Sue Baron: Exploring the Patient Journey: a collaborative and multi-disciplinary approach to patient-centred healthcare improvement

Sue Baron: Facilitating meaningful involvement: finding out about patients’ experiences of their journeys through healthcare using qualitative interviews with patients in their own homes

Researcher: Sue Baron

Sue Baron is a frontline nurse practicing in a separate National Health Service (NHS)    hospital and a lecturer in nursing; she also had extensive experience as a patient. Her PhD research centres around evaluating the provision and quality of healthcare within the humanisation framework, looking at the patient journey and how it can be improved to ensure a more empathic and higher quality of care for patients.

In action research, the method used in this study, a researcher engages with a community and aims to facilitate a collaborative investigation into existing practices for the purpose of improvement. The researcher’s principal objective is to empower members of that community, through the research process, to bring about their own social, organisational and or cultural change.

The participating community, a Vascular Patient Journey project team, comprised 25 core multidisciplinary members recruited from a vascular specialty and 17 service users; 6 family members and 11 patients diagnosed with peripheral vascular disease (PVD) who had undergone recent surgery. The study setting was an NHS hospital trust in the south of England (SE).

The action research process was framed by a six-step Patient Journey practice development/service improvement methodology developed and piloted by Campbell et al (2004) in an NHS trust in the north of England. This model was selected because of its affiliation to the United Kingdom’s (UK’s) NHS patient-centred modernisation agenda, and perceived wider potential which this study would investigate. Ethical and research and development approval was secured prior to project commencement. Patients were selected using matrix and purposive sampling. Data collection methods included mapping; semi-structured interviews, project team meetings, email correspondence, researcher’s journal, evaluation questionnaires and interviews.

Involving patients and staff in this structured and collaborative approach to service improvement was found to have far reaching impact. The richness of the patient experience data brought poignant insights into current services. The combination of patient and staff generated data highlighted areas of excellence and provided powerful catalysts for change and wider shared learning. These balanced results, and the open and supportive culture promoted amongst the group, enthused and empowered the team to work together and take action to ensure effective and sustainable change happened to improve their service. The outcomes of this study, which were also reported to have triggered a “cultural shift across the hospital”, suggest that it is time for healthcare organisations and regulators to think differently. If current issues and failings in healthcare are to be effectively addressed, this study indicates that the perspectives of both patients and staff should be gathered, and their involvement in service improvement measures actively promoted and supported.

Publications

  • Baron, S., 2009. Evaluating the patient journey approach to ensure health care is centred on patients. Nursing Times, 105 (22) 20-23.