We had the pleasure of chatting with one of our lay assessors, Jeffrey Goodwin, to discuss the ins and outs of being an accreditation unit lay assessor!
Lay assessors are an integral part of the assessment team; they are a lay person who represents the patient perspective throughout the process. During an assessment, they conduct patient interviews to hear patient experiences at the service. Lay assessors also review key evidence against patient-related standards and attend the onsite assessment. This informs their feedback to the wider assessment team.
It was fantastic to see the process from his point of view, and to hear how he views the benefits of accreditation for patients!
What parts of the assessment process are you involved in?
I find myself involved in everything. Right from the beginning I attend all the meetings of the assessors – I feel fully involved and contribute to them all. My perspective is slightly different to the lead and second assessor: when I go through the standards, I am looking for evidence that relates specifically to the patient experience. I feedback my findings to the team which informs the final assessment report.
All the assessors that I have worked with, have made me feel like I am in integral part of the process, as I think they are, and that my input is an important thing!
As part of the assessment process, we look at the patient pack provided by the service - when you are reviewing the patient pack, what are you looking for?
I like to view it as if I am the patient in this instance, so I look at things like: What do I get out of the letter received? Do I get all of the information I want? Have I got sufficient information so that I feel I know enough about what is going to happen?
It’s very difficult to tell somebody absolutely everything in just written materials but I want to have a really good idea and I want to know what the sorts of questions are I now want to ask, from that initial patient pack.
The other thing I’m looking for is for communication around how to get to the centre, what are the parking or public transport facilities like, and so on. It’s good for the patients to know what is going to happen when they get to the centre, as they do vary, so what is the process? As a patient when you arrive, you can get a bit anxious about these things, so being able to arrive and know what to ask for and so on – that’s what I am hoping to see outlined in the patient letters. On the whole, I find the information given by services is pretty good!
Moving onto patient interviews, what are the sorts of questions that patients will be asked about their experiences?
I like to look at the documents provided by the AU which have guidance and interview prompts so I can put together an interview schedule. This way I have a set of questions and I can ensure that I am covering the same areas for each patient I speak with.
With those questions I am going to ask, I usually send it to the other assessors and ask them if they want to change anything or add something in, helping me get a broad view of different things to cover with lots of different perspectives from different individuals. This process has meant I have been able to really refine the interview schedule and feel comfortable while I am doing the telephone interviews with them.
So, whilst talking to the patients, the first thing I do is link in with the patient pack and the patient’s impression of that. The most important question for me is: ‘Was there anything else you would like to have known?’ Referring to, if there are things that don’t make sense to the patient, or things that they don’t feel 100% comfortable with.
So, if you someone were to approach you with feelings of discontent or you know they’ve experienced something uncomfortable, how would you address it?
I would make a note of what was discussed, then during the pre-assessment meeting with the other assessors I would raise the issue. Prior to the on-site assessment, I send a copy of the interview schedule with the comments as a RAG rating, and if there was something that had come up during my interviews that was a concern, I would highlight for the assessors to discuss.
Ensuring that this is brought up prior, means that the assessors might be able to look for contributing factors during the site assessment. And so, if I have anything I feel a little concerned about, then the assessors who have gone in on the day will come back and reassure me about certain things and the core of the experience would be addressed in the final report.
Is there anything else you focus on during your patient interviews?
I try to get a view on what the patient’s impression of the service is.
How did the staff treat you? Were you treated as an individual and your progress identified? I need to get the feeling that the person feels that they are the centre for the work with that clinician and I’m interested in how that is being recorded.
Did you feel that you were engaged in decision making? Did someone ask them about the decisions that would be made about them and their individualised programme?
And then moving onto the end of the programme, I like to find out if they received exit leaflets, were they provided with options to continue on with the exercises somehow.
Sometimes patients can be hesitant around the interview because they don’t know what is going to be discussed – so thank you for sharing all of that with us!
How do you think PRSAS accreditation benefits patients?
I think it really benefits patients on two levels.
It’s all about national standards, so we are looking for that similar experience against those national standards and ensuring that the service is meeting those standards. We want to bring the service up or congratulate them on where they are – and I think that should give patients confidence in the service they are seeing.
Sometimes, it acts as a bit of a pressure point where there is something missing, and something has to be done about it by the trust. It might be buildings, staffing, training, etc. There might be some areas somewhere, that being a part of this process helps the service with – and I think at the end of the day, that’s what we want to do! All the services I have worked with, all want to know where they can improve to help their patients. So, that’s what I see the role of the process is.
Do you enjoy doing assessments? Do you get satisfaction from it?
Yes! I think it is supported really well. All of the units I work with, I find it an enjoyable process. I find myself looking forward to it, I do have to pace myself a bit, as there is a lot of work. The reading and meetings beforehand, and the onsite visit, but you get to work with an expert group of people who are doing this because they love to!
Thank-you to Jeffrey Goodwin for his time. If you would like to learn more about the PRSAS accreditation programme, click here. To get in touch with the PRSAS office, email pulmrehab@rcp.ac.uk