Our first patient-led guidance

An intriguing thing happened to me this week.

I started out with two patient stories from patient opinion that contained within them two important lessons for us to learn.

The first was the anxiety that can be created when a diagnosis is unclear and patients leave the hospital without a clear view of what is wrong and therefore how things will improve and what to do next. It hit home to me that we can give all the advice and information leaflets in the world to patients who fit into a box, but those who are left uncertain may have the greatest anxieties of all.

The second was related to our team not appearing to listen to a patient with a complex medical condition who simply wanted their usual doctors to be contacted for their peace of mind and to improve their care. Why we did not call them I will never entirely know, but it seems crazy that we would not listen to our patient and follow their simple request.

I thought about how we could prevent these things from happening to others and it felt to me that although most would consider the answer common sense it would need to at least be written down and communicated to all our staff. This would then set the standard that we expect others to follow.

I wrote two very brief and easy guidelines, the first about what information we should expect our teams to give to patients without a clear diagnosis prior to discharge and the second to state clearly when a patient's usual doctors should be contacted, including if the patient requests it to be done!

The guidelines on the face of it look entirely like common sense. Everyone would do these things. But clearly they don't.

The guidelines were ratfied by our medical division board yesterday and now form part of our electronic grey book. The guidance is brief and simple and the patient opinion quotes are contained on the same page to show those reading it why we produced the guidance and link it directly back to a patient experience. We also include a hyperlink to the patient opinion conversation.

I have never written guidelines like this before and as they were both direct results of patient opinion I labelled them "patient led guidance". I did toy with "patient initiated guidance" but thought PIG would be unfortunate!

It is true that we have updated or created guidelines before due to lessons learned, but only really if a guideline should already have existed. These PLG's are specific to our patients, relevant to many more and show that we are caring and responsive to our patient's needs. Or at least I hope that they do!

Well done to our patients, and thank you patient opinion.

Dr Ben Mearns

Clinical Lead for Acute & Elderly Medicine