What is PIE?
PIE is an observational method which
aims to:
- describe the culture for person-centred care
experienced by people with dementia or confusion in general
hospital wards
- help the ward team reflect on and develop
their approach to working with people with dementia
What does it involve?
- Following a one-day workshop, two
members of staff will carry out PIE in 2-3 hospital wards which
admit people with dementia (elderly care, acute medical or
surgical).
- Real-time observations of 5-10 people with
dementia will take place in each ward over at least two key times
of the day in 2-hour time periods (4 hours in total), one in the
morning and one during a meal-time.
- Background information about the people
receiving care and the ward will be recorded as well as comments
about their care made by patients or their relatives/ friends.
- Patients, visitors and staff should be
informed beforehand and given the opportunity to have any questions
or concerns addressed, with an on-going process of consent. The
observers will intervene in a crisis but should otherwise aim to be
as unobtrusive as possible and respect patient privacy.
- Verbal feedback to the ward team should be
given as soon as possible after data collection.
- An action plan to develop practice will then
be agreed with the ward team.
- Ideally, both observers will spend a shift of
7.5 hours to undertake PIE in each ward. This is required for
introductions to the ward team, data collection including 4.5 hours
observations (4 hours plus a practice of 30 minutes), reflection on
the findings between observers and feedback to the ward team.
What is observed?
The following prompts may help us to
consider the culture for person-centred care for people with
dementia in the ward at any given moment. These are (following the
PIE acronym):
- P – Person: whether staff
are using what is known, or not known, about the individual patient
as a person to personalise their care; observing what the patient
is doing and how they are affected.
- I – Interactions: a
person-centred care culture is particularly evident in the context
of relationships, or more specifically, through day-to-day
interactions with staff.
- E – Environment: this
looks at the modifiable ward environment and its impact on the
people receiving care.
What will happen to the
findings?
- The main impressions formed about the
culture for person-centred care will be discussed with members of
the ward team.
- Although members of staff may benefit from
one-to-one feedback, the focus is not on individual staff
competencies per se, but on the shared responsibility for the ward
culture experienced by people with dementia.
- Key action points will be derived to develop
person-centred care practice and improve patient experience e.g. to
engage people with dementia more often in conversation.
- The main impressions and action plans for each
ward will be submitted to the Royal College of Psychiatrists and an
overall thematic analysis of the results from the participating
hospitals reported at the national level.
- The findings are expected to complement those
from other parts of the clinical audit e.g. patient/ carer
questionnaire.
What are the potential benefits of
using PIE?
|
For people with dementia and their
carers
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For hospital staff
|
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Give a voice to people who might otherwise
find to difficult to convey their experience
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Provide a means by which staff can reflect
on the culture of care from the patient as well as staff
perspective
|
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Assess aspects of care which matter most to
people with dementia and their carers’ in acute care, particularly
their interactions with staff
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Raise greater awareness in the staff team
about the impact that their way of working has on people with
dementia, including what is done well
|
|
Raise awareness at the local and national
level about the quality of person-centred care received by people
with dementia in general hospital wards
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Empower staff to make small but significant
changes to everyday practice in their ward
|
|
Improve the experiences of people with
dementia in general hospital wards
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At the national level, share elements of
best practice and share solutions to problems
|
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