Preparation for group leaders Partnership – The Agreement Start Cancel
This is what we will be doing over the course of the next 50 minutes:
Get an introduction to the term the Agreement.
Share lessons from everyday life.
Discuss improvements.
Strengthen the partnership in our professional practice.
Practise giving feedback.
The group leader reads out loud
This is the third course session of the partnership module. We will be given an introduction to what the term the agreement means and we share with each other what we have learned from our everyday lives. We also have to agree on changes to start working with in our professional practice.
We will be given an introduction to how we can continue working to strengthen the partnership in our professional practice and how we can measure the change.
Listen together and follow the text below
One aspect of the partnership is that there has to be an agreement between the patient and professionals.
The agreement is based on the premise that the patient is a person with a will of their own and a responsibility for their health. The goal is to arrive at a shared view of the condition, the best approach to the patient and the best treatment.
Agreements can be reached on minor issues and in different ways for different patients. For example, if two people with dementia are demonstrating their frustration and anger, one person may appreciate a hand massage and feel calmer afterwards, while the other person may feel this to be a violation. In this situation, the professional and the patient can come to an agreement – verbally or via body language and observation – on what is right for that specific person in that situation.
Agreements can also be more long-term. In person-centred care we use a health plan, which is a document drawn up together with the patient. Goals for the patient’s health and the activities needed to reach these goals are set out in the plan. In the health plan, the patient and the professional also agree on who is to do what so that this is clear to both parties.
What currently happens all too often is that we inform patients instead of making decisions about their health together with them. However, there are risks associated with not actively involving patients or relatives in an agreement. If patients feel that it is the professionals’ plan they may completely rely on the professionals and not take any responsibility of their own for prevention and treatment. It may also be the case that the patient or relatives feel that the plan is not right for them and do something else instead, without an agreement with professionals.
If there is a clear agreement, which the patient and their relatives have actively developed, there is a much greater chance that it feels right for the patient. When the patient becomes a more active partner in their own health, there is also a long-term impact in terms of efficiency within the healthcare system.
During the last meeting, we each chose one situation where we would practise coming to an agreement with the patient in our everyday lives. We focussed on the following assertion:
B. The Agreement
Patient and professionals together have arrived at how health and social care shall function and what the goals are for the patient’s health.
We are now going discuss in groups how we together can become better at utilising the agreement with the patient. What can we start doing differently?
We will soon have finished module 1 on the partnership and will start making these changes in our day-to-day work. We will now get some tips that can help us along the way.
Listen together and follow the text below
1. Make your change plan visible
Put your situation map and list of changes in a place where they can be seen so that you can remind yourselves and each other. It is also a good idea to talk to other colleagues about your reflections regarding the situation map and about the changes you have agreed on. The more of you who are working towards the same goal, the easier the work will become and the greater the difference you will make. Your colleagues will surely also be able to add to this with more good ideas and suggestions.
Listen together and follow the text below
2. Remember that it is a journey
Change often happens in small steps. Sometimes it is two steps forward and one step back. In which case, it can be important to remind yourself that it is a journey and that every little change can make a big difference. As a group, you can help by encouraging and reminding each other.
In this module, you have chosen specific situations where you are to implement change. It is also a good idea to come back to the situation map after a few weeks. Perhaps you want to swap a pink Post-It for a yellow one, or a yellow Post-It for a green one? Perhaps you have come up with something else that works a lot better? It is important to stop and reflect in order enable you to improve and celebrate.
Person-centering on the person is not about working in a specific way in an individual situation, instead it is a comprehensive approach. We can always find situations and methods that help us become more person-centred.
Apply trial and error and remember to share what you learn with each other.
Listen together and follow the text below
3. Set objectives and measure change
What is the objective of what we are doing? How do we know whether what we are doing is actually an improvement? It is always good to be as clear as possible about what we want to achieve and to systematically follow up how we are doing.
Start by identifying what your objectives are. For the partnership in particular, one objective may be that the patient and the team shall have the same view of what is happening now and going forward. Or that the patient is an active part of the team. It can also be a wider perspective, where we want to know whether the patients have a greater sense of security and feel better. Or whether the healthcare is more relevant and of a higher quality. Or whether time and resources are being used more efficiently.
Then agree upon how this could be measured, and followed up. This could be by asking the patients questions verbally or by using a simple form; – Do you feel heard? – Do you know what will happen going forward? Or other questions that help us understand. Another way of following up is to ask the professionals questions. Either as a checklist where we evaluate what our partnership with the patient is like and whether we have made any clear agreements. Or as more open-ended reflections and discussions we have together over a cup of coffee.
Another way is to measure more tangible events. How often do patients or relatives contact us because they do not understand what it is that will happen? Perhaps by ringing the alarm by the bed, getting in touch by phone or showing up at the reception. How often do patients react in a certain way?
Finally, you should decide who is responsible for following up and ensuring that lessons learned are shared with colleagues. It is a good idea to get help from your head of department or the person responsible on your unit when deciding on this. Also ensure that you are measuring and evaluating the current situation so that you have something to use for comparison once you have begun making changes.
Through feedback we develop as individuals and as a group. Creating a culture of which feedback is a natural part takes time. A first step is to begin by providing positive feedback.
Now we will share what we appreciate about each other.
We are now finished with the first module about the partnership. The next module focusses on the patient narrative.
Well done!