Using patient stories to inspire quality improvement within the NHS Modernization Agency collaborative programmes

Authors

  • Peter Michael Wilcock BSc, MSc, Dip Psych, PG Cert (THE) C. Psychol, FBPsS, ILTM,

    1. Visiting Fellow in Healthcare Improvement, Bournemouth University, Institute of Health & Community Studies, Royal London House, Bournemouth BH1 3LT, UK
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  • Geraint Ceri Stewart Brown MB ChB, FRCA, MPhil,

    1. Consultant in Intensive Care, Critical Care Programme Project Development & Research Lead, NHS Modernization Agency, 4th floor, St Johns House, East Street, Leicester, LE1 6NB, UK
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  • John Bateson BSc,

    1. Dip Health Planning and Management, Programme Director North-East London Coronary Heart Disease Collaborative, Chatsworth House, Homerton Hospital, London E9 6SR, UK
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  • Jonathon Carver BSc, MA, RN,

    1. Project Manager, East Midlands Coronary Heart Disease Collaborative, Glenfield Hospital, Leicester LE3 9QP, UK
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  • Sheelagh Machin BA, RGN

    1. Dip Man, National Collaborative Leader, Coronary Heart Disease Collaborative, NHS Modernization Agency, 4th floor, St Johns House, East Street, Leicester, LE1 6NB, UK
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Correspondence to: John Bateson, Programme Director North-East London Coronary Heart Disease Collaborative, Chatsworth House, Homerton Hospital, London E9 6SR, UK (tel.: 020 8510 7283; e-mail: john.bateson@homerton.nhs.uk)

Summary

• The importance of obtaining the opinions of service users has long been recognized and, traditionally, most contact has focused on measuring their satisfaction with the services they receive. However, there is little evidence that this has had much impact on improving care.

• The Discovery Interview Process, a technique for listening to patients and carers and using their narratives to improve care, is discussed in this article. This approach has been used in the pilot phases of the UK Coronary Heart Disease Collaborative and Critical Care Collaborative.

• These narratives develop understanding grounded in experience. Those delivering care can interpret the narratives using their own clinical and professional knowledge and experience to create better or new ways of meeting patients' and carers' needs. Using their own expert knowledge they can identify needs within the narratives, including those that patients and carers did not know they had.

• The principal techniques for gathering these narratives are outlined, and ways of using such data to inform patient-focused service improvements are discussed. Various locally sensitive methods for presenting the narratives to expert interprofessional teams are also described along with emerging experience of this feedback.

• We consider the Discovery Interview technique for gathering patient and carer narratives to be a potentially powerful method for informing quality improvements, discovering what really matters to patients and their carers. This pragmatic approach could prove manageable within local quality improvement projects.

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