The power of stories 2

Expert in the room
The power of storytelling as a force
for transformational change
Pip Hardy
Supported by
5th June 2015

Joining in today and beyond
• Please use the chat box to contribute continuously during the
web seminar and raising your hand to join the discussion
• Please tweet using hashtag #SHCR and the handle
@School4Radicals @theedgenhs
• Join our Facebook group School for Health and Care Radicals
• We will produce summaries of the discussions on each module
using Storify and Pinterest and put on the website
• Join in the Tweetchat each Wednesday at 4-5pm (GMT) using
the hashtag #SHCR

The team today
Session lead:
Jackie Lynton
@jackielynton
Presenter:
Pip Hardy
@PilgrimPip
Chat monitor:
Carol Read
@CarolLRead
Twitter monitor:
Kate Pound
@kateslater2
Case study :
Bev Rodgers

In 2003, Pip co-founded the Patient Voices
Programme in the hope of reminding all those
who design and deliver healthcare of our
shared humanity and the need for kind,
dignified, respectful, compassionate patient-
centred care through the creation and sharing
of digital stories of health and illness, hope and
hopelessness, care and lack of it.
The Programme is now one of the largest and
longest-running digital storytelling projects in
the world and won the 2010 BMJ award for
Excellence in Healthcare Education.
Pip has an MSc in Lifelong Learning and is
currently working on a PhD investigating the
potential of digital stories to transform
healthcare.
Pip Hardy

Pip Hardy
Pilgrim Projects / Patient Voices School for Health and Care Radicals Expert in the room 5th June 2015

Pip Hardy
www.pilgrimprojects.co.uk ©2015 Pilgrim Projects Limited www.patientvoices.eu
Welcome!
Plan for the day
• A bit of background
• Why are stories so important?
• What makes a good story?
• Whose stories do you need to hear?
• How can you use stories?
• Finding your own story

Pip Hardy
Where in the world are you?

Pip Hardy
Where in the UK are you?

Pip Hardy
Patient Voices
patience, noun. calm endurance of pain or
any provocation; perseverance
patient, adj. having or showing patience
voice, verb. give utterance to, express
Concise Oxford Dictionary, 1964

Pip Hardy
Patient Voices:
a short history
• Established in 2003
• ~1000 stories facilitated/recorded
• ~600 stories released
• ~130 workshops, plus some home visits!
• ~15 Patient Voices stories WIP
• ~1 million hits on the website annually
• ~2000 hits per working day on PV website
• ~40,000 stories viewed during the year
• ~100 presentations
• 6 papers published
• 1 book published

Pip Hardy
Patient Voices:
where we work
[[insert world map with workshops]]

Pip Hardy
There is more that unites us…

Pip Hardy
Why tell stories?
‘We tell stories to
entertain and to teach.’
Pascal

Pip Hardy
The power of stories
http://www.slideshare.net/amitkaps/fifth-elephant-2014-talk-
crafting-visual-stories-with-data?sf3881865=1

Pip Hardy
Stories make us human

Pip Hardy
Stories and statistics
‘Statistics tell us the
system’s experience
of the individual,
whereas stories tell
us the individual’s
experience of the
system…’
Sumner, 2009

Pip Hardy
Lies, damn lies and . . .
'As always in history,
statistics give little
insight into individual
experience. That can
only be gained by
listening to stories.'
Laurence Rees

Pip Hardy
People before numbers
‘If there is one lesson to be learnt,
I suggest it is that people must
always come before numbers.
It is the individual experiences that
lie behind statistics and
benchmarks and action plans that
really matter, and that is what
must never be forgotten when
policies are being made and
implemented.’
Robert Francis 2010

Pip Hardy
Stories and empathy
‘Stories promote
empathy, which in turn
prompts reflection and
serves as the motivation
for learning and acquiring
new knowledge.’
Charon, 2002

Pip Hardy
Tacit knowledge and
ways of knowing
‘The things we
know but don’t
necessarily know
that we know….’

