Healthcare Assistants’ new idea to improve our care

News and Blog

Earlier this year, St Catherine’s started its Hospice Palliative Care Award for our Healthcare Assistants (HCAs). Specific to end-of-life care, the Award helps our HCAs to have the confidence and skills they need to work in palliative care. 

Emma Dyer and Catherine Ryan were in the first group of HCAs to complete the training. Here they tell us more about it, including their brilliant new idea that has been so well received, St Catherine’s will be implementing it in the near future… 

Emma says: “The HCA Award is a six-part course with training sessions on different aspects of palliative care, including: loss and bereavement, communication at end of life, and care in the last days. You have to complete all the modules and document your day-to-day work to show clinical knowledge on the ward and within the Hospice at Home team.  

“Previously I worked in property, so for someone like me who is new to this profession, the training has been really helpful. It definitely makes you think about how to have difficult conversations with people, talking with emotional people and dealing with death. A lot of people will start this job having never dealt with end of life before, so it helps make it less daunting.” 

Catherine explains: “We are in the first cohort of the Award, with eight other HCAs from the community team. The plan is that every new HCA will go through the system in their induction to ground their skills and start using it from the off. 

“The Award opens your eyes to the other parts of being HCA and not just the clinical side. It also gives us the opportunity to work on the IPU which is something that is being encouraged. HCAs on the ward have a slightly different skillset to us, who go into people’s homes.” 

For the last section of the Award, participants are supported to present a quality improvement idea – which improves patient care. They can work alone or in small groups, so Catherine and Emma paired up.

For me, it was good to work with Catherine because I was new, and Catherine has been here for three years, so we each brought different ideas.” said Emma 

Catherine added: “We were in a car with a senior staff member, and we were talking about what we might do amongst ourselves. Then Emma came up with the idea – an HCA notebook.” 

The HCA Notebook

Emma explains more: “When we visit people in their homes, we carry out observational checks. During our working morning we have five or six different people to visit and then we write up all our notes on our patient record system once we come back to the hospice afterwards, so we have to remember a lot of information.  

Catherine continues: “So Emma came up with this quick tick-box notebook idea, that fits in the pocket of our uniform, to help us jog our memories when we are writing up our visits. When you are having a really busy day, you go back to the office and sometimes it can be hard to remember all the details. Due to patient confidentially, we have to be so careful with what we write down. The HCA notebook has simple tick-box options and acts as a prompt for us to remember what we’ve done and to make sure we check the same things with every person we visit. 

“To keep the details confidential, we use either a number or initial to identify the person and all the pages are perforated, so once our notes are written up, the pages can be torn out and shredded in the confidential shredder.” 

A small notebook on a wooden table opened up to show text inside
The HCA Notebook

The notebook idea was received so well that it has already been trialed with the team.

Emma says: “We did a trial with our whole HCA team and it had really good feedback. Whilst one of us tidied up at the end of a visit, the other HCA went through the tick-box questions with the family. We thought there might have been some resistance to a new idea but even staff who have been here a long time were really positive about it. No one has been negative.” 

After completing the project, Emma and Catherine were invited to give a detailed presentation to the Senior Management Team (SMT).  SMT had shown great interest in the HCA award and wanted to better understand the work being done. This involved Emma and Catherine discussing their idea, their action plan and the research they had completed around the confidentially of the details logged in the notebook.

For Emma the presentation felt like being on the television: “We had to look at costing and what would happen if one of these books was lost. It felt like being on The Apprentice! Our presentation went down very well and we were then asked to present it to the SMT who were genuinely interested. We’re the people on the ground and it was nice for management to acknowledge our idea.” 

Catherine sums up: “The response has been so positive and people have said, “We can’t believe we haven’t got this already!” We still need to check the confidentially of the idea with the governance group, but as far as we’re aware our HCA notebook is going to be introduced in the near future!” 

Natalie Clow, Practice Educator, who is overseeing the new HCA Award has been delighted with how the first group have got on with the training: 

The HCA award has been really well received and I am delighted that the quality improvement projects are starting to have such a positive outcome for patient care.  Asking our HCAs to complete this element of the award means that they have the confidence and tools needed to make positive changes in the future for a better patient experience. 

Emma and Catherine worked really hard on their notebook idea, took on board all the advice they were given, piloted it with their colleagues and have made it a useable document that will support their record keeping.  

“I cannot wait to see what other ideas our fabulous HCAs will come up with next to improve the care they give to patients!”