Nurses Day! - Birmingham Children's Hospital

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Overview of Quality of Care
Complaints
We take all complaints about our services very
seriously and ensure that the way we respond is
tailored to the individual and that we answer all
of their concerns. Our Chief Executive is involved
in every response and writes personally to each
individual. Responding to a complaint can include
meetings with clinical staff and senior managers,
including the Chief Executive.
Formal complaints often originate in a concern
raised with PALS (Patient Advice and Liaison
Service) which supports families in obtaining the
response they need in the best way for them. We
encourage people to use our Formal Complaints
service and PALS as, if something has gone wrong
we want to know about it so we can try to put it
right, learn from it and improve. This information,
when combined with other quality information about
our services, can also help us identify when there
are other problems.
Fortunately, compared to the numbers of patients
we see every day, we receive very few formal
complaints. Each one is considered in detail and
incorporated into our Safety Dashboard and our
Quality Report.
Figure 28: Numbers of formal complaints per month/per 1,000 admissions
(This data is governed by local definitions)
15
10
5
0
J F M A M J J A S O N D J F M A M J J A S O N D J F M
2011
Complaints
Complaints per 1000 Admissions
2012
2013
As part of the formal complaints investigation
process, we identify any areas in which the quality
of the services could be improved, and make
appropriate recommendations. These range from
reminders to staff about proper practices and
behaviour, to fundamental changes in practice and
documentation. We regularly follow up on these
recommendations to make sure action has been
taken.
As a result of these recommendations a number of
changes have been made, including:
l Radiology: An area has been identified where families can discuss issues privately.
l Surgical Day Care: To avoid any discrepancy in recording weight and therefore incorrect
calculation of medication, the same member of staff who checks a child’s weight now also
writes the weight on the drug chart.
l Communication processes between Radiology and Rheumatology secretaries about
appointments have been improved.
l All wards: The handover process has been improved to ensure speciality patients on outlying
wards are more clearly identified.
l All clinical areas: A new discharge form has been designed to prevent failure to follow-up.
l The Breast-feeding training programme has been re-launched.
l Learning Disabilities: increased awareness has been raised amongst staff about the
importance of the Trust Learning Disabilities Passport and care pathways.
l The experience of a family will be used as a learning example for doctors in training.
l Heart Investigation Unit: A test results tracking process has been introduced.
Figure 29: Pattern of complaints per top 5 categories, 2010/11 - 2012/13 admissions
(This data is governed by local definitions)
30
25
20
15
10
5
0
Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2011
2012
2013
Waiting, delays & cancellations
Staff Attitude
Quality of Treatment
Communication
Other
In order to see whether there are any themes
amongst the complaints we receive, we group the
issues raised in each complaint into categories.
The pattern of complaints received about the 5
main categories is set out above.
In January 2013 the Patient Association published
a report: Complaint handling in NHS Trusts
signed up to the CARE campaign, which is based
on information about the complaint handling
systems and processes of a random sample of
trusts. Birmingham Children’s Hospital was one
of the randomly selected trusts and is included
anonymously within the report. The Patients
Association wrote to us and gave us some
positive feedback about what they have seen of
our systems and processes, in particular they
said: “Birmingham Children’s Hospital appears
committed to being a learning organisation.
An example of this is your unique approach of
measuring complaints against Trust values within
the Quality Report”.
Incidents
We have robust systems for managing incidents
and in 2011/12 were awarded NHSLA level 3, the
highest level for compliance with the NHS Litigation
Authority Risk Management Standards. In 2012 we
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carried out a ‘Lean’ process on our investigation
management system to ensure it is as efficient
as it can be. This means investigations can now
be concluded more quickly, which is better for the
patients and families involved and allows us to start
implementing learning from the incident earlier than
we previously could.
In 2013 our Internal Auditors gave an opinion
of ‘significant assurance’ about our incident
management processes.
We encourage all members of staff to report all
incidents, errors and near misses so we can
make improvements, work out what went wrong,
identify themes and drive quality improvements in
everything we do. We share learning from incidents
through our Safety Circular, a staff publication
which provides news on safety issues and changes
made as a result of incidents and incident analysis.
Our Quality Report - which is published on our
website - also includes information about incidents,
which any member of staff or the public can read.