528787 research-article2014

BJI0010.1177/1757177414528787Journal of Infection PreventionEditorial

Guest Editorial


atient centred care is a phrase we hear often these days – in our work places, on social media, in national directives. Patient centred care means many things to many people. The complaints process, for example, provides a real opportunity to listen to patients and families/carers; an opportunity to put their experiences, perceptions, and feelings at the centre of how we change and improve our services. Complaints should play a vital part in bridging the gap between our patients’ experiences and healthcare workers/organisational cultures. But complaints are just one way in which we can enhance patient centred care. Recently, a number of local and national initiatives have brought patient feedback to the forefront – a range of new ways in which patients can provide their feedback in a meaningful format that aims to focus on change – this action should have patient centred care at the core of everything we do going forward. Listening to the patient experience is invaluable; they see, they hear, they are at the centre of everything that happens in health care and additionally provide us with an opportunity to help them understand more about what we do and why, for their safety, for their best outcome. Many of us have experiences of health care. It can be scary, it is an eye-opener, it is often positive but we, in this privileged position as ‘carers’ in a complex interactive system, can always, always strive to improve the way in which our patients feel. I am encouraged to see colleagues speak out about their experiences in this journal issue, another way in which we can all learn and improve; while their comments definitely leave us questioning what we can do differently. Patient comments should at times make us feel uncomfortable, and it is not always about tangible healthcare outcomes, which as professionals we are so focused on, but about how they feel, how they perceive the experience. And those experiences actually do affect health outcomes whether we realise it or not; they play a part in anxiety and healing and we should not be dismissive, but take time to learn and improve together. At times, patients and/or carers are focused on key things that have been at the core of their particular healthcare experience; and at the right times just a smile, a caring touch could have made all the difference. We must strive to ensure that what are often deemed as everyday routines for us as busy staff are more visible, to make healthcare delivery appear both safer and more caring; more patient centred. We are getting many things right and we know for example that mandatory infection reporting has seen rates fall in recent years. But I, like you I am sure, am challenged to think how we can go forward in implementing, for example, EPIC 3 guidance, which was recently released. I am challenged to think how this important infection prevention guidance can be implemented in a way that makes it as easy as possible for frontline staff to adopt changes, providing even safer care for our patients, AND to do this in a way that patients both understand and feel comforted by. EPIC 3 presents state of the art, evidence-based recommendations, on what we need to do across health care for high quality, effective infection prevention and control. It lays out a blueprint for technical excellence, to move us towards better decision making, towards interventions that are provided more skillfully. But while

technical excellence is important in ensuring reliable processes of care, we should never overlook interpersonal excellence – care provided humanely, with patients and their preferences taken into account. An empathetic, participatory patient–healthcare worker interaction was mentioned decades ago by Avedis Donabedian as a key part of process improvement and it must remain at the heart of how we deliver health care today. Marrying these two aspects of process improvement, technical and interpersonal excellence, remains so important in improving the trust and understanding between patients and healthcare workers. I have already emphasised that patients see and hear everything that goes on and while patient involvement in feedback while they are actually receiving care can be challenging, it can also be achieved in a way that makes them and healthcare workers feel positive about the feedback experience, makes them feel together in improving patient centred care. So again, let’s take the opportunity to do this when implementing guidance such as EPIC 3; what aspects might you plan to engage patient feedback in when enhancing the standards of, for example, intravenous care? And while hand hygiene might not always be the only thing that can keep patients safe and enhance their healthcare experience, it is an overall quality indicator; there is no doubt about that. Let’s work to help patients see the importance of hand hygiene at the point of care, within the context of overall care; it should not be a distraction to other aspects of care, like a caring touch, but it is a powerful action if done at the right times – a powerful action that shows we care and that we want to protect the patients from alien microbes entering and invading their bodies. Providing patient centred care, and what that means for each and every one of us will not always be easy at this point in time but it is what we should all be striving for; to listen, to absorb, to act – act for change, for every single patient experience. I thank my colleagues for speaking out in this journal issue; it is a brave move and we in IPS are being leaders by publishing these types of articles, while we are only truly leaders if we are willing to change today, tomorrow, each day in the interests of our patients. Disclaimer The opinions expressed in editorials are the author’s own and not those of their employers, the journal, or any other organisation. Acknowledgement Professor Hart would like to acknowledge the assistance of Julie Storr, IPS President, and Claire Kilpatrick, IPS Communications Lead, in the preparation of the editorial. Professor Tricia Hart Chief Executive South Tees Hospitals NHS Foundation Trust; IPS Patron, UK [email protected] Reference Donabedian A (2003) An introduction to quality assurance in health care. Oxford University Press.

© The Author(s) 2014

78  Journal of Infection Prevention 

May 2014  VOL. 15  NO. 3

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Guest Editorial.

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