There is an increasing interest in patient stories as they are a fantastic way to engage both the people who use services and those who work in them.  A story can capture key themes that people can immediately understand and relate to and personal stories can help to more easily identify aspects of a service that need to improve.

Story collection is a sophisticated art and involves particular systems and skills for the story to really make a difference to the decisions that are made about the way services should be provided.  I am particularly interested in the way that the ground-breaking work of both Healthtalk Online and Wales 1000 Lives is developing to support the collection and use of stories for improvement.

A few weeks ago I met Dave Snowden and it has challenged the way that I think about service user stories in health and social care and how we collect them, analyse and attempt to understand them in order to then improve the services we provide.

Dave is the chief scientist and founder of Cognitive Edge and describes the way he works as “the intersect between natural science and the social system”.  He is interested in uncovering the way that personal narratives impact on what people do and feel, their motivation and how they behave.  It’s fascinating stuff.

Dave is the kind of person who shakes a room.  He has that rare talent to prompt us to question some long held beliefs and assumptions, such as a reliance on surveys to answer questions we have about services we provide.  We should probably call him a disruptor, but I am hoping that what he is suggesting also has practical potential and can help us to engage people in the front-line in collecting experience data.

Dave is against any kind of traditional patient survey because, he believes that people know what the expected answer is; he says that people either gift or game.  If people know that there is a right and a wrong answer to a question then they answer accordingly, without really exploring their true experience.  In response to this, he has created something called SenseMaker® which involves the collection of pictures, patient journals, diaries and what he calls “micro-narratives”.  Some of this might sound like familiar ground, the journals and diaries in particular, but what is very different about Dave’s approach is the analysis.  Normally, in the NHS, we collect stories from service users and carers in a variety of forms (video, diaries, surveys, focus groups, interviews etc.) and we then analyse them.  This means that the stories, and the people, remain as objects.  What the SenseMaker® method does is enable the story teller to interpret and rate their own story and they do this through “unconscious” means, in a way that enables deeper meaning to emerge.  Perhaps best of all for a health setting, this method produces quantitative data for the service commissioners and providers and a facility to look behind the numbers and see the stories behind them.

See this document for an example of the way experiences can be recorded:

I would encourage you to visit the Cognitive Edge web site, where the method is well articulated alongside other materials, blogs and papers.