Deepening our understanding of patient experience at this month’s PICH seminar.
We had presentations from Bea (practice champion manager for CC4C connecting care for children), and Dr Heidi – Paed trainee at the Royal London and former research fellow for CC4C.
Bea talked about collaboration of professionals and community members (on an equal platform) to meet needs of the local populations
Heidi described how to involve patients meaningfully in research, and how is it relevant to recurrent wheeze.
Connecting Care for Children: www.cc4c.imperial.nhs.uk.cc4c
Altogether better: www.altogetherbetter.org.uk
Public health info – Fingertips: fingertips.phe.org.uk
Presentation about Co-Design (Bea)
Collaboration of professionals and community members (on an equal platform) to meet needs of the local opulations
Tip to doing co-design: DON’T think in a clinical way!
Child Health GP Hub
Centred in primary care, built around monthly MDTs and clinics
One Based in Hammersmith and Fulham, co-design has helped bring about Saturday drop ins, Mums to be and 0-3 groups, buggy walking groups, and a Dads group
Know and understand their communities
Volunteers – application form identifies different peoples interests
- Different places have different terms e.g. “community champions” “practice champtions”
Example questions in co-design research
“What matters to you and your child?”
“What do you love about your GP practice?”
“How could you imrove your GP practice?”
Parkview Olympics (video)
Pilot project in White city
8-11 year olds
Brought together services that were already happening (e.g. Community gardening)
Children went from 0 hours of exercise outside school per week, to 2 hours.
Families exercising more together
Local stakeholders included QPR football team, Community gardens (Hammersmith community gardening association) and the London Sports Trust
How to do it again..?
Presentation 2: How to involve patients in research, and how is it relevant to recurrent wheeze. (Heidi)
Affects 30% of children in first 3 years of life
Less common in Greece than in UK – why?
Multiple phenotypes e.g. episodic viral wheeze, multiple trigger wheeze
Failure to discus environmental prevention of wheeze with families
Hospital admissions rates in UK are high for preschool children with wheeze, vs Australia for example, where 30-40% are discharged within 4hours, and >40% discharged within 7 hours
Currently there is no registry for “preschool wheezers” in primary care, some coded as asthmatic (at least they get follow up) some as infection
How do parents of preschool wheezers feel when they experience healthcare services?
An EMOTIONAL MAP was designed
Asked about their first encounter with services due to wheeze, and their emotions about it
Takes the story, breaks down the senstences into steps and then into codes/colours associated with neutral/positive/negative emotions.
This takes 2-3 or more people to arrive at a consensus on what negative or positive may be
Helps to turn emotions, expressed in vignettes/quotations, into data
Process: met familites at GPs, at St Marys hospital, at an ambulatory clinic in Hammersmith hospital
Some discussion points:
How to co-design a tool that can measure impact?
Are amazon/Google algorithms are kind of emotional mapping?
Patients wont tell doctors some things as they want to please them, sometimes better to ask an HCA/Pharmacist/practice nurse to ask the questions
This data was gathered retrospectively, retrospective analysis may color earlier feelings, but you could miss on the spot feelings which could be useful.
Challenge for the next month: Have a different sort of conversation with a patient, how they’re feeling and what matters to them.