What matters to you? by @jasonleitch

In July 2005 I sat in my first ever ‘Quality Improvement’ class. It was in Boston and led by Maureen Bisognano, now the CEO of the Institute for Healthcare Improvement (www.ihi.org). Maureen gave out three things: a timetable and two exercises. The schedule was a who’s who of quality and I was looking forward to it. The first exercise was predictable, we had to carry out a personal improvement project using aims, measures, changes and testing over the four weeks of the course. I chose to do “knowledge of the Boston Red Sox” as an excuse to get to games and watch ESPN. It helped that Maureen is a Red Sox fan and she was marking the exercise!

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The second exercise was the intriguing one. We were asked to speak to a friend or family member who had recent experience of healthcare. The twist was we had to ask about everything except the illness or disease. We had to concentrate on the experience of care, not the care itself. We had to interview our chosen ‘patient’ for a substantial period of time and probe their experience of healthcare.

I approached a friend and colleague who was nearing the end of treatment for multiple myeloma, a blood cancer. I’d known him for years and we’d worked together although we were from different cities. He was a senior healthcare worker and understood the system well. I expected a conversation about waiting times and perhaps some nurses in a bad mood and maybe some complaints about the food. What I got changed my perspective on person-centred care forever.

Because I was in Boston and he was in London we talked on the phone, we ended up talking for over two hours. He started with exactly the list above: annoying waiting around for chemotherapy appointments, parking difficulties and ‘the food is rubbish’. As time passed and he relaxed he started to get upset. it seemed like the first time someone had allowed him space to reflect on the whole experience. What he wanted to talk about was music. I knew he was an amateur jazz musician and enjoyed playing part-time in a band. He played the clarinet. What I didn’t know was how integral and important this element of ‘him’ was and neither did the healthcare system he found himself in every day for nearly eighteen months. He described missing his music, his appointments were in a hospital some way from his rural home and he either missed rehearsals because he was in a plastic chair waiting for chemo or because he was too exhausted. He even missed just listening to music. He got upset most when he described an evening when his mates in the band came round to the house unexpectedly and played for him. He survived his cancer and he plays in his jazz band again. by his own admission he’s not even very good but he doesn’t care.

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I didn’t know it at the time but others had learned this lesson before me and have described it as moving from ‘what’s the matter?’ to ‘what matters to you?’ medicine. Personalised, compassionate and person-centred. In NHSScotland we have an ambition to make all healthcare person-centred. This will mean asking patients and families what matters to them. There are examples of this everywhere, being spread as part of the person-centred care programme. In the paediatric ward in Paisley every child is asked to draw a picture or write a list of ‘what matters to them’. The answers are both inspiring and humbling. They are ‘nice nurses’, ‘good food to eat’, ‘seeing my gran’ and other similar expressions. They are not ‘on-time antibiotics’, ‘clean hands’ or ‘reduced length of stay’.

If you’re a healthcare worker, stop tomorrow and ask one patient ‘what matters to you?’, you may be surprised by what you hear. If you’re a patient or a family member of someone in the healthcare system stop tomorrow and tell the healthcare system what matters to you, you may be surprised at the response.

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Professor Jason Leitch is Clinical Director for NHS Scotland

6 thoughts on “What matters to you? by @jasonleitch

  1. It seems a bit of a “no-brainer” for people who work in the healthcare world to be person-centred as it should be the fundation of everything we do. However its all to easy to get caught up in the culture of no time and no resources to make postive changes to the experience of people we care for. This is a clear message Jason of how a wee bit of effort and thought ( and commom sense) can transform someone’s experience. Thanks

  2. Pingback: What matters to you? | weeklyblogclub

  3. Pingback: If it matters, it’s in. | weeklyblogclub

  4. Very true this is ‘what matters to you’ but I doubt this important question is rarely asked – this blog post should encourage us all to do so

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