The National Health Service is a large, modern organisation so what could it possibly learn from a micro-business like OurBoards and what could OurBoards say to answer the questions how could the NHS look after patients better and save money at the same time?
We believe that visual communication boards could bring benefits to several services where there are issues around supporting and managing people with neurodiversities and hidden disabilities. Neurodiversities and hidden disabilities includes a range of thought processes, brain conditions and diversities including ADHD, Autism, Anxiety, FASD, Dementia, Down Syndrome, Strokes and Learning Disabilities.
Accident & Emergency
A routine board can be used to support a person with limited cognitive functioning through a challenging situation or environment. The attached image shows a routine for an A&E department. A notice would be placed on the reception counter inviting people with any sort of anxiety to ask for a routine board. The board would be set, similar to the example, with pictures that show the steps of waiting in reception, triage, reception, treatment room, a doctor seeing the person and finally going home. The green side of the board shows the steps that are to be done. As each step is completed the patient moves the picture for that step over to the red half of the board, indicating that the step is now complete.
Care benefit: Reduced stress and anxiety, calmer patient being easier to treat, reduced impact of challenging behaviour on other patients, keep waiting times to a minimum, having the routine board provides a visible prompt to staff to explain each step of the process, simple to use board, minimum of training required.
Cost benefit: we would hope to reduce, or even eliminate, patient meltdowns due to anxiety saving money on unnecessary overnight stays. Calmer patients will also be more receptive to advice and instructions reducing follow up appointments.
Use of routine board similar to A&E, reducing patients anxiety by enabling them to understand the outpatient process. Being able to see the process will enable some customers to ask questions about what will happen, which they otherwise wouldn’t be able to ask.
Care benefit: Reduced stress and anxiety, calmer patient being easier to treat, reduce impact of challenging behaviour on other patients, keep waiting times to a minimum, having the routine board provides a visible prompt to staff to explain each step of the process, simple to use board, minimum of training required.
Cost benefit: we would hope to reduce, or even eliminate, patient meltdowns due to anxiety saving money on unnecessary cancelled appointments. Calmer patients will also be more receptive to advice and instructions reducing follow up appointments.
Short term ward care
Sharing of information in a simple an accessible way can be a problem for a busy ward. When a patient is admitted it would be helpful to have a patient board that outlined the events to occur each day over the next few days leading to a discharge on day X. Days would be labelled Day 1, Day 2 etc. The events, such as an x-ray or a procedure, would be noted on the relevant day and marked when completed. It would be obvious that a patient is on track for discharge on the estimated day or if the process was in advance or arrears of the original estimate. This board would be based on, but a variation of, the weekly timetable.
The board would be available for family to see so that they could discuss the events with the patient and offer reassurance. They would also be able to plan for discharge. A family communication section of the board would enable family members to leave questions and comments that could be answered by staff when convenient.
Care benefit: staff would immediately and easily see whether events had occurred when they should and if the patient was on track for discharge on the estimated date. Basic information would be available to the patient and family members, reducing stress and anxiety over lack of clear information.
Cost benefit: by keeping the patient process on track and sharing information with family it will be possible to keep patient stays to the minimum number of days. It will also eliminate waiting for discharge because the family weren’t aware that the patient was due for discharge.
Long term ward care
The weekly timetable (image attached) enables staff and family to share information about and with the patient. This enables staff and family to engage with the patient at a more personal level without incurring a lot of time. Social interaction about areas of interest for the patient will help their wellbeing and state of mind during their stay. Having a visual timetable of procedures and routines will enable staff and family to discuss upcoming events and help reduce the patient’s anxiety.
Care benefit: Reduced anxiety and improved wellbeing will lead to the patient being easier to support and manage their care.
Cost benefit: Improved wellbeing and easier management will lead to some patients having as short a stay as possible and saving unnecessary extended stays. This will reduce bed blocking and increase bed availability.
Ward discharge to long term care
Discharging patients from hospital into more appropriate long term care can be a complex process, organised by multiple staff over multiple shifts. If information isn’t shared in a simple and clear way discharge can be delayed. The college admissions board (image attached) shows a similar process, although in the opposite direction of travel, for managing admissions to the Seashell Trust college for children with communication difficulties. The team in the admissions office find the clear visual display helps to see what the next step is for each individual and prevents wasting time researching information already known within the organisation.
Care benefit: information immediately visible to staff to ensure discharge is done as efficiently and soon as possible. Information can easily be shared with the patient and family, reducing stress and confrontation.
Cost benefit: minimises costs and bed availability resulting from bed blocking