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Table 4 Examples of Practical Changes Resulting from TTT

From: Introducing the trajectory Touchpoint technique: a systematic methodology for capturing the service experiences of palliative care patients and their families

Area of change

Examples of resulting changes

External marketing communications

Design of new leaflets

Extensive changes to ways information is provided on Websites

New social media campaigns with patient stories

New weekly local press articles

Increased public engagement

New public open events include ‘meet and eat’ and ‘book a hospice tour’,

Significant increases in public engagement events such as fundraising activities, and participation in local fairs and fetes

New community liaison post

Works with community groups (e.g. Women’s Institute, church groups, school children)

New volunteer recruitment drives to spread knowledge about hospice services and increase volunteer numbers.

Internal communications

New and updated bedside information folders

Changes to staff name badges and lanyards for improved communication

Training

Staff training in non-cancer conditions (including dementia, heart failure, motor neurone disease, and advanced day therapies)

The adoption of principles for situated learning with different teams

Initiation of a new communication skills training programme which, to date, has been accessed by GP surgeries, hospitals, hospices, and community trusts in 9 different areas of the UK.

Planned new patient communication training packages in conjunction with the education team at one of the Hospital Trusts

Improvements to patient support services

Changes to support patient communication and integration (including improved Wi Fi, and the purchase of plug-in bedside phones and new hearing loops, iPads, and talking boards)

Increased counselling and initiation of several new support groups

Improved access to spiritual support

New patient support services

Introduction of a bedside companion service

Introduction of mobile hairdressers

Advance Care Planning

Feasibility project launched into Advance Care planning using an adapted version of the TTT rather than lists of questions

Service delivery methods

Changes to clinicians’ working rotas to improve continuity of care

Changes to the servicescape (improved signposting, privacy measures, use of chapel, room layout),

Improvements to equipment and facilities (chairs, sanitary bins, improved menus, audiobooks, headphones for managing noise).

Policy changes

Alterations to admission protocols to consider individual preferences for private rooms over shared wards

Hospital policy changes surrounding the movement of palliative care patients

Improved coordination between providers

New training sessions delivered by a hospice for local GPs on a (regular) bi-annual cycle

Monthly lunchtime training forum catering for relevant professionals (e.g., care home managers, ambulance staff)

Creation of a new role of ‘community registered nurse’ for palliative care education and support for health and social care professionals

Extension to a coordination of care programme within community nursing teams

Creation of new community care coordinator role for better integration of hospice and other palliative care professionals