1. Patient Stories Workshop Welcome

3. opportunitynowhere

4. Getting to know each other (a little better)

5. 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…

6. What do I / we want to ACHIEVE or CHANGE as a result of this workshop?

7. Patient Stories setting the context

8. Let’s look at the bigger picture! !

9. (Gray et al, 2005) Quality improves as we improve the match between our services and the needs of the people who depend on them.

10. “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

11. The common theme of these new measures for patients is improving quality. It must be the basis of everything we do in the NHS.

12. “Considers and acts on the views and experiences of patients who use the trust’s services.”

13. “The Trust needs to consider other approaches to get real feedback from patients and, importantly, their families.”

14. Develop a range of methods to capture patient experience and feedback

19. So what are Patient Stories?

20. Patient stories are… …recorded interviews with patients / service users about their experience of receiving care.

21. 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.’

23. Lunch Time

24. How do we undertake Patient Stories?

26. Preparing for Patient Stories? Ethical approval Gaining access Involving staff

27. 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

28. 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

29. Interview Process Interviews take place in an area acceptable to patients Interviews are audio taped / digitally recorded

30. 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...

31. 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

32. Presentation of Findings 1.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

33. 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

34. Friends bring me to hospital I feel unconscious that day after I open my eyes (now 6th June, one month here, remember nothing) Feel bad I can’t move 6th of May, a Monday START Became Unwell Patient 1

35. Friends bring me to hospital I feel unconscious that day after I open my eyes (now 6th June, one month here, remember nothing) Feel bad I can’t move 6th of May, a Monday START Became Unwell 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-assuring smiling Watching me Changed drip Friends around/TV/Music cassettes Patient 1

36. Became Unwell Waking Up Nurses Not Able to Move Other Depart- ments Ward Nights Being Trans- ferred Thank You Friends bring me to hospital I feel unconscious that day after 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-assuring smiling Watching me Changed 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 dayroom Made friends with a few patients, now they’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-ray and come back X-ray Dept. are lovely I visited ITU; they asked me to They saw me and were pleased; when I was there I was too sick I sit in the chair It takes a lot to do things After physio I am tired After supper I go to bed and 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 place I have promised that I will come back I will go and not come back;I have no treat- ment here Only medicine for blood pressure I will miss them all- they are kind & lovely Many thanks Long pause in response to ‘could anything be done better?’ To all of 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 I feel upset that I can’t do anything I can’t move or stand because I am weak

38. 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

39. 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

40. 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

41. Time for a Break

42. Patient Stories - hearing the patient’s voice

43. 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?

44. When people who are not used to speaking are heard by people who are not used to listening, then real change occurs!

45. Stuff Happens! Questions and ‘stuff’ raised from Day One

46. Patient Stories Workshop Day 2

47. Obtaining Patient Consent - practice skills

48. Undertaking a Patient Story - practice skills

49. Lunch Time

50. Patient Stories maps & themes

51. Break Time

52. Planning the next steps

53. Final Thoughts

55. ‘Trim Tab’ HMS

56. 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

57. What will I / we do differently as a result of this workshop?

58. “If you want to see change… …be the change you want to see”

59. People acting together as a group can accomplish things that no individual acting alone could bring about! Franklin D. Roosevelt

60. Yes, we can! Can we do it?

61. for it!

62. Patient Stories Workshop Thank You