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Daisy Hill Hospital Pathfinder Project

The Daisy Hill Hospital (DHH) Pathfinder Project was initiated in June 2017 in response to increasing concerns about the future sustainability of DHH Emergency Department due to ongoing difficulties in recruiting senior medical staff, particularly in the out of hours period.
The project brought together the collective skills, knowledge and expertise of clinical and non-clinical staff, managers, staffside representatives, representatives from the wider HSC system and local community members. The purpose of such was to develop an exemplar model which would ensure safe and sustainable unscheduled care services to meet the needs of the Newry & Mourne population.

At what level did the PPI take place?

  • One to one
  • Service development/delivery.

PPI helped the project to:

  • Improve efficiency of a service;
  • Improve quality;
  • Improve safety;
  • Increase ownership.

Background

The situation regarding Daisy Hill Hospital was a contentious, high profile, emotive issue with significant public concerns and media interest.
Ongoing challenges in the recruitment of senior medical staff to work in DHH Emergency Department (ED) led to mounting public fear that the ED could be closed at night. This resulted in almost 1,000 people attending a public meeting in Newry in April 2017 to voice their opposition to any change to ED opening hours. The project aim was, through a co-production approach, to develop a new model which would ensure safe and sustainable unscheduled care services.
The key focus was:

  •  To develop a long term plan to stabilise the Emergency Department
  •  To identify measures across primary, community and hospital services to deliver a sustainable unscheduled care model.

The design of the service model was:

a)      data driven (comprehensive population health needs assessment, clinical audits, benchmarking)
b)       evidence based (best practice guidance, literature reviews, learning from other models)
c)      consistent with regional strategy, policy and standards
d)     based on sharing of perspectives, experience and knowledge.

Feedback from members of the DHH Pathfinder Group was very positive throughout the evaluation of the planning phase of the project. Recognition was given to the benefits of good leadership and a co-production approach to engagement having been fundamental to the success of the project.

Aim of involvement

The aim of the Pathfinder Project was to create the right environment and supports to enable shared decision-making and power in the planning, design, delivery and evaluation of a new model of unscheduled care.
It involved bringing skills, knowledge and experiences together to create the best outcome which would help to:

  • build people’s knowledge and understanding;
  • develop relationships;
  • support the local community, staff and representatives from other HSC organisations.

The co-production approach enabled all parties to effectively outline their positions which they could consider within the context of transparent evidence and information. It also allowed them to share ownership in devloping future solutions.

Method(s) of Involvement

Focus groups

Public meetings, roadshows and seminars

Challenges

A key challenge facing the project was how to engage the Local Community. A new and innovative process for engagement was developed and widely promoted using a variety of methods, including an internet ‘Invite Video’. This enabled the Project Director to meet with individuals and small groups representing a wide range of community interests (with 30 separate meetings over a 3 day period in locations across Newry & Mourne). The meetings provided an opportunity to hear a wealth of local feedback and agree how best to involve the wider community in this work.

Outcomes due to involvement

The relationships and networks developed through strong leadership and co-production engagement, enabled the Trust to build the confidence and hope of the local community. The sharing of positive messages and a change in focus of the public campaigns from, ‘Save DHH’ to ‘Support DHH’ provided a sound platform for the successful implementation of the project.
A co-produced and co-designed plan for a new model of unscheduled care was developed to provide for system-wide transformation over a 5 year period. This was done through:

  • a stable ED workforce;
  • strong links with GPs;
  • enhanced services for sickest patients;
  • improved patient flow, including a new Direct Assessment Unit.

The new service model was approved by the Department of Health and significant investment made during 2018/19 to support implementation. This included the opening of a new Direct Assessment Unit in February 2019 as an alternative pathway to the Emergency Department for stable patients.

Community Representatives from the DHH Pathfinder Group, provided positive feedback on their experience of the process. They have been actively engaged in identifying service options and designing care pathways to ensure services meet the needs of the patient in addition to defining the measures and evaluating the success of the Pathfinder.

Satisfaction surveys have been developed to capture the views of patients attending the new Direct Assessment Unit; staff working in the unit and services referring into the unit (GPs and Ambulance Service). All of which will continue to drive consistent improvement in experience and outcomes.

Feedback/quotes from service users/carers involved

“I have been privileged to sit on the Daisy Hill Hospital Pathfinder Group … now is the time to change the wording and remove the negative. Replace the word ‘save’ with the word ‘support’, ‘Support Daisy Hill’
Michael McKeown, former President of Newry Chamber of Commerce & Trade.

“The funding that has been received will mean the development of a better quality of healthcare provision for the community served by Daisy Hill and, importantly, an improvement of working environment for current and future staff”

“We would pay tribute to the astounding response from the public, local businesses, patients and staff that worked together in a fantastic show of community spirit…”
Community Representatives on the DHH Pathfinder Group

Timeframe

June 2017- Current

Further Information

Further details can be found on the Daisy Hill Pathfinder webpage here.

Alternatively, contact:

Charlene Stoops (Project Director)
Email: Charlene.stoops@southerntrust.hscni.net
Tel: 028 37564819