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Improving Patient Enablement and Continuity of Care (IPECC)

The aim of this project is to create a culture of patient enablement in hospital, through enhancing professional and organisational interfaces and education


Working within the Trust, and with partners from neighbouring health and social care organisations, the planned areas of focus will be to:

  • Create an enhanced culture of patient enablement during the individual’s acute hospital stay, to maintain functional skills and independence, supporting their discharge once medically well again.
  • Develop trusted interfaces between Nursing, Occupational Therapy, Physiotherapy and Social Work, improving communication surrounding enablement and reducing duplication of effort.
  • Improve the interface and continuity of care between hospital and community therapy and Social Care services, linking with the development of the Discharge to Assess pathways and the Integrated Discharge Service, to ensure all staff across the acute and community focus on discharge as soon as an acute bed is not required.
  • The theme across each of these areas is the requirement to develop a training framework, incorporating practice-based training and a competency framework into day-to-day health and social care practice, and education, working closely with the Practice Development Teachers in the Learning and Development Service.

What is enablement?

Enablement is supporting people, not by doing things for them, but by working in partnership with them and encouraging them to be as independent as possible.

Enablement links with person-centred care as it recognises that every patient is a unique individual with their own views, preferences and wishes, and seeks to empower them to reach their potential.

The project is aiming to be completed in September 2016.

For more details, please contact:

  • Jane Hadfield, Assistant Director & Executive Coach, Learning & Development Human Resource & Development Directorate, North Bristol NHS Trust, Bristol
  • Cathy Timothy, Project Manager & Executive Coach, Staff Development, Learning & Development, North Bristol NHS Trust, Bristol

Cathy Timothy said: The IPECC project is continuing to progress at pace, with:

  • The initial HCA practice based enablement training and evaluation nearing completion
  • The next training pilot is planned, using learning from the first pilot
  • Health Coaching training dates have been arranged, such that 20 staff will become accredited in Health Coaching, with five going on to complete a ‘train-the-trainers’ course to enable greater sustainability and development of this skill within the Trust.
  • The Discharge-to-Assess e-learning training programme is nearing completion, using case studies provided from community services.
  • The development of the Enablement Resource Pack is about to commence.

Current IPECC Actions:

  • Review models of Health Care Assistant learning and development at North Bristol NHS Trust.
  • Identify vocational units that support enablement.
  • Map current enablement and competency training for HCAs.
  • Develop competency based training with a focus on enablement risk assessment.
  • Develop links between the different approaches to falls training to encourage safe enablement.
  • Pilot practice-based development teaching of enablement on ward 9B and then extend this to ward 9A.
  • Pilot development of a Patient Enablement Feedback Framework (PEFF) to support HCA communication, in a pre-emptive step towards a more formalized rehabilitation prescription.
  • Develop common enablement language and documentation.
  • Link with the Academic Health Science Network (AHSN) and use of SBAR framework (Situation, Background, Assessment, Recommendation) as an enablement communication tool for HCAs.
  • Implement practical training of the health coaching framework to enhance ‘the conversation’ between healthcare professionals and the patient.
  • Develop an e-learning training programme to enhance the implementation of Discharge to Assess and decisions about ‘safe between visits’.
  • Develop an e-learning training programme about patient enablement, using practical video clips.
  • Develop an Enablement Resource pack for the Practice Development Teachers to incorporate enablement in their current teaching.

Anticipated benefits:

Improved and consistent communication to support continuity of patient care, greater patient enablement, and efficient use of staffing skills and resources in supporting the discharge process.  There will also be a focus on including patients’ own wishes and ensuring effective holistic planning of services, that that truly appreciate and encourage a patient in their enablement.

Other benefits include:

  • Creation of links between risk assessments and enablement in relation to patient care.
  • Maintenance of patient function and mobility while in hospital.
  • Improving the usefulness and accuracy of documentation and feedback between staff.
  • Reduction of unnecessary assessments resulting in more effective use of resources.
  • Improvement of communication and shared decision-making between hospital and community staff.

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