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Step 5: Develop a shared vision for the ideal patient experience

In this step, staff draw up a collective vision of how the care experience should look in an ideal world, in order to compare this with reality.

This stage involves working together to write the story of the ideal experience of care as if you were the patient or family member. Group members contribute ideas and then one participant writes them up into a story. (See PFCC ideal patient story)

Quality improvement approaches should be used to identify opportunities for improving services. This step in the process does this by enabling staff to focus on what is good as well as what could be better, and to get a sense of what they want to achieve.

The activity focuses on using storytelling to develop a vision of what you want the experience to look like, and then to understand how your own role fits into achieving this. It differs from other methods, such as the driver diagram, because instead of identifying tangible factors that impact on a patient’s experience, the visualisation encourages staff to think about what could be possible in future.

Key points

  • Write the story in the patient’s voice, using the first person (‘I’).
  • We are all patients, or close relatives of patients, from time to time. Try thinking about one of these personal experiences to help put yourself in the patient’s place.
  • Try not to let your vision be limited by ideas such as costs or other practicalities – it is a picture of the ideal. Even if the vision is not attainable in full, it is an important way of visualising the success of the work, and looking back to how far the team has come. It is a way of countering the ‘deficit’ focus that is often prevalent in the NHS – focusing on the positive is more energising than tackling a seemingly intractable range of problems.
  • Some staff may find this challenging if the ideas discussed seem unattainable within the limitations of resources and existing systems. But by encouraging people to think big, it helps people to focus on their ideals and values, which can then be adapted into something manageable.
  • You may find it helpful for one group member to write the story up after the meeting, and then to return and read it back to the group next time.
  • After writing the experience, compare the story with what actually happens. Which elements of your ideal experience already take place? Which do not? Can you do anything to change any of these? If the answer is yes, these will become the focus for your improvement projects.
  • This activity may not feel comfortable for everyone –it is fine to acknowledge that. However, reassure participants even if many are extremely sceptical, that they may find that it produces some surprising and worthwhile results.
  • The activity helps with team-building across different roles, as staff in different roles have different but equally important contributions to make.
  • Once everyone has developed a collective sense of what ‘good’ looks like, and has signed up to this, then it is easier to get their commitment to do their part and make changes to enable it to happen.