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Step 3: Evaluate the current situation and develop a sense of urgency

This step involves understanding the position from which you are starting – the baseline – in order to know two things: what to improve and whether your interventions have been successful.

As soon as staff carry out shadowing, the approach generates a sense of urgency. They start to see things from the patient’s viewpoint and realise they could make changes quite easily, which fires their enthusiasm.

Within the PFCC approach, your baseline must reflect the experience of patients and their families. This is because they are the only people who can relate their experiences at each stage of their care. However, you may also want to include an assessment of the current state of the staff experience.

Staff are often surprised at what patients most want to change. When combined with staff knowledge, these views can form a full picture. For example, if patients complain of an unwelcoming receptionist, staff may understand that the receptionist is harassed because the doctor has turned up late and the notes are not delivered. So, this step is not just about identifying the problem – it is about finding out why there is a problem and what you could do about it.

To understand how patients and families experience their care, start by gathering existing information already held within the organisation. You can then supplement this through your shadowing, process mapping, driver diagrams and snorkelling activities, all explained in the Tools section of this toolkit.

Key points

  • To access baseline data on the current situation from within the organisation, look at patient feedback surveys and complaints, as well as staff experience data and staff metrics such as sickness, absence and performance data. Try to think laterally about what people across the organisation know about the care experience you are focusing on.
  • Boost any existing data by using process mapping, shadowing and patient stories to yield the fullest possible sense of what the care experience is currently like for patients and their families.
  • Once you have data from all these sources, you will start to identify glitches that highlight difficult experiences for patients and staff alike.
  • Setting a baseline enables you to demonstrate the impact of your intervention to the organisation, further down the line. This increases your chances of spreading the changes more widely and persuading others that the intervention was a worthwhile investment.