in existence (for example, current audit data) to evaluate each benchmark and to use valid tools that already exist to do so.

How can I get involved?

In order to measure how good care being provided is, and to ensure it matches good practice examples, the Trust invites people who use services to get involved and tell them what they think of the care they receive. For example if they think it is good, bad or areas they have noticed could be improved.

These ideas can then be used to make improvements to that service for the future. If you use Trust services and would like to get involved with this work to help improve patient experience speak to your care co-ordinator who will be able to give you some more information on how to do this and the Essence of Care initiative.