Doing something with stories No point in capturing stories and then doing nothing with them Need to extract the information in a methodical way No need to transcribe stories – lose the very essence of what they are (and it’s very expensive!) Not only what is said – it is the way it is said Use the methodology involved in theming

Doing something with stories Stage 1 Listen to individual stories and create a mind map Stage 2 Peer review Stage 3 Identification of good practice and areas for quality improvement

Stage 1 Bear in mind that this is the bit of the process that takes the most amount of time Best done a short while after story gathering Mind mapping is a useful technique Start with patient in the middle and work outwards as you hear different things being said Need your pause and rewind buttons!

Frustration with lack of choice Operation was carefully explained - important Frightening to be given surgery date with no info about what happens next Consultant 2 - world of difference, took time, explained, gave print outs Nice, professional feel to ward – went well Consultant 1 – “brusque” didn’t assess me Appointments & admissions really helpful – told you need surgery then hear nothing Pain relief after surgery – was very sick KL cholocystectomy Was asked if I wanted anti-sickness & automatically said no – should have said yes Given dinner sheet before went home – insensitive as unable to eat fat (cauliflower cheese & sausage casserole) Only knew to contact because I knew system Did accept medication – felt very random and unplanned Changing dates – make life arrangements e.g. childcare etc Would have liked to have been told before about post op medication rather than when woozy Unsure as to whether you’ve been forgotten Or even to be told this was OK Phone back in morning to see if a bed Very stressful – everyone said I would be cancelled so expected it – felt fortunate when wasn’t cancelled I feel like I had to ask for pain relief How do you know what is correct information?

Stage 2 Peer review – supports the team approach to story gathering A colleague listens to the story and creates their own mind map Remember that we all hear things differently – two sides to every story! Provides an opportunity to discuss different things you hear the patient say and compare different view points

Stage 3 Identification of indicators of good practice as well as areas for quality improvement It is essential to consciously do both of these – this is not simply a focus on the negatives Prioritisation of actions – make sure you can answer the ‘so what’ of story gathering so that it makes a difference

Pulling out the themes There are no hard and fast rules about numbers of stories – and remember that each story is valid in its own right Listening to several stories can help you to identify common themes and any consistent patterns that will help to prioritise any action But it is about identifying a systematic way to do this

Having a go at mind mapping I will play a story through from beginning to end first – use the time to listen and absorb the essence of the story I will play it again and pause (and rewind if you want!) and you can try mind mapping This is not for real so don’t worry if you don’t capture everything Compare what we each hear in our groups

Identifying themes Through listening to stories we will start to hear consistent themes coming through Don’t expect rocket science – themes may be as basic as communication or information Begs the question though – if this isn’t rocket science, why are we still hearing the same messages?

Essential to do something So, using your individual mind maps, use the post-it notes on your table to write down the different points that you have identified in the story – use one post-it per issue Stick these onto the flip chart paper As a group, we will start to see if we have identified consistent issues from the story (remember in real time this will be different stories)

To do this…. Pick one post-it note and stick it on your paper Pick up the next one – ask yourselves as a group “does this fit with the first one?” If it does, stick it next to it If it doesn’t, start a new column Keep asking the same question You will end up with themed groupings of all of the issues from the stories These will help you to identify prioritised actions

This is a whistle stop tour! If you have any further questions I will try to answer them, or contact me at anna.tee@wales.nhs.uk Thank you