Three months into my maternity leave, it takes something special to convince me to return to work early. To be asked to represent Wales at the BMJ/IHI International Forum and share the learning of my many dedicated colleagues is certainly one opportunity not to miss.
Wales has a long and recognised experience of using stories to drive improvement. I will be sharing the latest developments in this work at the Forum.
I started working on the use of stories in healthcare over six years ago. At the time, patient stories were mostly only used by nurses to identify and drive local improvement. From 2008-2010, The 1000 Lives Campaign worked to bring together the local expertise developed through the RCN Clinical Leadership Programme and the international approaches promoted by organisations such as The Institute for Healthcare Improvement and the Josie King Foundation.
The 1000 Lives team developed a framework of four potential uses of stories in healthcare improvement. We also included the use of stories at Board level into our Leadership programme. These two approaches, combined with supporting resources, were very effective at aiding the spread of stories beyond nursing. Stories began to be used more widely and at different levels of organisations.
Three years on we recognised that NHS Wales organisations had developed different approaches and skills around the use of stories. However, we also saw that often the collection and use of stories relied on few passionate individuals, who were often isolated
We also recognised that the term ‘patient stories’ could somehow deter people from listening to everyone’s experiences, not just those of the patients. For this reason in 2011 we decided to rebrand our work from ‘patient stories’ to ‘stories for improvement’. This may seem a minor change, but we felt that it would help focus attention on two important aspects:
- Everyone’s experience can help drive change, be it patient, carers, staff, or students.
- The use of stories should be ethical at all times, but also flexible according to the aim/s of what we are trying to achieve.
In March 2012 we launched a three part national learning programme. Each NHS Wales organisation was asked to nominate teams to specifically work on testing and spreading different methodologies around the collection, use and development of stories.
1000 Lives Plus worked with experts from around Wales to develop a driver diagram to help organisations take a more co-ordinated and sustainable approach to stories to ensure each story’s learning can be maximised and spread.
The result is that more members of staff in Wales are now trained in stories methodologies than ever before. Organisations have central teams leading and co-ordinating this work with governance structures in place to ensure a consistent and ethical approach. Stories collected in one area of the organisation are now made available for further use according to consent.
Within Wales we also now have an active and growing network willing to share lessons, stories and more importantly resources. Organisations are actively seeking and sharing stories for the purpose of improvement like never before.