20MEDICAL STUDENTS AS ADVOCATES - IMPROVING CARE FOR OLDER ADULTS

Abstract

Background: Geriatric Medicine is a speciality whose ethos is to provide high-quality patient-centred care for every older person. Obtaining patient feedback allows us to identify areas for improvement and work towards a patient-led healthcare service. Medical students can be encouraged to play an active part in the continuous quality improvement of how we care for older adults. Drawing on principles described in the "ASK ONE QUESTION" campaign coined by the Institute for Healthcare Improvement Open School for Health Professionals (Carson-Stevens A et al. Am J Med Qual. 2013. 28(2) 174), we aimed to enable University of Manchester medical students to become advocates in identifying ways to improve care for older patients. Sampling Methods: Over a two-year period we recruited medical students completing placements in Geriatric Medicine at Salford Royal Hospital. We requested that during each patient encounter they ask, "What could we have done to improve your care?". In groups they presented a chosen patient with that individual's feedback at the end. In total, we obtained 104 pieces of feedback. Results: The most common feedback was that patients could not think how their care could be improved (22/104). A large proportion of suggestions were communication based; communication regarding current admission (14/104 patients), communication regarding discharge (5/104) and communication between members of the MDT (4/104). Other recommendations included; getting home sooner (13/104), and more therapy (8/104 patients). A total of 28 themes for improvement were obtained. Conclusions: Medical students have understanding of the healthcare system and available time to explore patient's thoughts, some of which may be overlooked by the clinical team. This student led patient feedback survey has highlighted communication with patients about their care, as an area for improvement in our local Geriatric department. Medical students are tomorrow's doctors and empowering them to identify ways of improving patient-centred care can be invaluable to all parties.