The challenge of the 15 steps

Mònica Almiñana

They say that from outside the problems look different. How many times have we heard or said this phrase in our lives! Perhaps that is why different organizations, in recent years, have decided to take it literally and implement strategies to incorporate the external vision into the day-to-day work.

The National Health Service of the United Kingdom (NHS) presented at the end of 2017 "The challenge of 15 steps (15 Steps Challenge): quality from the patient's perspective".

These are guides dedicated to several health areas, eight in total, which were published in 2012 but that in 2017 the NHS decided to update and incorporate new tools to support their different organizations and suppliers to implement an approach different, external, based on patient experience.

They promote the participation of patients and professionals and their purpose is to help professionals identify improvements and share good practices. It involves recruiting a small group of staff and patients or caregivers. Attempting to be inclusive of diverse groups in which there are people with disabilities, of different nationalities or different sexual orientations so that the contributions are more enriching. The team will walk through the hospitalization or primary care room (hence 15 steps) for 15-20 minutes and stop to observe patients and staff in common areas (corridors, waiting rooms, hospital rooms). The guides contain a tool kit that helps structure the thoughts, observations and discussions of team members. It isn't a checklist, but the intention is to see with the patient's eyes what we see every day with our professional eyes. The goal is to look for and reflect the first impressions that occur when they walk through these areas and try to answer these questions: what do I see? What do I hear? What do I smell? What do I play? How do I feel being here?

They seek to look at aspects such as, for example if the environment is cosy, informative, clean, safe, organized and quiet. The kindness and the feeling of personalized attention are also important points during the observation.

The patient team then explains to the ward staff and the coordinating team their experience to address any suggested improvements. Similarly, it also collects and shares with the staff in the room the positive aspects.

The NHS explains that this 15-step tool is one more initiative, which complements the other strategic improvement measures that it establishes within organizations. More than 25 hospitals have been challenged to participate voluntarily in this project.

It may seem like an excessively simple thing and someone could call it of little value, but undertake the process of being admitted and you will see with your patient eyes how many things are easy to improve although you did not see them with your professional eyes and that now, from within the patient's pyjamas, they seem obvious. Would you like to be asked sometime?

The challenge of the 15 steps:

• The challenge of the 15 steps - Maternity
• The challenge of the 15 steps - Guidance for commissioners
• The challenge of the 15 steps - Services for hospitalized patients
• The challenge of the 15 steps - Mental health services for hospitalized patients
• The challenge of the 15 steps - Community services
• The challenge of the 15 steps - Services for hospitalized children and youth
• The challenge of the 15 steps - Tools for children and young people - Easy reading
• The challenge of the 15 steps - Clinics and outpatients