"Observations of an Outpatient Department"

About: Norfolk & Norwich University Hospital / Ophthalmology

(as a carer),

I must congratulate the hospital on its cleanliness in the departments when taking a relative to the Out-patients eye clinic yesterday.

Having to sit for a couple of hours I observed patients & staff in this department & over all I was impressed by the service, especially the large screen telling patients if any clinics were running late.

I observed the 2 automated check in screens at the entrance to the department, both placed in rather a strange place which could be moved closer into the department for ease of access for your patients (one was hardly being used because of this).

The welcome screen was large and good contrast for the patients with visual impairment (yellow writing on black) although as you went from screen to screen the writing was small & held too much information for the patient to take in. I was wondering if you had patient representatives with visual impairment who could help you with the design of this.

I would also note elderly patients struggling with this technology & ended up going to the manned reception for confirmation that they had checked in. Perhaps a better confirmation screen on the check-in computer might be better.

The main reception area is large & bright & seemed to cope with the patients. Access for wheelchairs was good with room to spare.

I would note that patients were confused in making their way to the manned reception desk with a row of chairs restricting direct access making patient double back to get there. Not easy for those using walking aids or wheelchairs.

The main waiting area was good with chairs at differing height for those who needed them, however there did not seem to be spaces for those in wheelchairs. From experience carers seem to have to park their loved ones in awkward places. Removing a couple of chairs to allow the wheelchair to be positioned next to where you sit helps with inclusion in sitting arrangements. From what I saw 2 spaces in the main area would be sufficient.

There is an area for young children, & I congratulate you for including the area. Small chairs makes it comfortable for children & parents away from the other patients. I would note the toys were lacking for a variety of young people. Perhaps one of your charities would help towards the cost of updating these together with a TV & videos to show whilst the department was open.

As mentioned, the main TV screen in the waiting area showing information was good especially telling patients of delays in clinics. I wonder if in the future this information could be "Tweeted" on the internet to let patients know without having to be seated. Position of the screen was not brilliant but I think you are a bit restricted on where you can put it. Another screen might be better.

Perhaps some of the patient posters could be removed as there were a few, not really written for those with sight difficulties, but they were relevant.

The nurses called out for the patients when this was their turn, how ever due to the layout it was not always easy to hear who they were calling. I am not certain how this could be improved but perhaps staff & patients might have a better idea.

But all staff & receptionist seemed to deal with patients well including those with any disabilities, and I congratulate you & the staff on this. The nursing staff acted promptly when the emergency alarm was accidently triggered by a cleaner who was in there. Even though this was a false alarm prompt action saves lives! A small point of congratulations.

There is a cold water machine in the main waiting area, mainly use for staff to full their water bottles, & for children to play with. Personally I don't think it is in the best position. As children might play with this there is a temptation to spill the water. As this is next to the main walkway I am certain one day an elderly patient might slip. I would recommend moving it so it is easier for staff to get to saving them having to bring their water bottles to the waiting area.

I did not go into the rooms with my relative, but from her experience everything was explained to her at every stage of her journey, answering all questions to her satisfaction.

After testing of the eyes the patients wait in a secondary area to see the doctor. I think you already know that this area can get crowded with no place for those in wheelchairs to wait. I am uncertain how you could improve this for patients.

Overall staff maintained patient confidentiality with patient notes covered or the back of the folder showing, although 1 or 2 did slip up here.

There did seem a need for a lot of patients to take A4 slips of paper back to the reception after seeing the doctor, in our case for another outpatients appointment only to be told we needed to phone up nearer the time. Perhaps with technology & a joined up approach with your various IT systems this step might be eliminated.

Overall I was impressed as a observer/carer of the outpatients eyes clinic, & hope my observations might help you, not to act but to help make those little things that turns a good service into an outstanding one.

As for the "Friends & Family Test", yes what I observed I would recommend!

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Response from Janice Bradfield, Senior Communications and Membership Manager, Norfolk and Norwich University Hospitals NHS Foundation Trust We are preparing to make a change

Thank you for taking the time to let us have such detailed feedback about your visit to the eye department.

We will pass your comments to the sister in charge for her to review and see where we can improve.

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Update posted by Informationmadeeasy (a carer)

I would be interested if there were any outcomes from my suggestions, especially around wheelchair access within the seated waiting area.

Many thanks

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