See the person

This is what we will be doing over the course of the next 50 minutes:

Get an introduction to the term See the Person. 

Share lessons from everyday life.

Discuss improvements.

Strengthen the patient narrative in our professional practice.

Talk about lessons we have learned.

This is the third course session of the patient narrative module. We will be given an introduction to what the term see the person means and we share with each other what we have learned from our everyday lives. We also have to agree on changes to start working with in our professional practice. 

We will be given an introduction to how we can continue working to strengthen the patient narrative in our professional practice and how we can measure the change.

A patient is always a person, but a person is not always a patient. 

When we come into contact with health and social care, we are patients, but we are of course so much more than that. If you get a picture of the patient as a person, you can also provide better healthcare, treatment and social care. What is it that can motivate the person to improve their health? How does the person live their life? What possibilities and challenges are there? One aspect of the patient narrative is understanding the patient’s perception of their condition. An equally important aspect is understanding the person outside of their pathological picture. 

Professionals often concentrate on the patient’s needs, what the person is suffering from, what the person is unable to do or what the person needs help with. This is certainly an important part of healthcare, treatment and social care, but understanding the person’s potential, resources and desires is also invaluable. For example, there may be personal qualities that strengthen the patient or a desire to be able to return to certain activities. There may be relatives who provide support or an active lifestyle that can facilitate recovery. 

Helping patients to highlight their abilities may also be fortifying and healing for them. It will become clearer to them how they can contribute to their healthcare, rehabilitation or social care. If all of the focus is on the professionals’ expertise, there is a risk of the patient not trusting their own abilities and becoming passive.

Patients may talk about their needs or resources, for example that they used to exercise a lot and want to get back into shape again as soon as possible. You may also observe needs and resources, for example whether there are relatives around and whether they are committed and supportive, or worried and uncomfortable in the situation. Sometimes there are qualities that you notice over time, like a patient showing incredible will-power and determination and fighting through challenges. It is clear what the patient is saying or what you are seeing, but you will often need to interpret and analyse. It is important to take your time and to document the patient narrative as soon as possible after all meetings with patients so that nothing important is lost.

When someone becomes ill or realises that they need to adapt their life, their priorities and relationships often change. Even when our health does not change, we all enter different stages of life where our needs, context, resources and motivations change. Consequently, the patient narrative must not be static and should instead be something to build on and develop together.

During the last meeting we each chose one situation in which we would practise finding out about the patient’s situation in order to get a picture of the person. We focussed on the following assertion:

D. See the person

We understand the patient’s abilities, life situation, and challenges.

Instructions

• Everyone in the group talks about what they thought worked well and what worked less well.
• Those who are listening make notes if there is something that is particularly interesting.
• Divide the time so that everyone is given equal time to talk.

We are now going discuss in groups how, together, we can become better at seeing the person and utilising that in our work. What can we start doing differently? 

Instructions

• Agree on 3-5 changes that could make a difference. They should be as tangible as possible.
• Write on blue Post-It notes and place on the square on the situation map called change plan patient narrative.

We will soon have finished module 2 on the patient narrative and will start making these changes in our day-to-day work. We will now get some tips that can help us along the way.

1. Make your situation map visible to everyone. You may receive valuable comments from colleagues.
2. Remember that making changes is a journey. Set the demands at a reasonable level so that it does not become too much. Take one step at a time.
3. Start thinking about what measurable objectives you could set when the training programme is complete.

1. Make your situation map visible

Put your situation map and list of changes in a place where they can be seen so that you can remind yourselves and each other. It is also a good idea to talk to other colleagues about your reflections regarding the situation map and about the changes you have agreed on. The more of you there are who are working towards the same objective, the easier the work will become and the greater the difference you will make. By making your situation map easily visible, your work colleagues who are not participating in the training can also contribute with ideas and suggestions.

2. Remember that it is a journey

Change often happens in small steps. Sometimes it is two steps forward and one step back. In which case, it can be important to remind yourself that it is a journey and that every little change can make a big difference. As a group, you can help by encouraging and reminding each other.

In this module, you have chosen specific situations where you are to implement change. It is also a good idea to come back to the situation map after a few weeks. Perhaps you want to swap a pink Post-It for a yellow one, or a yellow Post-It for a green one? Perhaps you have come up with something else that works a lot better? It is important to stop and reflect in order enable you to improve and celebrate the improvements.

Continue to think about whether there are other situations where you can become more person-centred. Person-centering on the person is not about working in a specific way in an individual situation, instead it is a comprehensive approach. We can always find situations and methods that help us become more person-centred. 

Apply trial and error and remember to share what you learn with each other.   

3. Set objectives and measure change

What is the objective of what we are doing? How do we know whether what we are doing is actually an improvement? It is always good to be as clear as possible about what we want to achieve and systematically follow up how we are doing. 

Start by identifying what your objectives are. For the patient narrative specifically, one objective might be that we understand the patient’s perception of their condition. Or that we know what their situation and everyday life is like, or what their wishes and prerequisites are. Or that the patient knows what qualities and resources can be seen as strengths or opportunities in their own care. Or that professionals document and share the patient narrative better and more efficiently between team members, wards and units.

Then agree on what is to be measured and how this can be followed up. It may be that we ask patients verbally or using a simple form with simple questions: Do the staff understand how you perceive your situation now? Do the staff know what your situation is like? Do you feel like you need to repeat the same information frequently? Or other questions that help us understand. Another way of following up is to ask the professionals. Either in the form of a checklist in which we evaluate what we actually know about the patient and how we have utilised this. Or as more open-ended reflections and discussions we have together over a cup of coffee.

Another way is to measure more tangible events. How often does a patient or a relative say that they have already told a colleague something? How often do we notice that we are missing certain important information about the patient that we should have asked the patient or relatives about earlier? 

Finally, you should decide who is responsible for following up and ensuring that lessons learned are shared with colleagues. It is a good idea to get help from your head of operations or the person responsible at your ward when deciding on this. Also ensure that you are measuring and evaluating the current situation so that you have something to compare with once you have begun making changes.

What has been the most important lesson you have learned during this training programme?

Instructions

• Contemplate in silence and write a sentence about this, preferably with an example.

What has been the most important lesson you have learned during this training programme?

Instructions

• Everybody says what they have written down. One at a time.
• Divide the time so that everyone has a chance to talk during the five minutes.

You have now finished the second module of this training programme. The next module focusses on documentation.

Well done!