New Strategy

Over the next few months I will be talking with our staff, volunteers, service users, local GPs and District Nurses about the future direction of the Hospice.

We have supported thousands of people over the last 26 years, many have appreciated and benefited from the support we have given to them and their families. Some of the challenges we have been discussing have included:

• More people with cancer are referred to the Hospice than people with any other illness like serious heart or lung conditions.
• Many people are anxious about being referred to the Hospice, but when they meet one of our team in their own homes or come to the Hospice they realise we are here to help people live life to the full and sometimes people wish they had been in contact with the Hospice earlier in their illness.

Families and patients tell us that they appreciate that we are able to have those difficult conversations about dying - helping them to prepare and plan for death - something that will happen to all of us one day.

We need help with ideas how we can promote the message that we here to help with quality of life and are here to support the families as well.

These are some of the things we do, (but not everyone knows):

• Give advice to GPs, District Nurses and Doctors working Out of Hours (e.g. Harmoni)
• Attend meetings at GP practices to discuss how to support people at the end of their lives
• Give advice and support to care homes
• Organise school visits to the Hospice
• Give advice about talking to children about serious illness in the family

We are also developing a new website - are there things you would like to see on there?

Please post your comments, thoughts and suggestions and I will look forward to receiving your feedback.

Vision, Mission and Values

In preparing the Hospice for the future we need to agree our Vision, Mission and Values. The vision is where we want to get to (aspiration), the Mission describes what we do (perspiration) and the values are how we work (inspiration) and what hold as important.

This Mission gives greater emphasis on working with others, because as demand increases we will need to enable others to give care and support.

Following meetings with staff, volunteers and users I have put together this draft and would welcome your comments.

Our Vision
Services - To improve the quality of lives of patients and their families during life-limiting illness, death and bereavement.
People - A great place to work, inspiring staff and volunteers to be the best they can.
Organisation - Continually strive for excellence and lead in the field of Hospice Care.
Financial - To work with financial integrity, giving best value and securing our long term future.
Partners - To build successful partnerships with our local community, in a socially responsible way.

Our Mission
To work compassionately in the fields of life-limiting illness, death and bereavement by:

• Enabling patients and families to live with illness and bereavement
• Empowering communities to care for those affected
• Giving specialist care
• Teaching and influencing others

Our Values

• Leadership
• Communication
• Integrity
• Resilience
• Learning
• Developing
• Quality
• Teamwork
• Respect
• Equality

Technology

This timeI thought I would talk about some new technologies that could help save time. Links to other websites are embedded in my blog. If you right click the links you can open a new window or tab.

With technology becoming an increasing part of our world at the Hospice we have been looking at new ideas. Basecamp was one of the first web based products we tried that has helped us with the refurbishment project. Recently Vicky has been developing online questionnaires that at the same time stream information directly into a spreadsheet using a product called Zoho creator.

For some time I have been recommending Firefox as a safer browser this page tells you why Firefox is so good and here you can download Firefox 3.

Once you have Firefox I would recommend you having a Google account, not only does it give you a good email account it gives you access to all sorts of free products click here to sign up and see what else you can do.

A video about RSS feeds explains a way of keeping up to date with news from your favourite websites or blogs, use Google reader as your feed reader and then you can put your Google reader on your home page by customizing your home page on Google.

So now you are set up and surfing the web, but how to save the links to sites - rather than saving your bookmarks in Firefox you can keep them on a bookmarking website, then you can access them whichever computer you are using - Commoncraft is a site that explains this.

The bookmarking site some of us started using is Diigo and we have a Group called St Nicholas Hospice that we can add links to.

All these ideas may be new to some of you the links will stay on my blog feel free to try as many of them as you would like to and let me know how you get on

Multidisciplinary Team Meetings

Last week I was teaching in Oxford about improving the assessment and support of families. Part of the day was encouraging participants to think about the patient and the family (using the word family in the broadest sense) as one unit and then describing what was happening in the family in relation to:

• Family organisation and character
• Parenting
• Communication
  
• Emotional Life
• Alliances
  
• Identity
  
• Adaptability

Many struggled to separate the work they were doing with the families to what was happening in the family. There was much discussion and in trying to generate ideas we discussed how complex MDT meetings were and how threatened people felt. Many felt such meetings could be helped by:

• Displaying the family genogram
• Summarising the key issues for the family (not what their focus of intervention was)
• Asking the team to generate ideas about what was happening rather than give suggestions about what the clinician could do

It would be the responsibility of the team to come up with ideas rather than the critique what was already being done

May

A month has gone by and this is the first time I have had to update my Blog. The Hospice has been busy with moving patients onto the Summer Ward and clearing the IPU ready for refurbishment. Colin and is team of helpers have worked all hours to make sure it is ready for the builders.

