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Both Sides Now - improving means understanding not just 'rating' patient experience
Both Sides Now
Patient experience is about relationships.
To improve it we need to understand,
and not just 'rate' those relationships.Both Sides Now uses evidence-based digital storytelling techniques to support patient experience improvement across a diverse group of East London NHS Provider Organisations.
Both Sides Now is based on our British Medical Journal Award Winning work with Patient Voices in 2010 using Patient Voices' peer reviewed and internationally acclaimed approach to governance and informed consent.
The work was also reflected in our winning entry for the 2010 Health Service Journal Liberating Ideas Awards.
We enjoyed the Hothouse event in Coventry and met some truly inspirational people from across the country. What a exciting chance to make a difference. We were especially impressed by work going on in Northumbria, Cornwall and Devon, and by the visionary work done by the carers who created the Care Card.
Why Both Sides Now?
Too much of the patient experience quest is limited to looking at what happened then, without the understanding needed to transform what is happening now.
Facts about the past can be opened up using digital storytelling into multiple dimensions, creating viral products capable of transforming people and organisations.
Both Sides NOW is a new way of doing just that. By combining technology with evidence-based organisational development techniques we will help NHS organisations to make patient experience the oxygen of their corporate life.
Digital storytelling is a radical process which gives the patient or clinician total possession of the medium, making the message truly theirs.
The power of these messages in combination has already delivered impacts on a national scale, changing the lives of those delivering services and the patients and families who receive them.
Both Sides NOW will deliver these effects at scale.
Evidence of Outcomes:
The Royal College of Nursing re-wrote their Learning Outcomes for Continence Care as a direct result of a patient story created using this approach. The impact of this change can be tracked across literally hundreds of NHS Providers throughout the country. Patient Voices digital stories are used from Sydney to Saskatoon, Harrogate to Hong Kong, Oslo to London to make healthcare and healthcare education more humane by promoting greater understanding between patients and clinicians. Universities and medical schools throughout the English-speaking world are using the Patient Voices digital stories to promote deep reflection and help students develop greater empathy and better communication skills.
Academic sources include:
Pip Hardy and Gemma Stacey
"Changing the Shock of Reality Through Digital Storytelling", Nursing Education in Practice 30: 2010 pp 1-6Next Steps:
1. Attending the Hot House event on 13th June along with our NHS Provider partners. Our aim is produce a detailed and costed proposal for working with local patient groups.2. Identify Spread Partners
3. Plan rollout of Both Sides Now starting with four Pilot Sites including East London
Patient stories are such a powerful way of connecting people to the reality of what happens in the health care settings and the real impact it has on the people who receive that care. This submission is such important work and it gets my vote hands down!
Listening to patient stories of their experience of healthcare is an essential part of service improvements and developing a more patient centred and responsive NHS.
Give patients the chance to tell their stories! It's an amazingly powerful tool - you can't imagine the effect it has, giving people who have been made to feel worthless and powerless - even abused - the chance to take a bit of power back and feel valued. I give this project total support.
Someone once said
"The future belongs to people who can tell their stories."By enabling people to tell their stories, this project will enable people to own that future.
The idea of linking the patient and the clinician directly to one story is very innovative,and will be an invaluable tool in learning development
The wonderful thing about stories is that they remind us of our shared humanity and re-connect us with the things that really matter. They are one of the most effective ways of bringing about real transformation and getting behind the numbers and statistics - just as Robert Francis warned us we should do!
Both sides now is an excellent and internationally recognised way of gathering stories which show both the patient's and the doctor's viewpoint. This evidence based method is really useful in developing new strategies for health. I am very supportive of this initiative
Thanks everyone. Stories are where facts find their feet.
There is robust evidence listening to patients -and relatives- stories is escential to inform patient-focused service improvements.
"Patient narratives can develop understanding that is grounded in experience and can stimulate reflection that leads to the generation of new ideas" Greenhalgh&Hurwitz, 1998Thank you Ian,
It sounds a fantastic tool, have you had a look at the blogs already submitted to see if there are any immediate connections you cam make with potential NHS partners?
Can you share with us some actual service improvements as a result of the stories?
well i think its time both side are connected, i want my story to be heard i really hope this project becomes success.
FANTASTIC PROJECT. about time we hear from bothsides.
Hi Ian, do you truly believe that this project will listen to peoples stories? as i stated i think its a fantastic project but feel through my time with the NHS as "Hugh Hillyard-Parker" said above - giving people who have been made to feel worthless and powerless - even abused - the chance to take a bit of power back and feel valued. would the project reflect that ?
