G414(P) Always events: lessons in paediatric care

Aims‘Always Events’ is a framework of practice that aims to improve patient experience through positive goal-setting in a person- and family-centred approach. Through partnering with patients and their families, the aim is to identify fundamental behaviours that should be performed by the healthcare system for every patient, every time1.The aim of this study was to explore families’ experience of their inpatient journey to inform the development of Always Events guidelines with the ultimate goal of enhancing families’ experience of care.MethodsWe conducted one to one structured parent interviews exploring aspects the parents or their child had experienced while on either the general paediatric or neonatal ward. The interviews and questions were designed to encourage open discussion focusing on the patients’ journey in the department from admission to discharge, aimed at identifying practices that could be integrated as Always Events. Responses were transcribed, collated and coded.Results23 interviews were conducted: 9 from the general paediatric population and 14 from the neonatal unit. The responses were positive, with all parents reporting a high level of care and appreciating being asked what mattered to them. Themes considered to be key in improving their experience included honest and informed communication (both staff to staff and staff to parent), collaborative and practical understanding of care (parental education, familiarisation of the unit before and during admission, and comprehensive discharge decision making), and the creation of a safe and comfortable environment. Parents on the neonatal unit also cited peer support as highly valuable.ConclusionThis pilot study highlighted the value of engaging families in establishing potential Always Events within the paediatric department. Two benefits emerged: firstly, parents enjoyed providing feedback and found the process rewarding; secondly, it identified valuable experiences relating to everyday care which could be explored further and used to develop fundamental principles. Our next stage is to explore these themes through multi-professional and parental focus groups with the aim of co-designing and implementing Always Events.Reference. A focus on ‘always events’. Improving Patient Care.Institute for Healthcare Improvement, 2014.