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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