Doncaster and Basetlaw NHS Foundation Trust

Project Aim: By March 2022 70% of children aged 11-19 Years with Epilepsy will have Digital feedback forms offered in Clinics (Consultant and Nurse led) and on acute wards!

Project aim

By March 2022 70% of children aged 11-19 Years with Epilepsy will have Digital feedback forms offered in Clinics (Consultant and Nurse led) and on acute wards! 

Background

Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (DBTH) is one of Yorkshire’s leading acute Trusts, serving a population of more than 420,000 across South Yorkshire, North Nottinghamshire and the surrounding areas. Our Children Epilepsy service provides care to 200-300 diagnosed patients with Epilepsy currently and 6 appointments per week to new/suspected Epilepsy patients. Children Epilepsy team in Doncaster is a dynamic and enthusiastic team in a Trust that values professionals who constantly strive to make positive changes

We participated and successfully completed the pilot EQIP wave, which was fantastic experience for our team, but above all it has immensely uplifted our service delivery and patient experience. We believe sustainable quality improvement can be only achieved by persistent engagement with patients and families, along with cohesive team working. As a team, we aim to accomplish the following objectives by participating in the new wave of EQIP collaborative.

Progress of patient satisfaction and care:

Our diverse multidisciplinary team will have the opportunity to reflect on our current practice and learn new ideas; implementing the experience from the training will enhance our patient care and satisfaction. We practice in partnership with our patients and their families by effective communication, sharing our experience and listening to other teams from across the country, will provide us initiatives to plan sustainable high-quality care of our patients.

Tests, changes and what was learned in the process

September 2021

Asking patients (11-19 Years old) whether they would like to have a digital feedback forms about Epilepsy services. 

November 2021

Asking patients (11-19 Years old) whether they would like to have a digital feedback forms about Epilepsy services. 

Patient and parent engagement: Open questions asked from the patient at the end of consultation, what and how they would like to give feedback about the Epilepsy services at Doncaster and Bassetlaw NHS Foundation Trust.   

December 2021 

Development of digital feedback loop.

Patient and parent engagement: 

November 2021

Open questions asked from the patient at the end of consultation, what and how they would like to give feedback about the Epilepsy services at Doncaster and Bassetlaw NHS Foundation Trust. The comments and views of patients were listed for group discussion on WhatsApp in order to develop a tool which can represent the pool of views expressed by patients.  

December 2021 

Open questions asked from the patient at the end of consultation, what and how they would like to give feedback about the Epilepsy services at Doncaster and Bassetlaw NHS Foundation Trust. The comments and views of patients were listed for group discussion on WhatsApp in order to develop a tool which can represent the pool of views expressed by patients.

Challenges and retesting

September 2021

  • Communication between team members, WhatsApp group
  • Allocation of roles
  • Agreeing on Aim and Tests
  • Mapping pathway for change
  • Education and training

November 2021

  • Two geographical areas within same service/trust 
  • Epilepsy nurses work for community trust 
  • Clearance on aim and objectives 
  • EQIP training days have given more confidence team members 

March 2022

  • Virtual clinics are not always the answer,
  • Psychiatric support is patchy,
  • Recourse allocation for transition care.

Successes

  • Established user friendly and easy to analyse data tool for patient engagement,
  • Split sites working more organised,
  • Team education and training about QI.

Results

September 2021

Four Patients asked, 2 in consultant clinics, 1 in nurse clinic and 1 on the ward. All the patients would like to participate; idea of electronic/digital forms is considered more users friendly. 

  • Recourse assessment,
  • What should be included in the forms,
  • Ideas from team,
  • Patients views.

November 2021

Seven patients aged 11-15 years were spoken to informally at the end of clinic, they would like to participate in feedback and want to talk about different aspect of care including transition, mental health support, involvement of technology particularly expanding distant access to the service and suggested a continuous digital feedback platform 

  • Questionnaires on paper,
  • continue informal feedback,
  • Aim to develop digital feedback loop.

December 2021

With the suggestions and agreement of the team, we have formatted a questionnaire with only 4 questions :

1. How do you feel about the visit to the clinic today? 

This general question is going to initiate patient involvement giving them a blank canvas to share their views and enabling us to enhance our services accordingly.  

2. Do you have information how to seek support for mental health like stress/anxiety? 

Although patients do receive information and sign posting about mental health, it would be interesting to know what they understand and utilize while not in contact with Epilepsy team.  

 3. What are views about virtual Epilepsy follow clinic jointly with doctors and nurses? 

Our Epilepsy Specialist Nurses are employed by a separate community trust, which causes lots of communication difficulties, if we can engage patients and develop a virtual clinic for follow ups of patients with both medical and nursing team in attendance that would certainly improve collaboration and patient care.  

4. What do you know/feel about transition to adult medical care? 

Again it is good to start talking about transition at an early stage, which will help us tailoring the transition plan individually, improving flexibility for patients.  

 The questionnaire will be linked to a QR code and data will be gathered on MS Forms platform for which the Trust QI team has kindly helped us.  

March 2022

  • 49 Responses received between Jan/Feb 2022 from QR code and email links
  • 41/49 ranked the service “very good” and 8 were “good”
  • Majority were extremely satisfied with the information given by Consultants and ESN.
  • 15/49 needed more information about psychological support
  • Views about virtual clinic, surprisingly 24/49 patients responded they would rather have face to face appointment
  • 37/49 were feeling more worried about transition to adult services.

 

  • Combined doctors and ESN Virtual clinics.
  • Signposting about psychiatric support.
  • Transition care pathway.
  • Establishment of local support groups.
  • Streamlining First Fit Clinic.

Team presentation


Would you like to know more about these projects? If you would like to contact any of these teams about their QI work then please get in touch with the EQIP faculty at eqip@rcpch.ac.uk

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