Improving patient experience of feeling their problems are listened to and understood by professionals

 7th October 2014

This month the QI team caught up with the Coborn, children and adolescent mental health, service which started a QI project to try improve service experiences of their young clients. We interviewed Rachel Northover, Assistant Psychologist, who is leading on the project entitled: Improving patient experience of feeling their problems are listened to and understood by professionals.

 

 

Hello Rachel, firstly how did you come to work at the Coborn?

I previously worked within adult services in the trust and was keen for a new challenge. I have always enjoyed working with young people so The Coborn seemed like the natural progression and a great opportunity to work in a specialist service.

Can we get a summary on your service please?

The Coborn Centre for Adolescent Mental Health offers a service for young people suffering from a diverse range of acute and severe mental illnesses. These include major mood disorders, psychosis, eating disorders and some emerging personality disorders.

The Coborn admits young people from 12-18 years old and provides a highly specialist team including psychologists, occupational therapists, art and drama therapists, a family therapist as well as a large nursing and medical team. Whilst being under one roof, The Coborn contains a Psychiatric Intensive Care Unit (PICU), an Acute Admission service and a Day Hospital. These three wards work together to help young people through the most acute phase of their difficulties and aims to reintegrate them back into their communities as soon as they are ready.

What is best part of your job and working with young people?

The best part of my job is that I get to spend part of my week working on the ward itself and part of the week in an office working on various projects where my time is more protected. The job split means I can get to know the young people really well alongside being able to have space to think about ways to improve the service we provide. Working with young people is a lot of fun. In the middle of hugely difficult circumstances and challenges the young people are facing, I love being able to sit down with them and enjoy the most normal of activities such as painting nails, playing on the Wii or enjoying a game of basketball in the garden.

What made you want to start a QI project?

We wanted to improve young people’s experience of the service and the QI work we are doing aims to improve one main area: patients feeling their problems are being listened to and understood. Patient participation is one of the core aims at the Coborn.

The QI model fitted with what we already wanted to improve but provided the tools we needed to measure change in a quantifiable way. The project has now been broken down into a number of smaller projects, each with a mini team. Staff at The Coborn have always been open to change and it was therefore not difficult to create small teams of staff with experience in different areas.

What are your and the team’s experiences of QI learning? How did you hear about it? Did you attend the first wave of QI training?

James and Amar from QI came to present at The Coborn away day back in June and following this, a group of staff from the Coborn attended the (first wave) full 3 day QI training. The plan is to relay this training to others working on QI projects and to encourage others to attend the next wave of training.

How did you and your colleagues find the QI 3 day face-to-face training? What have you learnt that has been useful to your QI project?

The 3 day QI training was both comprehensive and engaging. Whilst breaking down the theory of QI, the course never wavered from its focus of supporting the projects of those present and thinking about how these could be practically implemented locally. For the staff who attended from The Coborn, it was a great opportunity to spend time thinking creatively together about how to bring about change in our service. The driver diagrams we created for the training went through an evolution over the 3 days but continue to provide the backbone and structure for our projects. We also found the instruction on data collection particularly useful we are faced with challenges surrounding the amount of data we can collect. During the training we were taught about the importance of measuring change, however small, on a frequent basis and not letting this be a barrier to trying new ideas.    

Do you think the QI project will significantly impact on your service provision?

I certainly hope so! We are under no illusion that improving young peoples’ experiences of feeling listened to and understood is a huge task spanning almost every point of contact our young people have with the service. Added to this is the fact that adolescents, even without mental health difficulties often feel misunderstood and not listened to. Despite these challenges, I believe that our formula of combining a number of targeted projects will gradually help to improve the overall picture amongst our young people that The Coborn is a service that prioritises listening to young people and demonstrates an understanding of their needs.

Thank you to Rachel for agreeing to share their QI project experience and doing this interview. The project is being supported by the QI team and aims to be completed successfully by March 2015.

Below you will find some of the listed reasons young people at the Coborn gave for feeling or not feeling their problems are being listened to and understood.

Reasons young people have given for feeling listened to and understood:

Reasons for NOT feeling listened to and understood:

– “I always had someone to talk to whether it was the day or the middle of the night”- “They helped me understand my problems and how I could cope with them”- “Opportunities for reflecting” – “Family therapy sessions” – “I like that the service listened and took into account what we were unhappy with and took our argument into action”

– “Not feeling involved in important events regarding my recovery plan”- Young people not receiving feedback about changes made in response to their ideas.- Admission outcome measures are completed by young people for the Coborn database but are not responded to individually regarding the areas they have highlighted as needing particular help – Young people feeling frustrated with the ward round process