Going into hospital, whether unexpectedly or planned, can be a very difficult time for patients and their families. Care and support from hospital staff can make a huge difference to their experiences, but when staff face increasing demands on their time, this is not always easy to deliver.
A joint project between Bournemouth University, Royal Bournemouth Hospital (RBH) and the University of Hull funded by the Burdett Trust has been exploring how to support a caring culture for patients and staff through considering what makes us feel human. Bringing together researchers and practitioners has made a tangible difference to patient care, with encouraging results for both.
Researcher Dr Carole Pound explains: "The research was underpinned by a theory of caring developed at BU by Professor Les Todres and Professor Kathleen Galvin, which sets out eight interconnecting aspects of humanised care. We used the framework that they developed to explore what health care staff and previous stroke patients understood humanised care to mean and how these ideas could be used in practice."
"We wanted to work together with staff and former stroke patients to make sure that people are at the heart of everything the stroke team does," says Dr Caroline Ellis-Hill, a Senior Lecturer in Qualitative Research who led the research in Bournemouth. "It was about putting the humanising framework into practice and working together as staff, patients and researchers.
"We met with staff and stroke patients over the course of several weeks and explored what being human meant to each of us. We didn't go in with any particular agenda or outcome in mind; the idea was to learn from each other as the project progressed. We wanted to move away from measurements and targets, which re so often part of working life, and go back to the basics of caring."
Caroline Bagnall, a Clinical Specialist, Speech and Language Therapist and Humanising Care Champion at RBH has been involved in the project since the beginning: "We're always keen to improve the service we offer, so I jumped at the chance to get involved," she says. "I found it incredibly valuable to have the time to reflect on the service we offer with both our staff and ex-patients. I was surprised how much I learned from just 'being'. Being in a group of staff and former patients, and reflecting on our experiences without having a specific outcome in mind was a really powerful experience.
"It's made me much more conscious of the power of the little things we do. Coming into hospital can be a really traumatic experience, as people are in an alien environment, which is very new and can be quite overwhelming. The little things we do as staff can go a long way towards helping people feel less vulnerable or scared. It’s just about remembering that we're all human."
Nikki Manns, Ward Sister on the stroke ward at RBH, wanted to get involved in the project as she saw it as a good opportunity to bring staff and patients together to share their stories and look at ways to improve patient experiences.
"I've really seen a difference in our staff as a result of the project," says Nikki. "They were so motivated to take part and have carried on sharing snippets and stories from the groups they were involved in. It's been inspirational to see the way that the team have worked together, with everyone suggesting and putting into practice new ideas. Over the last few months, our feedback has shown that there's a real team environment on the ward, so it's great that this has been picked up by patients and their families too.
"One of the most valuable aspects of the project has been the opportunity to get face-to-face feedback from our patients. It’s been really powerful and much more meaningful for our staff than paper-based forms. Knowing that what you're doing is making a difference and being told that by patients is extremely motivating."
"Patients and their families have commented that they feel the ward has an atmosphere of reassurance and calm. Through developing supportive relationships with staff who can see the bigger picture, provide gentle explanations and small kindnesses; they feel able to ask questions, contribute and be more fully involved in their care."
The health care practitioners who have been through the programme have become RBH's first Humanising Care Champions and are working to share their insights with other staff in the hospital. As a visual reminder of their work, they have created a humanising care tree on the unit, where staff share humanising moments, stories and feedback. It helps the team to keep focused on the things that really matter. A group of second generation Humanising Care Champions have also been developed, supported by RBH – taking the research even further into practice.
The project led by BU and RBH was part of a wider research project exploring humanising care led by Professor Kathleen Galvin in Hull. It was also part of a wider body of work led by the Centre for Qualitative Research into the Humanisation of Education, Practice and Research.