Patient Stories & Mediation “A Light Bulb Moment” Paul Jones Head of Patient Experience ABMUHB

A Patient Story!

Patient Story “The experience of a range of potential storytellers, communicating for different reasons with a range of different audiences” The driver being to gain understanding of a healthcare experience from a story-teller’s viewpoint

Mediation Technique for resolving issues between two or more parties Facilitative Mediation  Typically, a third party, the mediator, assists the parties to reach a conclusion Evaluative or Transformational Mediation  Here mediators may challenge, evaluate and question each parties story and help to draw out common ground for a firmer foundation

Mediation has a structure, timetable and dynamics that "ordinary" listening and negotiation lacks The involvement of all parties and the presence of a mediator is the distinguishing feature of the process Mediation

Mediators use various techniques to open, or improve, dialogue between parties, aiming to help the parties reach an agreement Patient stories are a good vehicle to bring parties together, develop mutual understanding and inform service and skill development The mediator is wholly impartial and is there to ensure each party can voice their perspective Stories & Mediation

Story Content Stories are considered subjective and slanted to the story-teller and their recall of events The narrative structure aligns these events like reading a novel (time vs. plot) Stories are also non-linear as they are often made up of complex events, actions, relationships and environments The end result can be beneficial but can lead to more questions and unresolved issues

Unpacking How did that make you feel?

Outcome is it Spaghetti? A large plate of information A range of emotions A lot of tangled strands some of which link together Other ingredients

Interactive Challenges Effective listening to all parties – detachment Traffic Lights Sensitive listening & question phrasing Effective summarising and goal setting Listening and analysis Next steps – stories into actions

Case Study Meeting with daughter of a deceased patient to listen to her story Clarify outstanding issues and questions Listen to the story from the perspective of some of those involved in the care of late parent Meeting with all parties involved to unpack the issues and develop actions Post meeting review of benefit and learning

The Angry Story Anger & emotion Interest Listening Understanding Replay Rephrasing Review Actions Traffic lights

Question - How many mediators does it take to change a light bulb? First of all: –it isn't the mediator's function to change the light bulb. The mediator will explore: –how the light bulb feels about the on and off nature of its job – its unhappiness at always having to work nights – its relationships with the other parties, including the new light bulbs that it feels are a threat to its position..

The mediator will talk to the new lightbulbs, reframing and normalising their observation that: – the principal light bulb is completely out of its box, and identifying that their real issue is that being picked on one at a time constantly undermines their team spirit The darkness is also hostile to all the light bulbs, telling them to go and unscrew themselves. The mediator will allow it to vent its anger and express its distress at how it always feels unwanted.

The mediator will then use the stories to help guide the darkness and the light bulbs, both new and mature, to a solution reflecting their new understanding of each other Bright sparks will realise that you'll have to be left in the dark now because the final outcome is confidential – unless all parties agree to share their experience

In Conclusion There are many techniques for capturing patient stories and a variety of opportunities for taking stories The approach I am suggesting is one of those techniques, it is inclusive of all parties and can lead to a positive outcome to often difficult situations

Thanks for Listening Happy to take some questions