patient stories workshop welcome. opportunitynowhere
TRANSCRIPT
Getting to know each other
(a little better)
What I’m bringing to the workshop…
What I want to take away from the workshop…
What could get in the way of my learning…
Something others may not know about me…
What do I / we want to
ACHIEVE or
CHANGE as a result of this
workshop?
Let’s look at the bigger
picture!
(Gray et al, 2005)
Quality improves as we improve the
match between our services and the needs of the
people who depend on them.
“Asking patients what they think about the care and treatment they have received is an important step towards improving care for patients in
hospitals and other health services.”
Professor Sir Ian Kennedy, Chair, Healthcare Commission, 2004
The common theme of these
new measures for patients is
improving quality.
It must be the basis of
everything we do in the NHS.
“Considers and acts on the views and
experiences of patients
who use the trust’s services.”
“The Trust needs to consider other approaches to get real feedback from patients and, importantly, their families.”
Develop a range of methods to capture patient experience and feedback
So what are
Patient Stories?
Patient stories are…
…recordedinterviews with
patients / service users about their
experience of receiving care.
Aim of Patient Stories
‘To find out about patient
experiences of being cared for &
to…
…recognise & celebrate the good
things & change the not so good
things.’
Lunch Time
How do we undertake
Patient Stories?
Preparing for Patient Stories?
• Ethical approval
• Gaining access
• Involving staff
How are patients recruited to tell their story ?
• Randomly selected patients invited to participate
• Explanation and information sheet
• Consent agreement form signed
• Mutually acceptable time agreed
Selection of Patients• Random
• Selection criteria requires that patients:
– have been cared for ……. days– can process and are able to recall the
experiences of hospitalisation– other criteria specific to the area
Interview Process
• Interviews take place in an area acceptable to patients
• Interviews are audio taped / digitally recorded
Patient Story-telling Prompts
• Tell me about when you became unwell…• Tell me about when you went into hospital or
when this episode of care began…• What do you remember most?• What was your care like?• What were some of the significant memories of
your care?• What, if anything, surprised / worried / pleased
you about your care?• Tell me more about...
Stages of Story Analysis
• Stage 1: Listening and mapping
• Stage 2: Peer review
• Stage 3: Identification of areas for quality improvement and indicators of good practice
Presentation of Findings1. Present to the disciplines mentioned
in the stories
2. Develop an action plan with key stakeholders with review dates to address issues arising from stories
3. Written report
Mapping out a Patient Story• Write the patient code in the centre of your paper
• Beginning in the top right corner, working outwards and clockwise, record key words that represent the events of the story. These key words may represent significant incidents or describe a phase or episode of care (e.g. admission, manipulation of my knee, when I was told my diagnosis)
• These key words can form sub-centres around which significant phrases or words should be recorded
• This process should be continued until the map represents the meaning of the interview
Friends bring me to hospital
I feel unconscious that dayafter I open my eyes (now 6th June, one month here, remember nothing)
Feel bad I can’t move
6th of May, a Monday
START
BecameUnwell
Patient 1
Friends bring me to hospital
I feel unconscious that dayafter I open my eyes (now 6th June, one month here, remember nothing)
Feel bad I can’t move
6th of May, a Monday
START
BecameUnwell
Waking Up
Didn’t tell me I had a stroke(he thinks it wasn’t good to tell me)
I can move my hands and legs and feel week
Have to do physiotherapy,especially my legs. I improve slowly
Upset- I have to be patient.I can’t do anything
Friends said ‘no problem, you’re doing fine’
2 nurses beside me
In side room #1
Re-assuringsmilingWatching meChanged drip
Friends around/TV/Music cassettes
Patient 1
Patient 1
BecameUnwell
Waking Up
Nurses
NotAble toMove
OtherDepart-ments
WardNights
BeingTrans-ferred
ThankYou
Friends bring me to hospital
I feel unconscious that dayafter I open my eyes (now 6th June, one month here, remember nothing)
Feel bad I can’t move
6th of May, a Monday
START
Didn’t tell me I had a stroke(he thinks it wasn’t good to tell me)
I can move my hands and legs and feel week
Have to do physiotherapy,especially my legs. I improve slowly
Upset- I have to be patient.I can’t do anything
Friends said ‘no problem, you’re doing fine’
2 nurses beside me
In side room #1
Re-assuringsmilingWatching meChanged drip
Friends around/TV/Music cassettes
Nice
Smiling
‘Don’t worry,you’ll recover’
They had to feed me
I like all of them
Trying to help me, always
Very kind, encouraging
Can’t move with-out wheelchair
I go to the dayroomMade friends witha few patients, nowthey’ve gone
I’m a patient person
I’ve been in many places: Rm 1, Rm 3, Bay 6, Rm 2. They moved me and didn’t ask me. I don’t care about moving beds.
I don’t visit them
Just have X-rayand come back
X-ray Dept.are lovely
I visited ITU; they asked me to
They saw me and werepleased; when I wasthere I was too sick
I sit in the chair
It takes a lotto do things
After physio I am tired
After supperI go to bedand sleep
They try to make me ‘happy’
Going to rehabilitation
I am sad that I am leaving here
Going for physio
Strange feeling-I am used to this placeI have promised
that I will come back
I will go and not come back;I have no treat-ment here
Only medicinefor blood pressure
I will miss them all-they are kind & lovely
Many thanks
Long pause in response to‘could anything be done better?’
To allof them
Doctors & nurses,all of them
I would like to be able to stand and walk again I am used
to my situation
I don’t mind
I feel all right now
Every morning Ifeel upset that Ican’t do anything
I can’t move or standbecause I am weak
Themes
• Identify areas valued and areas for improvement
• Once you have agreed the areas identified, move into themes
• Once you have the themes for each Clinical Leader, look at themes across the organisation
Action planning process
• Ensure the action plans are developed with the key stakeholders
• Ensure action plans are maintained and reviewed at regular intervals
• Celebrate the success of implementing your action plans
• Articulate the impact of implementation to key stakeholders
Examples of improvements made to patient care
• Noise reduction
• Patient privacy or confidentiality
• Attention to detail
• Appropriate use of names
• Active listening
• Cross infection
• Pain management
• Discharge planning
• Bob’s story
Time for a Break
Patient Stories - hearing the patient’s voice
1st
2nd
3rd
= THE NURSE
How do you see the situation?
What does this situation mean to you?
How do you feel about what you heard?
What can you celebrate and what would you wish to change?
= THE PATIENT
How do you see the situation?
What does this situation mean to you?
How do you feel about what you heard?
What can you celebrate and what would you wish to change?
= THE MANAGER
How do you see the situation?
What does this situation mean to you?
How do you feel about what you heard?
What can you celebrate and what would you wish to change?
When people who are not used to speaking are heard by people who are not used to listening, then real
change occurs!
Stuff Happens!
Questions and ‘stuff’ raised
from Day One
Obtaining Patient Consent
- practice skills
Undertaking a Patient Story - practice skills
Lunch Time
Patient Stories maps & themes
Break
Time
Planning the next steps
Final Thoughts
The world is moved along, not only by the mighty shoves of its heroes, but also by the aggregate of tiny
pushes of each honest worker. Helen Keller
What will I / we
do differently
as a result of this workshop?
“If you want to see
change…
…be the change you want to see”
People acting together as a group can accomplish things that no individual acting alone could
bring about!
Franklin D. Roosevelt
Yes, we can!
Can we do it?
for it!
