Living with and beyond cancer: The improvement story so far - NHS ...

32 | Living with and beyond cancer: The improvement story so far
• The assessment and care plan was
uploaded onto an IT system
accessible to the primary health care
team
• Any unresolved problems identified
within primary care during this period
were communicated by phone to the
hospital based urology support nurse
prior to the patients follow up
appointment.
Baseline measures and results
• A total of 24 patients have received
an assessment of needs within six
weeks of completing treatment.
Twenty patients were seen in person
and four had their needs discussed by
telephone, pre and post intervention
Distress Thermometer (DT) scores.
• The average holistic assessment using
the PepsiCola aide memoir took 30
minutes to complete
• Picker ‘Experience of Care’
questionnaire focusing on experience
of care measures was completed.
Testing so far has identified the
following improvements to the patient
experience:
• The optimum time for initial
telephone contact is about three to
four days following completion of
treatment followed by a full holistic
assessment in the patient home
within two weeks
• 75% of patients at the time of
assessment were helped with
difficulties associated with change of
bowel habits
• Earlier symptom management
avoided patient’s symptoms
becoming more complex and
distressing
Distress Thermometer scores pre and post holistic assessment
DT Score
12
10
8
6
4
2
0
1
DT score pre-intervention
2 3 4 5 6 7 8 9 10 11 12 13 14
Patients
• Prescribing appropriately and giving
expert oncology advice at the time of
the assessment. 85% of patients
required additional prescribing of
medication due to side-effects of
treatment and this twice avoided
hospital admission through A&E
• Earlier onward referral to additional
primary care services. 40% of
patients required additional support
from other community services e.g.
additional nursing support
DT score post-intervention
• Providing emotional support, a
contact number and information for
patients within primary care has
reduced patient and carer anxiety.
The majority of patients were
unaware that primary care services
existed
• Identification of the specific
educational needs of health care
professionals in supporting all types
of patients following pelvic
radiotherapy.
‘Why can’t we all have a little ‘talk’ at the end of our
treatment so we know what might happen and how to
deal with problems/symptoms if we do get them I can
assure you that I’d rather know what might happen
that have no information at all’