Pip Hardy
Transforming culture
‘Storytelling is the
mode of description
best suited to
transformation in new
situations of action.’
Schön, 1988

Pip Hardy
‘… refers to all the ways in
which human beings
overcome their original
barbarism, and through
artifice, become fully human’.
Samuel Pufendorf
Culture
‘…the attitudes, feelings, values,
and behaviours that characterise
and inform society as a whole or
any social group within it.’
Collins English Dictionary

Pip Hardy
Changing culture
• Open and transparent
• Respectful and dignified
• Kind and compassionate
• Just and equal
• Humane and connected
• Trustworthy and blame-
free
• Continuous learning

Pip Hardy
Sustaining culture
• Good communication
• Two-way flow of
information
• Sharing values
• Sharing stories

Pip Hardy
Communication
‘Assure a substantial
flow of vital information
… so that the
information derived
would be helpful to all
and harmful to none.’
Rex Hardy, 1990

Pip Hardy
Case study 1:
a culture of safety
‘How can we create
a culture of safety if
we don’t know what
one looks like?’
Association of Air
Medical Services (AAMS)
Survey

Pip Hardy
Go around
Cathy Jaynes 2006

Pip Hardy
Good stories are….
Effective
Affective
Reflective

Pip Hardy
Several years later….
‘In the meantime, one story at a time, we can leave a lasting
impression with those who come behind us.’
‘I felt the stories were so powerful and did a much better job
than any other safety lecture in telling the true story.’
‘The ability to share these, and other stories like them, is
critical if organisations are to learn from mistakes and
develop a just culture in which every voice can be heard.’
‘Stories are essential in creating a culture where safety and
humanity are prized and the values of intellectual, emotional
and spiritual intelligence inform ‘the way we do things here.’

Pip Hardy
What makes a good story?

Pip Hardy
What makes a good story?
‘I’m sorry to have
written you such a
long letter – I
didn’t have time
to write a short
one.’
Mark Twain
‘The foundation of a story is an emotional foundation
– in other words, a good idea that moves.’
Yann Martel
‘Show, don’t tell.’
‘Stories are always
true: it’s the facts
that mislead.’
Jeanette Winterson

Pip Hardy
Change
‘All great literature is
one of two stories; a
man goes on a journey
or a stranger comes to
town.’
Leo Tolstoy

Pip Hardy
It’s not what you say…

Pip Hardy
Story or anecdote?
‘Anecdote has no conflict, no
crisis, no resolution.’
‘In contrast to anecdote, story
– at least in the literary sense
– offers so much more:
narrative arc, unification of
action, irrevocable change.
Meaning.’
Aaronson 2013

Pip Hardy
Passages past dragons
‘No matter what form
the dragon may take, it
is of this mysterious
passage past him, or
into his jaws, that
stories of any depth will
always be concerned to
tell….’
O’Connor, 1969

Pip Hardy
Case study 2:
a ward after the crisis
Introducing Bev Rodgers, Ward Manager

Pip Hardy
The problem
• Very sick patients
• Not enough beds
• Not enough staff
• Not enough time
• Poor management
• Records in disarray
• Medical model of care
• No one listens
• Culture of fear

Pip Hardy
The man in Bed 5
Mett 2013

Pip Hardy
Personal impact
‘It’s helped me get a lot off my chest –
I’ve put it to bed now.’
‘I didn’t realise how sad everyone was.’
‘I’m still angry, but making the story helped me
process those feelings and I’m not as angry now.’
‘I feel like we’ve learned a lot about each other’s
stories that we didn’t know before. This has brought
home what the ward means to everyone.’

Pip Hardy
And now…

Pip Hardy
Professional impact

Pip Hardy
Seven elements
1 Point
2 Dramatic question
3 Emotional content (authenticity)
4 Voice
5 Soundtrack
6 Economy
7 Pacing

Pip Hardy
Point (of view)

Pip Hardy
Dramatic question

Pip Hardy
Emotional content
(authenticity)

Pip Hardy
Voice
‘One of the
hardest things
in life is having
words in your
heart that you
can't utter.’
James Earl Jones

Pip Hardy
Music / soundtrack

Pip Hardy
Economy

Pip Hardy
Pacing

Pip Hardy
A very short story
For sale
Baby shoes
Never worn

Pip Hardy
Case study 3:
Dignity and respect

Pip Hardy
The challenge
Poor patient and
staff satisfaction
survey scores in
relation to dignity,
respect and
communication

Pip Hardy
What happened?
• 8 workshops over
three years
• 64 participants
• 58 stories created
• 67 stories released
(to date)

Pip Hardy
What happened?
• friendships and
support networks
established
www.pilgrimprojects.co.uk © Pilgrim Projects Limited www.patientvoices.org.uk

Pip Hardy
How are the stories
being used?
• Stories shown at the
start of every Board
meeting
• used in recruitment
and selection
interviews

Pip Hardy
How are the stories
being used?
• induction and staff
training
• public screenings to
raise public
awareness of mental
health

Pip Hardy
How are the stories
being used?
• strengthening the
patient voice
• reminding staff,
patients and carers of
our shared humanity

Pip Hardy
Guides
ComfortWarning
Markers
What stories do they tell?