Simple rating systems favour those that get good ratings early. It could foster a herd mentality. Patient stories are different - they provide a rich narrative and personal insight into the encounter with the health service. Having had personal experience of using the digital story telling technique, I see the transformative power of the medium for both, the story teller and the empathetic listener. I find it hard to imagine a successful transformation of health services without having stories as the catalyst.
i am very supportive with this, alot of people even my self have a story about my experience but felt I won't be listen too, talking to other I have found each and everyone of us have a story to tell when it comes to the Nhs. I can see Doctors greatly benefiting from this aswell as trainee doctors or staff members joining Nhs. So thumbs up on this project.
Clinicians rightly focus on communication based on coming up with a medical diagnosis but what they forget is that it is equally important to communicate in way that comes up with therapeutic solutions that meet the patients needs and situation. Communicating in way that enables patients to make their own choices that fit within their lifestyle may have equally effective medical impacts. Patient stories are an effective way of enabling clinicians to see the importance of developing broader communication skills in order to improve medical outcomes. I think this is essential if we are going to start to change the culture of hospitals to treat people not conditions.
I hope you don't mind a response on Ian's behalf - I am part of the Both Sides Now team.
We not only believe that the project will listen to people's stories; we know that it will. The Patient Voices Programme has been helping people create digital stories of healthcare since 2003. The stories are heard (and seen) in lecture theatres, Board rooms, conference halls and elsewhere throughout the world. Clinicians' stories offer patients a new insight into the pressures of those who care for them, while the stories of patients and carers offer unique insights into what really matters to individuals in the context of their lives. People who have made stories tell us that they feel stronger, more connected (to themselves and others) and more able to play a confident part in their own care - in other words, more empowered. Take a look at www.patientvoices.org.uk Some people have even made stories about the impact of making stories!
Both side now !!!! WOW that will be a great way to connect both side and understand. this will be a very powerfull tool to get feedback.
What a wonderful idea. So many health professionals become inured to the patient experience over time and patients are often terribly afraid of what lies ahead of them as far as treatment and prognosis. Having the opportunity to express their stories can only assist in creating empathy and understanding for those involved. This needs to go ahead.
Hi Ian, I am looking forward to meeting you on June 13th and discussing how The Care Card fits with Both Sides Now. We really appreciate your comments about The Care Card - although it is a Dorset initiative!! You are so right about the impact of patients' and carers' stories: my daughter is 23 and has been in hospital and on a Section of the Mental Health Act for the last 7 years. Some of her care has been excellent and some of it has been atrocious and writing about it has helped me when I feel powerless to improve things for her. She has given me permission to use her story in any way that will improve care for others in the future and in doing that we have regained strength and power and made sense of very distressing circumstances. It is a story which really moves people and provokes searching questions about the way in which care is provided in the NHS today.
HI Ian, the more am reading peoples comments am getting to love the project more and more, look forward meeting you on the 13th GREAT project.
This is a great idea - storytelling and listening are such powerful tools.
very good i like this idea
I think this is great project idea as story telling is very effective.
Very good idea
The best way to empower patients is by listening to them - it seems that the potential impact of projects such as these could be wide-ranging and positive in a number of areas.
Been there, seen it and done it - it works!
Just want to add to all the comments, its a brilliant project idea. It's going to give people a chance to express their stories and get their voice heard. that what we need.
A Message from Dr Sam Everington, Chair, Tower Hamlets Clinical Commissioning Group
Patient stories are vital evidence when commissioning in the NHS, but too often challenged because they do not fall easily into the traditional mould of scientific evidence.
If we are to have the focus on the health and well being of patients, the stories are critical to the commissioning process.
Sam
the strength of this idea is combining both qualitative and quantitative data to create sustainable improvement
This concept of understanding both sides is something that is very much required, and is imperative in delivering quality services.
"The doctor should be opaque to his patients and, like a mirror, should show them nothing but what is shown to him."
one of the greatest benefits is digital storytelling’s ability to reach the many ‘unheard and unseen people. Story telling will no doubt give patient a voice. However, digital storytelling can also give doctors and others working for the NHS a voice ‘in ways that are not possible without the technology. Would be interesting to meet you on the 13th and be part of the project.
