Danielle West	 ‘Listening	for	improvement’

1. Challenge: describe your challenge, including all of the relevant

information

I work for a large healthcare organisation. I am in the role of Organisational  Development manager. My main responsibility at the moment is to design a  behavioural framework to support the launch of a new set of organisational values.  The output, (a new set of organisational values) has been decided by our board.  However, how I go about creating this has been left with me.  I believe that the Design-thinking process and tools will help to work through this  challenge in a way that the outcome will be more meaningful to all of our  stakeholders.    I believe this framework needed to encompass the expectations of our customers  (patients and their families) and our staff in order for it to be supportive of the cultural  transformation we are seeking.    I enlisted a small team of people from a range of disciplines to support me in this work.

2. Selection: In your own words briefly describe the tool you selected

(eg. What is it and why did you select it for your challenge – include  any appropriate video lecture references)

The Storytelling tool was the one that resonated strongly with me when considering  the challenge I was working on.     We have received a lot of feedback (complaints) from patients, describing that they  felt dehumanised in the care process that we provide and that they are an input to the  system, rather than a human being in need of care and support.  It seemed important that we understand the actual experiences of our patients, in their  words and through their eyes.    We also felt that it was important for staff to be able to share their experiences of  working in our organisation. I used a story-telling method (modified) for this part also.

3. Application: Describe how you applied the tool you selected to your

challenge (eg what you did and how the tool was applied effectively  or ineffectively)

Patient Sessions  We invited patients to come into the hospital to share their experiences of our care.  We ran 4 sessions, with 10 patients in each session.  We constructed a session where we invited 10 staff members to listen to the  experiences of the patients. The staff member documented everything that the patient  talked about. Patients were prompted about how their experiences ‘made them feel’.  Once the storytelling process had occurred, we asked patients and the staff listeners  to work as a group and begin to theme their experiences together (the start of a mind  mapping process).  This was done to help patients and staff to identify themes in the stories at the time.    At the end of the session we gathered up all of the data, all the documented  experiences to analyse.    Staff sessions

The staff sessions were slightly different.  We invited staff to come to one of a number of sessions. We ran groups of approx. 20  people per group.  Staff were asked to pair up with people they don’t normally work with and they were  asked to share their experience of:  What makes a good day at work for them?  What makes a bad day at work for them?  In order to answer these questions, we asked them to visualise a time when they had a  good day, and a bad day and to speak of how these experiences made them feel.  The partner in the pair was asked to document the experience. Similar to the patient  experience process, we asked for the staff participants to start to theme their  experiences, in the room. At the end of the session we gathered up all of the stories  provided to add to the analysis process.

4. Insight: describe the insight you gained from applying the tool you

selected to your challenge (eg how an insight affected your thinking  about the challenge and about design thinking more broadly)

The insights that we gathered were very interesting,  We often have made assumptions about the care that our patients want.   Our assumptions (as staff and care providers) are that patients want the best technical  care, the latest and best procedures and medication.  Analysis of our experience data told us that whilst this was important, they weren’t the  most important factors that came out through the storytelling.  Patients emphasised the factors of ‘care’, feeling welcomed, not scared,  communicated with and included in the decision making process.  This has allowed us to reflect on the way in which we deliver our care, not just the type  of procedures etc that we provide.   This has been a huge shift in the understanding of our workforce, in terms of  understanding the ‘unmet need’ of our patients. This has provided a huge  opportunity to make improvements in all of our services.    As a result of this process, we have decided to run patient ‘Listening sessions’ on a  regular basis so that we can continue to build our understanding and be responsive to  the needs identified.    Similar to the insights gained during the patient listening sessions, we have been able  to gather insights and understanding about how our staff experience working with us.   The insights for staff centred around being recognised for the work that they do,  providing feedback (both positive and negative) and for the care team to be seen as  equals, rather than the hierarchy of professions which currently exists.  These insights have allowed us to build an improvement programme centred around  ‘real-time, team feedback’.    We will also be running staff listening sessions on a regular basis to ensure we  understand the experience of our staff.    We have been able to build our organisational values, standards and behaviours with  the outputs of this work. Given the process that we used, these are authentic and  resonate with both patients and staff.

5. Approach: Describe what you might do differently next time –

applying the same tool you selected or a different one – and the  reasons why.

As part of the process that we undertook, I built in an evaluation system to ensure that  we could learn from the experience of running these listening sessions for staff and for  patients.    We have a range of learnings that we will be implementing in our future sessions.  Some of the learnings centre around logistics – ie when and where we run the  sessions.    These learnings are important as given that we ran our sessions during the working  week, we will not have had representation from patients who work, and also staff who  were not able to be released from their day jobs. These logistics will impact the  breadth of the stories that we heard and therefore there may be further unmet need  that we have not yet identified and explored.    We have decided to use this tool for more focussed care re-design work. This will  allow us to understand the experiences of specific groups of patients which will help  us to improve the care pathways alongside the way in which we deliver the care.    This tool has been a very powerful change agent, in my work.