Pip Hardy
What’s changed?
• patient-led ‘dignity walks’
• more confident patients
and staff, able to tell their
stories
• increased involvement of
patients and carers in
creation of care plans
• greater recognition of
‘experts by experience’
• more engagement with
family members

Pip Hardy
Impact on the organisation
• Reduction in complaints related to care (45%)
• Reduction in complaints related to staff issues (9%)
• Reduction in complaints related to communication
(22%)
• Reduction in CNST claims (50%)
• Reduction in management costs

Pip Hardy
Impact on the organisation
• Reduction in staff time spent investigating complaints
• Improvements in patient/carer communication and
relationships = better care and increased confidence
• Overall quality of care is good/excellent
• 95% of 2018 patients would recommend the Trust

Pip Hardy
Impact on storytellers
‘It's reminded me of how
our creativity connects
with part of our soul - how
wonderful it is to be part of
something that does not
have measurable targets
or hard matrices.’
A storyteller

Pip Hardy
Transformation
‘People reach greater
maturity as they find the
freedom to be
themselves and to claim,
accept and love their
own personal story, with
all its brokenness and its
beauty.’
Vanier 2004

Pip Hardy
A decisive moment

Pip Hardy
Connection
‘Only connect the prose
and the passion ...
Live in fragments no longer.’
Forster 1910

Pip Hardy
Context

Pip Hardy
Crisis

Pip Hardy
Closure
‘We shall not cease from
exploration, and the end
of all our exploring will
be to arrive where we
started and know the
place for the first time.’
T. S. Eliot
‘What we call the beginning is often the end. And to make an end is
to make a beginning. The end is where we start from.’ T. S. Eliot

Pip Hardy
Stories, values and identity
Identity
Stories
Values
‘It's like everyone
tells a story about
themselves inside
their own head.
Always. All the time.
That story makes
you what you are.
We build ourselves
out of that story.’
Patrick Rothfuss
‘We know what we
are, but not what we
may be.’
William Shakespeare
‘Our bodies are made of stardust; our souls are made of stories.’
Rev. Thomas Rhodes
‘It is only in the
narrative mode, that
one can construct an
identity and find a
place in one's culture.’
Bruner, 1986

Pip Hardy
Creating ourselves
‘Narrative is radical,
creating us at the
very moment it is
created.’
Toni Morrison 1993

Pip Hardy
Stories change lives
‘We think we tell stories, but stories often
tell us, tell us to love or to hate, to see or to
be blind. Often, too often, stories saddle us,
ride us, whip us onward, tell us what to do,
and we do it without questioning. The task
of learning to be free requires learning to
hear them, to question them, to pause and
hear silence, to name them, and then to
become the storyteller.’
Rebecca Solnit, The Faraway Nearby, 2013:4)

Pip Hardy
Vulnerability, courage
and resilience
What they don’t
teach you in
medical school….

Pip Hardy
An education
Powell, 2008

Pip Hardy
EAR
Was it:
Effective?
Affective?
Reflective?

Pip Hardy
The culture of the mind…
‘The culture of the
mind must be
subservient to the
culture of the heart.’
MK Gandhi

Pip Hardy
The stories are all one
‘Each affects the other
and the other affects
the next and the world
is full of stories and the
stories are all one.’
Albom 2004

Pip Hardy
If you’d like to know
more…
Published by Kingsham Press
www.kingshampress.com
Paperback: http://bit.ly/1IoAYAX
Kindle: http://amzn.to/165zTzg

Pip Hardy
The sleepless ones

Pip Hardy
Thank you
pip@pilgrimprojects.co.uk
www.patientvoices.org.uk
@PatientVoicesUK
@PilgrimPip

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