Literacy is no longer viewed simply as reading and writing. To be effective communicators in the twenty-first century, we need to be able to employ a number of different literacies Digital storytelling will helps reach existing multi-literacies. One of the benefits of digital storytelling is its unique way of giving voice to, space for, and validation of peoples emotion…this will create a personal narrative which I think will be perfect for the feedback challenge
This looks like an excellent idea which is tried and tested in other contexts so should really well!
I like the way that this builds on previous activity, but more "two way" than before - fits well with principles of co-production of health and wellbeing between patients and clinicians.
I have a story to tell, a big ONE. i have writen about it, but now reading about this project am thinking i should of done that myself instead of making endless calls, Ian i want to be part of this project i can offer alot of input. see you on the 13th.
Both Sides Now - storytelling it has been used throughout history for teaching and learning. Stories help make meaning out of experience. Experience, and the stories created to make sense of that experience, is key to learning. Great Project.
As a social worker working with adults, having both side connected in this project i can see great outcomes, its very true its not about rating the service but much more deeper to undersatnd what people are going through. i thaink for the feed back challange this project will be the backbone, as the outcomes can be understood by doctors. If i may add something, i think we need to hear the doctors side in the same way, will that be done??
Excellent ideas - good luck!
For me, part of the power of this lies in the academic underpinnings - not just the 'Reality shock' paper that Ian mentions, but also: Mark Shea's Masters Dissertaion (http://patientvoices.org.uk/pdf/papers/MarkSheaMScThesis.pdf) on what it means to be heard in this way, and that the methodology faciltates the empowered inclusion of a wide range of service users - see:
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01900.x/abstract;jsessionid=7E2EEAD3AA97FB06CC48CCBA362245E7.d03t02?deniedAccessCustomisedMessage=&userIsAuthenticated=false
for an example of how it can facilitate service users with early-stage dementia in co-production of care, and how it can engage the designers of assistive technologies with the experiences of the users of those technologies - see: http://patientvoices.org.uk/pdf/articles/wrhip14.pdf...and, as Robert Francis, QC, said about Mid-Staffs: ‘If there is one lesson to be learnt, I suggest it is that people must always come before numbers. It is the individual experiences that lie behind statistics and benchmarks and action plans that really matter, and that is what must never be forgotten when policies are being made and implemented.’
It's the stories that matter to service users, not the statistics because:‘Statistics tell us the system’s experience of the individual, whereas stories tell us the individual’s experience of the system…’ Sumner (2009)
In the Australian context, our health reform is focused on the development of meaningful engagement. Our current research work clearly shows that service user or consumer involvement (the term we use in Australia) tends to be one sided. That is, that people who use the health care system express their views but they are often not heard. Some interesting current work shows that people who use the health system often don't have the opportunity to hear the views of health professionals or those that manage services. Creating the space to listen and be heard is exactly what this project is focused on. Projects such as this are vital to create the participatory action needed to drive health care change by all members of a community (policy makers, researchers, educators, health professionals, consumers and citizens). I will eagerly watch this work from the other side of the world as I believe that the outcomes are important from a global perspective
Amanda Kenny
Ian, do you know is this approach has been used by commissioners to support their commissioning decisions?
Patient Voices digital stories have been used as qualitative evidence by the National Audit Office value for money audit of, for example, stroke services, restructured antenatal care and end of life care. They have also been used to demonstrate the value of commissioning care via Telehealth systems and to inform commissioning decisions.
Alison, The Inner London Peoples Platfom, produced a DVD of Patient Stories with money given by the commissioners at East London, The outcome was a conference at St Josph,s Hospice,were Life limited Patients attended. This led directly to the production of an information guide, called Putting the Patient First in Pallative Care, which will be distrobuted to all health outlets across East London
An important part of commissioning effective, value for money services is finding those who can deliver them effectively .. Manchester Mental Health and Social Care trust is using Patient Voices digital stories at the very sharp end of the commissions process by brining the experiences of service users into the recruitment process for the consultants who will deliver care. Candidates are interviewed by a panel that includes patients. A Patient Voices digital story is shown and the candidate is invited to respond to the video and answer questions designed to reveal their values.
Alison in answer to your question yes it has been used in commissioning and see above from Sam Everington who chairs Tower Hamlets CCG.
I'm really looking forward to meeting people who want to share in our quest.
This is fascinating. Stories are so important and powerful, allowing people to speak and be heard in a way that is accessible to all. Vital stuff. Wholeheartly supportive of the project. Good luck.
Great idea - good work!
Paul Deemer
Excellent ideas - good luck!
Jun 1, 2012