Kōrero mai project teams need to understand the experience of patients, family and whānau who are concerned and the experience of responding staff. By using a co-design approach for Kōrero mai, hospitals can look at a problem from many perspectives.
The ‘Capture’ stage gathers information on the experiences of people who deliver and receive care. This helps identify the challenges and opportunities for improving patient, family and whānau escalation of care processes.
This stage focuses on capturing the voices of consumers, staff and the organisation. Here we give examples of how these voices have been captured.
- Capturing the experience of consumers
- Capturing the experience of staff
- Capturing the experience of the organisation
- Cycles of capturing and understanding data
- Dealing with out of scope issues
- Downloadable examples and resources
- Compliments and complaints data
- Individual interviews
- Group interviews and focus groups
- Surveys: face to face, over the phone and online
- Focus groups
- Ongoing conversations
- Case event reviews of patients who experienced an ‘early warning score’ escalation, to review staff processes and occurrences of patient and whānau involvement
- Review incident forms of patients who transferred to a higher level of care
- Analysis of existing datasets to look at the volume of responses to deteriorating patients, for example, RiskPro data, 777 medical emergency calls, Quality and Safety Marker data
Project teams may need to go through a few cycles of capturing and understanding data to really understand the problem from different perspectives.
Whatever tools are used, the focus is on documenting the actual experiences of consumers and staff. By paying attention to ‘emotion’ words (for example, delighted, confused, angry or happy) teams gain an understanding of which parts of the process work well and not so well for all.
[Side note] We needed to capture more information from consumers, particularly ‘emotion’ words around raising concerns about the condition of their child, barriers to this and what they believed would improve things. [Canterbury DHB]
Kōrero mai teams found that:
- if staff are interviewed before observational studies are done it relieves staff anxiety about being observed
- it is helpful to have a script ready to explain to the charge nurse or ward staff why and how you want to gather patient experience data
- patients, family and whānau relate well to consumer team members interviewing them. They also respond well to being interviewed by a member of the hospital quality team (non-clinical staff member) or the Māori health team.
[Side note] The Commission recommends consumers are paid for their time in some way so they are affirmed and helped to take part. For example, consumers who attend focus groups have often been paid with supermarket gift cards ($50 or more) or fuel vouchers and free parking. For focus groups, also provide refreshments.
During data capture, issues may come up that are outside the project’s scope. However, it is important these are heard and not lost. Capturing these voices is important to validate the process. Make sure to note down the things that are important to people but that fall outside the work of the project. You will need a process to deal with these. (This has often been a role for the project sponsor.)
[Side note] At times it was difficult focusing on the project purpose i.e. conversations, ideas, issues often went off project scope, and raised lots of out of scope issues that will still need follow through. [Waitematā DHB]
Resources available on request
Observation template (Health Quality & Safety Commission)
From case studies
Southern Cross Hospital (Christchurch) consumer experience questionnaire (see page 19 of the case study)
Canterbury DHB questions for interviewing parents (see pages 8-9 of the case study)
MidCentral DHB script for talking to staff about gathering a patient story
MidCentral DHB guidance for engaging with patient, family, whānau for their experience
MidCentral DHB script for talking to staff before an online survey
Canterbury DHB questions for interviewing clinicians (see page 9-10 of the case study)