Piloting discovery interview technique to explore its utility in improving dignity in acute care for older people

Bridges, Jackie and Tziggili, Maria (2011) Piloting discovery interview technique to explore its utility in improving dignity in acute care for older people. International Practice Development Journal, 1 (2), 4.

Record type: Article

Abstract

Background: In 2008 the Foundation of Nursing Studies funded City University London, Brighton and Sussex University Hospitals NHS Trust (BSUH), University College London Hospitals NHS Foundation Trust (UCLH) and NHS Improvement to work together to pilot the use of discovery interviews to improve dignity in care for older people in hospital. Both hospitals were in the National Health Service (NHS) in England. The use of discovery interviews for this purpose has not been previously documented.
Aims and objectives: This project aimed to use the discovery interview technique in two NHS organisations to explore and improve aspects of dignity in care for older people.
Methods: This project aimed at service improvements that were stimulated by interviewing older patients and their relatives (n=12) about their experiences of in-patient care using discovery interview technique. Introducing this technique to each trust required a practice development framework. Evaluation of the impact of the project was undertaken through one focus group with UCLH staff, six one-to-one interviews with project team members and written reports from the two trusts.
Results: While the use of discovery interviews led to changes on the two wards where patients were involved in discovery interviews, wider organisational changes were not achieved. The discovery interview process did not develop as anticipated, and findings reflect the importance of good leadership, skilled facilitation and a culture that welcomes patient feedback. A complex organisational context meant that the project was not always seen as the core daily business of the trust and this led to setbacks in progress.
Conclusions: Lessons learned about the importance of organisational groundwork prior to sharing discovery interview stories with staff are supported by recommendations from an earlier evaluation of discovery interviews.
Implications for practice:
•Discovery interviews are a valuable way of finding out about patient experiences and of promoting staff learning and service developments
•The impact of discovery interviews depends on the support and receptiveness of the wider organisational culture, so time spent educating key stakeholders in the organisation and tying the project into the business of the organisation is time well spent
•Preparation should include intensive working with clinical teams to explore their understandings of dignity and develop their preparedness to listen to patients’ stories
•The discovery interview process is best targeted at stable ward teams with the support of a practice development approach
•Project teams need adequate support to enable them to lead change and to manage the uncertainty and setbacks of the innovation journey. Active learning sets for project teams can be a useful support and create the reflective space needed to explore complex concepts such as dignity

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