{"id":392,"date":"2016-09-02T16:01:05","date_gmt":"2016-09-02T16:01:05","guid":{"rendered":"https:\/\/blogs.bmj.com\/quality\/?p=392"},"modified":"2016-09-02T16:02:12","modified_gmt":"2016-09-02T16:02:12","slug":"catalyst-for-change-some-insights-into-the-power-of-story","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/quality\/2016\/09\/02\/catalyst-for-change-some-insights-into-the-power-of-story\/","title":{"rendered":"Catalyst for Change: Some insights into the power of story"},"content":{"rendered":"<p><strong><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-393 alignleft\" src=\"https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Nancy-at-Tower-Bridge-London.jpg\" alt=\"Nancy at Tower Bridge London\" width=\"158\" height=\"211\" srcset=\"https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Nancy-at-Tower-Bridge-London.jpg 960w, https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Nancy-at-Tower-Bridge-London-225x300.jpg 225w, https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Nancy-at-Tower-Bridge-London-768x1024.jpg 768w, https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Nancy-at-Tower-Bridge-London-300x400.jpg 300w\" sizes=\"auto, (max-width: 158px) 100vw, 158px\" \/>Biography<br \/>\n<\/strong>With scientific and healthcare underpinnings, Dr Nancy El-Farargy is a researcher and educationalist.\u00a0 Her work covers a range of quality, improvement and safety research &amp; development to support the delivery of safe, effective and person centred<br \/>\ncare.\u00a0 She is based at NHS Education for Scotland (NES), which is the national health board for education, training and workforce development for the NHS in Scotland.<\/p>\n<p>Twitter: <a href=\"https:\/\/twitter.com\/NancyElFarargy\">@NancyElFarargy<br \/>\n<\/a><strong><br \/>\nEvery Person, Every Time<\/strong><\/p>\n<p>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.\u00a0 The following \u2018Quality Ambitions\u2019 (p. 7) outline the principles of safe, effective, and person centred care at every healthcare encounter, for every person, every time.<\/p>\n<ul>\n<li>Safe: \u201cThere 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 healthcare services at all times.<\/li>\n<li>Effective: \u201cThe 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.<\/li>\n<li>Person centred: \u201cMutually 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\u201d.<\/li>\n<\/ul>\n<p><strong>Person Centred Care<\/strong><\/p>\n<p>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.\u00a0 As highlighted in the above person centred \u2018Quality Ambition\u2019 this also broadly involves (Ahmad, Ellins, Krelle, &amp; Lawrie, 2014, p. 28):<\/p>\n<ol>\n<li>Care that is respectful, compassionate, dignified, and sensitive to the whole person and their needs.<\/li>\n<li>Care where individuals can participate in their own treatment.<\/li>\n<li>Collective involvement in service design, delivery, and improvement.<\/li>\n<\/ol>\n<p>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).<\/p>\n<p><strong>Our Voice <\/strong><\/p>\n<p>The following presents some examples of how experiences are being used to highlight improvements, catalyse change, and transform services.<\/p>\n<ul>\n<li>Recent research has highlighted how <a href=\"http:\/\/www.nes.scot.nhs.uk\/media\/2729337\/what_matters_to_you_poster.pdf\">stories<\/a> \u2013 based on staff and patient experiences \u2013 have the potential to support ongoing quality improvement, learning, and reflection.\u00a0 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 of good practices.\u00a0 Alongside quantitative data, stories (including other qualitative data) offer a \u201c<a href=\"http:\/\/www.nes.scot.nhs.uk\/media\/3200354\/Patient%20Safety%20Stakeholder%20Report%20-%20January%202015.pdf\">human side<\/a>\u201d to ongoing service improvement, and could perhaps provide the impetus for swifter action.<\/li>\n<li>The \u2018Patient Opinion\u2019 website offers patients the opportunity to narrate their healthcare encounters and experiences.