Galway Hospice Foundation was established in 1986 by a group of local doctors and nurses who wanted to develop hospice services for the people of Galway city and county. The hospice home care service started out with one doctor, one full-time and one part-time nurse. Today, the service is fully multidisciplinary, consultant-led, providing services across all of County Galway and the adjoining islands.
A new inpatient facility was opened in 1997 with funding from the local health board and a day care facility opened in 1998. Today, the hospice operates to full capacity and is currently expanding all of its services to meet the growing need. Although there is no legal requirement for the Foundation to be accredited, the management team wanted to
benchmark their services. Sean O’Healy, chief executive, says: “We are one of the smallest hospices in Ireland and although we feel we are providing care to a high standard, at least comparable with larger hospices, we wanted to have some evidence for this.”
The Foundation’s ambition was to carry out a root and branch review of the entire business to ensure the service was meeting international best practice standards. “We rely heavily on public fundraising and it is very important for us to be able to reassure the public that we are providing the best possible service and that patients are at the heart of everything we do,” says Sean.
The Foundation began to look for an accreditation partner and discovered that CHKS offers a specifi c hospice-focused accreditation programme. Sean says: “We therefore knew that CHKS would understand what we did and how palliative care delivery in a hospice setting differs from what can currently be provided by mainstream healthcare providers.”
The Foundation initially carried out a gap analysis to show which standards were being met in full, in part and not at all. It was able to identify where processes were in place, but weren’t being documented. It then set up four working groups for inpatient care, home care, day care and corporate governance. Work on ensuring compliance with the standards was then broken down into each area accordingly.
The Foundation made sure that every single person within the organisation was involved in the process of mapping against standards, which meant staff didn’t feel it was something that was being forced on them.
“By documenting these processes it meant we started to discuss whether there was a better way of doing things. This discussion with front-line and back-office staff was an important part of the improvement process. We knew that if our policies and procedures were to stand any chance of being implemented we had to take into account the views and input of those people who would be putting them into action,” says Sean. “This was one of the areas that the CHKS surveyors recognised and supported.”
Each working group looked at standards and processes within their respective areas. Policies were then drafted which went to the management team to finalise. “In terms of support from CHKS, we built up a great relationship with our dedicated client manager who provided expert support and advice. Although she kept us on our toes she was very
fair and kept us focused on the surveys.”
Sean explains that within a few months of starting the accreditation process, staff began to see the value and the benefits of having clearly written standards. A further benefit was that internal communications improved considerably, such was the level of engagement with staff. A number of committees were set up that hadn’t existed before and everyone in the organisation was included in at least one committee. This meant that everyone was able and encouraged to have a say.
When the CHKS surveyors came to visit they provided feedback which was then made available to all staff via these committees. “Having an open and transparent process was very important to us,” says Sean. “The whole process of accreditation is about making changes that will improve quality, and this is achieved by improving processes and standards along the way. CHKS was a supportive partner in this process and I think any hospice in a similar situation will regret not having embarked on the accreditation journey sooner.”
