Catalyst for Change
Some insights into the power of story.
Every Person, Every Time
The Healthcare Quality Strategy (Scottish Government, 2010) aims to deliver the highest quality
healthcare to the people of Scotland and in turn, it aims to make Scotland one of the international leaders in healthcare quality. The following ‘Quality Ambitions’ (p. 7) outline the principles of safe, effective and person centred care at every healthcare encounter, for every person, every time.
Safe: “There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times.
Effective: “The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.
Person centred: “Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.”
Person Centred Care
There is a revival in healthcare that is focusing on active engagement, patient experiences, and the power of story in driving improvements and transforming services. As highlighted in the above person centred ‘Quality Ambition’ this also broadly involves (Ahmad, Ellins, Krelle, & Lawrie, 2014, p. 28):
- Care that is respectful, compassionate, dignified and sensitive to the whole person and their needs.
- Care where individuals can participate in their own treatment.
- Collective involvement in service design, delivery and improvement.
Hence, in working together, people can highlight what matters the most, make decisions about care and treatment, and identify and achieve goals (Health Foundation, 2014, p. 8).
Our Voice
The following presents some examples of how experiences are being used to highlight improvements, catalyse change and transform services.
- Recent research has highlighted how stories – based on staff and patient experiences – have the potential to support ongoing quality improvement, learning and reflection. For instance, they are used during team meetings, safety briefs and formal presentations, and they appear to be powerful in catalysing positive action and sharing good practices. Alongside quantitative data, stories (including other qualitative data) offer a “human side” to ongoing service improvement, and could perhaps provide the impetus for swifter action.
- The ‘Patient Opinion’ website offers patients the opportunity to narrate their healthcare encounters and experiences. In turn, service providers can tune into what really matters to users, and employ the narratives to inform patient focused service improvements. Whilst it’s a relatively simple concept that’s grounded on user experiences, it’s the actions that result which appear to make it a useful tool for driving improvements.
- The board game ‘Whose shoes?®’ uses narrative scenarios to support participants in reflecting on their own practice and interpretations of person centred care. The exercise also highlights the importance of practitioners/professionals of actively listening to service users and working together to reach shared goals.
- Starting out as ‘Stronger Voice’, the ‘Our Voice’ initiative aims to support people to engage with health and social care providers to continuously improve and transform services.
Summary
Stories – in their wider context – have been used throughout history for sparking knowledge, disseminating lessons, and supporting ongoing reflection. Whilst they often reflect on the past, their power lies in their ‘memorability’ and their universal links with current contexts and situations. Within healthcare, stories generally appeal to what people really care about and there is a growing recognition of their use to support safe, effective and person centred care.
References
Ahmad, N., Ellins, J., Krelle, H., & Lawrie, M. (2014). Person-centred care: from ideas to action. London: The Health Foundation. Retrieved from http://www.health.org.uk/publication/person-centred-care-ideas-action
Health Foundation. (2014). Person-centred care made simple. London: Health Foundation. Retrieved from http://www.health.org.uk/publication/person-centred-care-made-simple
Scottish Government. (2010). The Healthcare Quality Strategy for NHSScotland – putting people at the heart of our NHS. Edinburgh: Scottish Government. Retrieved from http://www.gov.scot/Publications/2010/05/10102307/0
Further Reading
Avicenna (Ibn Sina) (published c. 1012 – 1025). The Canon of Medicine (Al Qanun fi al Tibb). Retrieved from: http://www.canonofmedicine.com/ The Definition of Medicine (commentary 46). Retrieved from: http://www.canonofmedicine.com/book-i/part-i/thesis-1/1-the-definition-of-medicine/
Hippocrates Quotes – BrainyQuote. Retrieved from: http://www.brainyquote.com/quotes/authors/h/hippocrates.html
Copyright
Except where attributed, © Nancy El-Farargy, 2015.
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