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Orthopaedics patients to reward quality nursing with badges

  • 38 Comments

The Royal National Orthopaedic Hospital NHS Trust is set to launch a reward scheme that will see patients themselves award badges to staff for standout examples of quality care.

Managers hope the scheme will not only recognise the hard work of nurses and others but also prompt discussion and boost understanding of what really matters to patients.

“The icing on the cake is the feeling of satisfaction and recognition our staff will get”

Paul Fish

The scheme is part of wider efforts to improve the admissions process and patient safety, with a new welcome pack for all inpatients due to be introduced across the specialist hospital trust in Stanmore next month.

As part of the pack, patients will be given an “I delivered great care” pin badge, which they can award to any one member of clinical or non-clinical staff who made a real difference to them during their stay.

The badges are the brainchild of director of nursing Professor Paul Fish, who joined the trust in February last year.

“We tend to have award ceremonies and recognise work annually but there is only one winner,” he told Nursing Times. “Yet there are thousands of interactions between staff and patients every day that are great, so I had the idea of this badge.

“There is something about the awarding of a badge in real time to staff members by patients that is really powerful,” he said. “It’s about patients defining what quality is and a vehicle for them to be able to say to staff ‘this thing you did for me was the most important thing of my stay’.”

Nurses who earn five badges will get a bronze badge. Five bronzes will earn a silver badge and five silvers will lead to a gold award.

Royal National Orthopaedic Hospital NHS Trust

Orthopaedics patients to reward quality nursing with badges

Paul Fish

In addition, Professor Fish hoped the awarding of badges would prompt conversation between patients and staff and staff and colleagues about the meaning of quality care.

“The most important thing for me is this is about conversations – conversations between patents and staff and between staff and staff about quality as patients define it,” he said.

“The icing on the cake is the feeling of satisfaction and recognition our staff will get. If you go to an award ceremony you see people go up on stage to get that recognition and they are walking tall. I am looking forward to seeing lots of people around the organisation walking tall because they have had recognition for the great care they are delivering,” he added.

Around 40 welcome packs and the badge concept were tested on the hospital’s Duke of Gloucester ward, which cares for most of the trust’s cancer patients among others.

Professor Fish said feedback from both patients and staff had been extremely positive.

“One patient told us their only problem was they wanted to award the badge to lots of people,” he said. “The feedback from staff has been wholly positive.”

The welcome pack – a concept that has already been trialled at other NHS trusts – also includes a comprehensive information leaflet, eye mask and ear plugs to help patients sleep at night and anti-slip socks to help prevent falls.

As part of the new admissions process, which will be “administered in a similar way to what you get on a plane”, every patient will get a pack, receive a bedside briefing from a nurse and be shown a safety film on an ipad.

“We want to learn what really makes that difference for patients”

Paul Fish

The packs will be piloted for a year during which the effectiveness of these new measures and the reward scheme will evaluated in collaboration with London Southbank University.

Professor Fish, who is a visiting professor of nursing leadership at the university, said the evaluation would look at whether the scheme had any impact on performance measures, such as Friends and Family Test data, from both patients and staff, and nurse sensitive outcome indicators like falls.

It will also include focus groups and surveys to explore why patients decide to award badges and what they award them for. “We want to learn what really makes that difference for patients,” said Professor Fish.

The welcome packs have been funded by the Royal National Orthopaedic Hospital Charity at a cost of around £45,000 for the year. Mr Fish said this equated to a pound or so per inpatient.

Both child and adult patients will get packs. Mr Fish said the hospital was currently looking at how to make packs “more interesting” for younger patients but anticipated they would “love” the ability to award the quality badge.

Royal National Orthopaedic Hospital NHS Trust

Orthopaedics patients to reward quality nursing with badges

Patient packs

  • 38 Comments

Readers' comments (38)

  • Glad I spent my career abroad where we all worked together to look after patients in a collegial environment and nobody was singled out or had to endure all this pettiness seen in the NHS and other British establishments.

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  • Its like being in the bloody Brownies.

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  • Absolutely ridiculous, totally undermining professionalism. Can't believe what I've just read - lost for words !

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  • Laha78

    Another 'genious' idea thought up by the Ivory Tower brigade.
    Disgusting!
    Talk about creating cliques on wards!

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  • I agree with the above comments. Nurses are highly trained Professionals. This feels as though we are being relegated to the NURSERY. Is there no longer any respect for your colleague's within the NHS.
    I am glad I no longer have to deal with this nonsense. A thank OR a thank you notelet to you from the patient's and a return visit to let you know how they were doing said it all.

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  • That is making an absolute mockery of our profession!! I have two children who come home from school with stickers gained from "being good".

    It is the responsibility of the line managers to recognise good patient centred care.

    This is degrading and quite frankly embarrassing.

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  • I have to agree with the previous comments also. I find this extremely unprofessional and highly insulting. as has been said this is treating health care staff like primary school children. If it is felt that good staff in this Hospital need to be singled out then they are admiting they have a problem which is what needs addressing and not with such childish means. I have nursed over 33 yrs and have always worked and cared to the best of my abilities, I was given a sage piece of advice by my first Tutor when I started Nursing School "Treat everyone the way you expect you and yours to be treated at all times and you wont go wrong". I have always worked to this mantra so maybe the Hospital would be better served if it tried to instil these values or are they going to implement a "Naughty Step" for under performing staff.

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  • Agree wholeheartedly with the above comments. I could not believe what I was reading how insulting and so unprofessional.

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  • michael stone

    Right - here I go, then.

    “It’s about patients defining what quality is and a vehicle for them to be able to say to staff ‘this thing you did for me was the most important thing of my stay’.”

    It is 100% right, that patients can provide feedback about what I might term 'their experience of the care provided by nurses [and by doctors]'. Absolutely, unequivocally necessary, if the 'care experience' which cannot be measured by clinical outcome alone, is to be assessed and improved.

    But is this 'badges' scheme a good idea ? Probably not - it does seem to be 'rather insulting to nurses', and I agree about that. And if they keep it, badges for doctors should also be included.

    So I completely agree with the objective here, but I'm doubtful about the 'methodology'. However, perhaps the folks who came up with this, had pondered other methods, and decided that none of them would work: I don't know, and I'm not going to bother thinking about possible alternative methods (although charts on each ward's wall, with 'comparative ranking by the ward's patients', is the sort of end result I personally would prefer instead of this badges idea).

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  • In response to Mike Stone; patients can provide feedback with regards to the care they receive, but they should not be allowed to give out ' reward badges' it's a ludicrous sugestion. Imagine the abuse that 'subjective' patient opinion could be open to. I can't understand why you agree with the 'objective'. Have you looked at the 'Patient opinion' site I have; total whingeing - no objective evidence of poor care, just slating nurses, as usual. We have not trained and gained professional qualifications to be treated like schoolchildren and be handed ' badges' by patient opinion. C'mon Mike you surely are not condoning any of this nonsense.

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