Scottish Inpatient Experience Survey 2016 Volume 1: National Results

Results - Hospital and Ward Environment

Summary

At a general level, people rated the hospital and ward environment positively, around nine out of ten ( 89 per cent) rating the 'overall' hospital and ward environment as 'excellent' or 'good', a rise of one percentage point since 2014.

As in previous surveys, when asked about more specific aspects of the hospital and ward environment, responses were mixed. People tended to be most positive about cleanliness and the visiting hours, however they were markedly less positive about food and drinks, noise at night, and knowing which nurse was in charge of the ward.

In general, results for questions relating to the hospital and ward environment saw similar results or an increase in positive ratings from the previous survey in 2014. The only exceptions to this were in relation to the availability of hand- wash gels and the time taken to get assistance, which both saw a decrease in percentage positive response.

The hospital and ward environment

People were positive about their overall rating of the hospital and ward environment: around nine out of ten ( 89 per cent) rated the hospital and ward environment positively, a rise of one percentage point from 2014 (Figures 8 and 9).

Figure 8 Overall rating of the hospital ward and environment (%)

Figure 9 Overall rating of the hospital ward and environment (%)

As well as providing an overall rating, people were asked how much they agreed or disagreed with eight statements covering:

• hospital and ward environment: cleanliness; noise at night; catering and drinks; receiving assistance; impact of other patients and visitors
• overall rating of the hospital and ward environment.

In addition they were asked to indicate the extent to which they were content with the visiting hours, ability to spend time with others and the availability of hand gels (Figures 10 to 12).

Figure 10 Summary of hospital visiting (%)

In general, responses were mixed. People were most positive about the following statements regarding the hospital ward:

• 97 per cent were happy with the visiting hours, a rise of two percentage points from 2014 (Figure 10)

• 96 per cent thought the main ward or room they stayed in was clean, a rise of one percentage point from 2014 (Figure 11)

• 95 per cent thought the equipment used for treatment was clean (Figure 11)

Figure 11 Summary of the ward environment (%)

However, people were markedly less positive on the following statements regarding the hospital ward:

• around two in five ( 43 per cent) knew which nurse was in charge of the ward (Figure 12)

• over half of people ( 55 per cent) were not bothered by noise at night from other patients, with around seven in ten ( 69 per cent) not bothered by noise from staff (Figure 12)

• around two in three ( 68 per cent) were happy with the food/meals received (Figure 11)

There were slight improvements in peoples' ratings of cleanliness (ward/room and bathroom/toilets) which both showed an increase of one percentage point from the 2014 survey.

Improvement was also seen in people's rating of being able to spend enough time with the people that mattered , 84 per cent felt they had enough time, a rise of three percentage points from the 2014 survey.

People were slightly less positive than in 2014 about the availability of hand-wash gel for patients and visitors, and receiving assistance within a reasonable time. Both fell by one percentage point.

There was some variation in results for NHS Boards around knowing which nurse was in charge of the ward, results ranged from 34 per cent to 65 per cent.

Figure 12 Summary of the ward atmosphere and noise (%)

Food and drink

Food and drink play an important part in a patient's recovery and consequently they are subject to national standards for food, fluid and nutritional care in hospitals ^{[ 5]}. NHS Boards' performance in the provision of food, fluid and nutritional care are assessed based on these standards.

People were asked about the food and drink they had received while in hospital. Food is an area where a substantial percentage of people reported a negative experience, however they were more positive about the drinks they had received (Figure 11):

• around one in six people ( 18 per cent) were not happy with the food they had received

• around one in 15 people ( 7 per cent) were not happy with the drinks they had received

As with the previous survey, there was considerable variation between NHS Boards in the responses to the question 'I was happy with the food/meals I received'. Positive response rates ranged from 56 to 91 per cent.

Noise

Noise at night can be disruptive for patients, affecting their sleep and potentially their recovery (Figure 12):

• around one in four people ( 28 per cent) felt they were bothered at night by other patients during their hospital stay

• with one in six people ( 17 per cent) reported being bothered at night by hospital staff

There was considerable variation between NHS Boards in responses to the question 'I was not bothered by noise at night from other patients'. Positive responses ranged from 37 to 81 per cent. In comparison, there was less variation between NHS Boards in relation to noise at night from staff with results ranging from 56 to 85 per cent.

Knowing who was in charge of the ward

One of the aims of the Leading Better Care programme ^{[ 6]}was to redefine the role of Senior Charge Nurses. This included making sure that the Senior Charge Nurse is visible and accessible to patients. People were asked if they knew who is in charge of the ward (Figure 12):

• around two in five ( 43 per cent) indicated that they knew who was in charge of the ward all or most of the time,

• 24 per cent indicated that they knew who was in charge of the ward some of the time

• 12 per cent indicated that they did not know who was in charge of the ward but they would have liked to know

• the remaining 22 per cent indicated that they did not know who was in charge of the ward, but it didn't bother them

These results show that people still find it difficult to identify who was in charge of the ward; over one third of people indicated that they didn't know which nurse was in charge of the ward. It is worth noting however, that of these people who did not know, the majority ( 64 per cent) were not bothered by this.

Single rooms

People were asked if they had a single room at any time during their most recent stay in hospital:

• two out of five ( 41 per cent) indicated that they had a single room

• three out of five ( 59 per cent) were not in a single room

Most people, four in five ( 81 per cent), were happy about whatever room(s) they had occupied, irrespective of whether they had had a single room or not (Table 2).

However, additional analysis has shown that those in a single room were more likely to be happy with their room. The majority of people ( 91 per cent) in a single room responded positively about the room they were in whereas only three quarters ( 75 per cent) of those patients who did not have a single room were happy about it.

Table 2 Experience of different room types

Statement	Happy with room (%)	Would have preferred another room (%)	Total (%)
Stayed in a single room	37	4	41
Did not stay in a single room	45	15	59
Total	81	19	100

Single room and noise by patients and staff

As might be expected, those who had been in a single room were less likely to have been bothered by noise at night by patients than those that did not have a single room ( 22 per cent vs. 33 per cent). However, there was little difference when it came to being bothered by noise from staff ( 16 per cent vs. 17 per cent) (Figure 13).

Figure 13 Being bothered at night by patients or staff by whether patient had single room or not (%)

Moving wards

Moving wards can be disruptive to patients and in cases where patients are moved from a specialist ward to a ward treating different conditions known as 'boarding', it can result in longer hospital stays ^{[ 7]}. It can also increase in the risk of infections spreading. Effective management of patient flows through hospital is a key priority for NHS Boards to minimise the need for moves.

We asked people to indicate whether they moved wards during their stay and if so the time of day (Figure 14):

• over a third of people ( 36 per cent) had moved ward at least once during their hospital stay

Of those that moved:

• over half ( 52 per cent) were moved during the day

• one in six ( 16 per cent) were moved during the middle of the night ( i.e. after 10 pm)

Figure 14 Time of day patients were moved ward (%)

Patients that had moved ward were also asked whether the ward moves were well-managed. Of those that had moved wards, seven out of ten ( 70 per cent) felt that their moves had been managed well (Figure 15).

Figure 15 Experience of whether ward moves managed well (%)