\u00a0 In turn service providers can tune in to <img loading=\"lazy\" decoding=\"async\" class=\"wp-image-394 alignright\" src=\"https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Whats-your-story-Catalyst-for-Change-Blog-Photo.png\" alt=\"What's your story - Catalyst for Change Blog Photo\" width=\"197\" height=\"156\" srcset=\"https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Whats-your-story-Catalyst-for-Change-Blog-Photo.png 456w, https:\/\/blogs.bmj.com\/quality\/files\/2016\/09\/Whats-your-story-Catalyst-for-Change-Blog-Photo-300x238.png 300w\" sizes=\"auto, (max-width: 197px) 100vw, 197px\" \/>what really matters to users, and employ the narratives to inform patient focused service <a href=\"https:\/\/www.patientopinion.org.uk\/info\/patient-opinion-scotland\">improvements<\/a>.\u00a0 Whilst it\u2019s a relatively simple concept that\u2019s grounded on user experiences, it\u2019s the actions that result which appear to make it a useful tool for driving improvements.<\/li>\n<li>The board game \u2018<a href=\"https:\/\/www.hsj.co.uk\/home\/innovation-and-efficiency\/game-changer-the-board-game-making-a-play-for-person-centred-care\/5075840.article\">Whose shoes<\/a>?\u00ae\u2019 uses narrative scenarios to support participants in reflecting on their own practice and interpretations of person centred care.\u00a0 The exercise also highlights the importance of practitioners\/professionals of actively <a href=\"http:\/\/www.knowledge.scot.nhs.uk\/erf\/qi\/events\/the-power-of-story-in-driving-improvement-19-mar-15.aspx\">listening<\/a> to service users and working together to reach shared goals.<\/li>\n<li>Starting out as \u2018Stronger Voice\u2019, the \u2018<a href=\"http:\/\/www.scottishhealthcouncil.org\/patient__public_participation\/our_voice\/our_voice.aspx#.V77rjvkrKUl\">Our Voice<\/a>\u2019 initiative aims to support people to engage with health and social care providers to continuously improve and transform services.<\/li>\n<\/ul>\n<p><strong>Summary<\/strong><\/p>\n<p>Stories \u2013 in their wider context \u2013 have been used throughout history for sparking knowledge, disseminating lessons, and supporting ongoing reflection.\u00a0 Whilst they often reflect on the past, their power lies in their \u2018memorability\u2019 and their universal links with current contexts and situations.\u00a0 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.<\/p>\n<p><strong>References<\/strong><\/p>\n<p>Ahmad, N., Ellins, J., Krelle, H., &amp; Lawrie, M. (2014).\u00a0 Person-centred care: from ideas to action.\u00a0 London: The Health Foundation.\u00a0 Retrieved from <a href=\"http:\/\/www.health.org.uk\/publication\/person-centred-care-ideas-action\">http:\/\/www.health.org.uk\/publication\/person-centred-care-ideas-action<\/a><\/p>\n<p>Health Foundation. (2014).\u00a0 Person-centred care made simple.\u00a0 London: The Health Foundation.\u00a0 Retrieved from <a href=\"http:\/\/www.health.org.uk\/publication\/person-centred-care-made-simple\">http:\/\/www.health.org.uk\/publication\/person-centred-care-made-simple<\/a><\/p>\n<p>Scottish Government. (2010).\u00a0 The Healthcare Quality Strategy for NHSScotland \u2013 putting people at the heart of our NHS.\u00a0 Edinburgh: Scottish Government.\u00a0 Retrieved from <a href=\"http:\/\/www.gov.scot\/Publications\/2010\/05\/10102307\/0\">http:\/\/www.gov.scot\/Publications\/2010\/05\/10102307\/0<\/a><\/p>\n<p>Dr Nancy El-Farargy, NHS Education for Scotland, <a href=\"mailto:Nancy.El-Farargy@nes.scot.nhs.uk\">Nancy.El-Farargy@nes.scot.nhs.uk<\/a>.<\/p>\n<p>This article was originally <a href=\"http:\/\/nancyelfarargy.co.uk\/catalyst-for-change\/\">published (independently)<\/a> on 16 August 2015.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"qua-blog-post-description\">Biography With scientific and healthcare underpinnings, Dr Nancy El-Farargy is a researcher and educationalist.\u00a0 Her work covers a range of quality, improvement and safety research &amp; development to support the delivery of safe, effective and person centred care.\u00a0 She is based at NHS Education for Scotland (NES), which is the national health board for education, [&hellip;]<\/p>\n","protected":false},"author":178,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-392","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/posts\/392","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/users\/178"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/comments?post=392"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/posts\/392\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/media?parent=392"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/categories?post=392"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/quality\/wp-json\/wp\/v2\/tags?post=392"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}