Recently, I had the misfortuneof becoming a patient.
Overall, I was satisfied with my care. The environment was clean and I was seen in a reasonably timely manner by the right professionals. However, the doctor left the room three times in as many minutes while she was examining me to answer a bleep. I felt the bleep was more important than me, and the interruptions were disruptive to both of us.
We know interruptions increase errors. So, perhaps the doctor could have answered the bleep between patients. This would have speeded up the examination process and improved the experience for us both.
We need to strengthen efforts to meet patients’ and family members’ needs and expectations (Ledema et al, 2011). Emerging evidence points to a link between patient experience and clinical outcomes, and between quality and financial performance (1000 Lives Plus, 2011; Dr Foster, 2010).
One way of meeting patient needs is through listening to their stories. These stories provide a very different lens through which to view the world we work in, offering a unique, anecdotal and also powerful insight into what has happened from the patient’s or carer’s viewpoint.
Patient stories are a rich source of information and can expose issues and ideas never considered before. They can be used to mitigate against potential complaints, and grant us insight into the disruptiveness of illness that we can only begin to imagine.
Some conversations can be difficult and painful both to the story-teller and to person taking the story. Equally, they can reveal positive experiences to build on.
Taking and analysing patient stories is a skill that requires development and training. A governance structure is needed to ensure the appropriate use and information management of these stories. The Royal College of Nursing has a recognised analysis methodology, which is widely taught.
As nurses, we see “dignity maintained at all times” written in notes. How do we know this has been achieved? Cardiff and Vale University Health Board has a database of more than 400 stories. A ward sister has used patient stories to develop a team approach to ensure dignity and respect is maintained, based not on what nurses think, but on what patients want.
Many of our board meetings start with a story, which enriches decision-making and maintains a focus on patients. On a larger scale, stories have been used to develop the cancer genetics service for Wales.
Imagine if stories were used at all levels from the proverbial board to ward to inform decision-making and effect change. How different would our care and service provision be? NT
Joy Whitlock is quality and safety improvement manager, Cardiff and Vale University Health Board
Ledema R et al (2011) Patients’ and family members’ views on how clinicians enact and how they should enact incident disclosure: the “100 patient stories” qualitative study. BMJ;343: d4423.
Dr Foster (2010) Patient Experience. London: Dr Foster.
1000 Lives Plus (2011) Programme Area: Patient Stories. Cardiff: 1000 Lives Plus.