At Wrightington, Wigan and Leigh NHS Foundation Trust (WWL), these whiteboards have been installed and used in every inpatient ward for over 12 months. However, over this time, despite their presence and education of staff around the importance of keeping them up to date, patient surveys have failed to demonstrate any significant sustained improvement in patients, specifically, being able to state that they know the name of the Consultant treating them.
An initiative was undertaken by Dr Stephen Gulliford (Consultant in Acute Medicine) at WWL with the aim to improve this in a sustainable and cost-efficient way. He created a business card which he would trial by giving to patients on the ward round on the Medical Assessment Unit. The card is in Figure 1 below:
Figure 1 : Business Card
This card contains Dr Gulliford’s name and credentials. It also shows the Trust name clearly and provides the details of his secretary (name and telephone number.) This is to provide written real-time information to the patient about the Consultant (Dr Gulliford) who has seen and treated them that morning and taken responsibility for their care, and also his secretary’s details for later use should they (or their relatives) have any future queries later in the admission , or post-discharge, and thereby providing a clear named point of contact for them.
These cards were given to patients seen on the ward round on the Medical Assessment Unit at WWL on 2 non-consecutive days as part of this initial pilot work. This ensured 2 different cohorts of patients. It was explained by Dr Gulliford to each patient that these cards were part of a quality improvement project to hopefully improve patient information and engagement during their stay/admission. During the trial week, further ward rounds were conducted by Dr Gulliford’s colleagues where cards were not given out.
Results
Following the ward rounds, patients were surveyed by an independent member of WWL’s patient engagement team. None of the Consultants were present at the time that the survey was undertaken. Patients were asked:
- Did they know the name of the Consultant who had seen/treated them today? and
- If so, did they feel the business card was useful?
Some very positive comments were received from patients. These included:
- “It is a very good idea and all Consultants should use them”
- “I know which Consultant is treating me”
- “I know who to ring if I have a concern or a problem”
When the patients were asked if they felt the business card was useful, 66.5% of patients felt that having the card was good and had helped them, 25% were unsure if it had helped them having the card and 8.5% of patients felt it did not help them. It is a great result that approximately 2/3 patients responded positively to receiving the business card. This is shown in the graph below:
Conclusion
Overall, the receipt of the business card was received positively by patients. It significantly improved patient engagement and communication with the patients, demonstrated by the significantly higher proportion of patients knowing the name of the Consultant treating them when they had received the card.
Subsequently, one patient had used the card two days after the ward round to contact Dr Gulliford’s secretary to discuss an issue around a follow up referral. Dr Gulliford’s secretary was able to provide the patient immediately with the relevant information to satisfy his query. The patient felt that having the information given to him on the business card had made it much easier for him to contact the right person directly at the Trust to address his query.
The cards cost £4.99 per 100 cards. It is anticipated that around 200 cards per month would be sufficient, costing just £10 therefore per month to maintain. Thus, this business card model has demonstrated a very cost-efficient effective method of improving communication with patients, maintaining responsibility for patient care by a named clinician (“name on the card”) and improving patient engagement.
We intend to expand this model to all consultants within Acute Medicine and then re-survey the patients to demonstrate sustained improvement before further dissemination on a Trust-wide basis as an example of anticipated best practice.
References:
1 – The Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry available at www.midstaffspublicinquiry.com/report
2 – Guidance for Taking Responsibility: Accountable Clinicians and Informed Patients. Academy of Medical Royal Colleges – June 2014. Available at: www.aomrc.org.uk/images/dmdocuments/aomrc_papers_takingresponsibility_final.pdf
Author:
Dr Stephen R Gulliford BSc MB ChB FRCP(London) PgDip(Toxicology), Consultant in Acute medicine and Clinical Director (Unscheduled Care)
Wrightington, Wigan and Leigh NHS Foundation Trust.
Email: [email protected]
Twitter: @StephenGulli