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

40 | Living with and beyond cancer: The improvement story so far
Improve communication between
all services (Productivity and
Quality)
We aimed to ensure effective
communication between the service
providers to enabling a seamless care
pathway and improving patient
experience and care. To establish how
effective GP’s and hospital teams found
the existing form of communication
from the hospice we surveyed local GPs
using ‘Survey Monkey’.
Findings
• The generation of a referral pathway
provided staff with a clear
framework, but did not help to
overcome the difficulties of time and
space to assess patient suitability of
referral in an outpatient setting.
Current work is focusing on
empowering the patients to discuss
referral
• The focus group findings
demonstrated the importance of
providing information and
introduction to DTU in patient’s
pathway. One participant had not
been informed that he was being
referred to a hospice but was told
“…it was another department across
the road”. There are also issues with
the media and public image of the
hospice. Patients experienced
difficulties in explaining their referral
to the hospice to friends and family
due to the connotations with the
word ‘hospice’. One participant
strongly expressed ‘…It frightened
the life out of my friends and family.
General public needs to know you
don’t come here just to die. It needs
to be addressed’
• One of the other key themes of the
focus groups was care planning. All
participants from the four focus
groups expressed their involvement in
planning their care. Feedback from
the focus groups challenged the
assumption that professional jargon
such as ‘care plan’ is understood by
patients
• It was difficult to design an
assessment framework that is
practical yet records all the relevant
information. Experienced clinicians
found that the assessment and care
plan framework hindered the
assessment process that they would
usually undertake using either a
reflective model or a narrative
assessment because it was time
consuming and complex. However it
was felt that the format might suit a
less experienced practitioner to guide
discussion and assessment
• The evaluation of the self assessment
form produced very mixed feedback
from the patients (see table below).
Evaluation of self assessment forms
Self assessment form received
Self assessment forms completed
Patients who found the self assessment
form helpful
Any comments made by the patient
‘It is helpful to go through this before the appointment’
‘Good for focusing thoughts’
‘Found it difficult to structure thoughts’
‘Needed help filling it in’
‘Too tired to complete it’
‘Overwhelmed…poor concentration’
‘Not sure what it was for’
Learning so far
• Joint collaboration between the NHS,
primary care and voluntary sector
hospice can support the health and
wellbeing of patients after their
cancer treatment.
Next steps
The intervention informed by this
process will be evaluated via a
randomized controlled trial to start in
June 2010 titled; An evaluation of a
complex rehabilitative intervention for
patients with advanced, progressive,
recurrent cancer.
Contact
Jane Eades
Clinical Nurse Specialist
jane.eades@mariecurie.org.uk
28 Patients
16 Patients
7 Yes
17 Did not know