I have finished my first assignment for my Masters and am awaiting the results. Writing 5000 words seemed an enormous task initially and then the week before I was trying to reduce it from 6000 to 5000.

This week a journalist from the East Anglian Daily Times spoke to me about a topical video on the Internet by an American Randy Pausch who had given a Last Lecture about his life and written a book (he called a manual) for his family for after his death, the PowerPoint presentation he used for the lecture is also available. A shorter interview can be found on the Times online. Details about Randy are on Wikipedia.

You might ask what relevance this has for us at St Nicholas, well if you listen and read his words, Randy is talking about exactly what we do here at the Hospice - we help people prepare for their death and help their family make preparations as well.

There is nothing that can take away the pain of leaving someone you love but making preparations can help a little, though it may not be for everyone. Not everyone would want to make a video or write a book, but some make a Memory Box, leave a letter or a special item. Families left behind also value the opportunity to be prepared, I have known many husbands who have had some cooking lessons from their wives and wives who have been taught how to manage the fuse box.

Randy Pausch is leaving 3 young children - nothing can be worse for a parent and Winston's Wish gives advice on how to talk to children and manage a serious illness.

There is no right or wrong way to prepare for a death, but staff at the Hospice have the skills and training to support families who want to make their own preparations and help them live every day to the full.

Back to normality - Major milestone

Well it seems a long time since last week when I spent a day in this tent overlooking a lake on the Yorkshire moors - view on the right. (I think tent is an exaggeration, as it offered little protection.)

Major milestone
I am delighted to say that at a meeting this week with the architects, we have agreed the contractor, who is going to undertake the work on the In Patient Unit. The quotations for all the work have come in line with expectations, this means we will be able to do all the work we have planned. However we will be working to a tight time frame and there will be little or no movement to make any further changes to the plan.

It is hoped that we will begin the work around the 21 - 28 April and it will take 16 weeks. We are being visited by the Health Care Commission on 7 April to assess whether our new Day Hospice department is fit to receive patients and a great deal of work is happening to ensure that we pass. (We will have a contingency plan if we don't pass on that day.)

We have also received the grant from the Department of Health and will be submitting reports to them about what the work we are doing.

I must say the fact that we have got to this point so efficiently, is much to the credit of all the people who have been working so hard in agreeing specifications and deciding on fixtures and fittings. I know many people across the In Patient Unit and Day Hospice have spent hours pouring over plans and details .

One of the key people in all of this has been Colin Bacon who has been been working tirelessly with the architects and all the firms that have been visiting as well as coordinating all the office moves that have been happening. Always ensuring that people have phone and computer access.

I hope will join me in giving him our heartfelt thanks.

Embracing change

As we are experiencing changes in our surroundings we are also coping with the normal changes that happen in organisations when people leave and join the organisation. We will be saying goodbye to some staff, seeing changing roles for others and welcoming new additions to the team.

Change can feel unsettling, but our work with patients and families makes us realise that change is part of life, although we cannot always have control of change we do have control on how we react and respond to it. But I do believe that our work with the dying and bereaved perhaps makes us more sensitive to change, perhaps because we deal with other people's uncertainties we would like less uncertainty in our own lives. Therefore if we all get involved with, and see how we can influence change it should decrease the uncertainty we may fear.

For the Hospice to continue to develop and thrive in the future we must all embrace change positively, over the next months we are going to be developing a plan that will carry us through the next 5 years.

Some of the ideas I have been thinking about are:

• Making sure that all patients who might need our support really understand what we do and can easily access our services
  
• Raise the profile of our work locally and nationally
• Offer training placements to those who want to see excellent hospice care in action

I know that the whole team is passionate about the work we do and everyone will have a part in contributing to that plan and I look forward to hearing people's ideas.

Ideas are going to be collected:

• On noticeboards
• Via email
• Comments on my Blog
• Written suggestions to me or via your manager