NHS Institute for Innovation and Improvement All rights reserved.

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1

2 Film: Introduction

3 The ebd approach a service improvement methodology

4 Before we start, a quick survey How satisfied were you with the information you received prior to this event? A B C D E Very Good Very Poor

5 Satisfaction A and B

6 Satisfaction D and E

7 Satisfaction C

8 Normal Distribution Curve

9 Before we start again, a quick survey What was your experience of getting to this event? A B C D E Very Good Very Poor

10 Experience A and B

11 Experience D and E

12 Experience C

13 Experience Findings

14 The ebd approach is about using experience to gain insights from which you can identify opportunities for improvement. It s about experiences not attitudes or opinions.

15 The components of good design Performance How well it does the job /is fit for the purpose Functionality Engineering How safe, well engineered and reliable it is Safety The aesthetics of experience How the whole interaction with the product/service feels /is experienced Usability Berkun, 2004 adapted by Bate

16 The components of good design Performance How well it does the job /is fit for the purpose Functionality Engineering How safe, well engineered and reliable it is Safety The aesthetics of experience How the whole interaction with the product/service feels /is experienced Usability Berkun, 2004 adapted by Bate

17

18 Capture Storytelling

19 Capturing stories and observations allows us to obtain a deeper understanding of people s experiences

20 Film: Capture

21 Capture Capture It s about listening Silence is ok Suspend judgement / don t make assumptions Practice active listening Allow the storyteller to express their emotions without trying to solve problems Stay quiet when the story teller is talking Always remember to thank the story teller for their time

22 Capture Capture Asking open questions Ask questions that are open, such as What do you do?, as opposed to closed questions that can be answered yes or no Ask follow up questions such as How did that make you feel? Ask prompt questions such as Tell me more about that Remember that telling the story can be an emotional experience

23 Capture Capture Activity Storytelling Think back to the last time you were a patient. Invite your partner to tell a story they are happy to share.

24 Capture Capture 3:00

25 Capture Now change roles Capture - Listener becomes story teller and story teller becomes listener

26 Capture Capture 3:00

27 Capture Capture It s about seeing and observing Taking a step back Seeing something for the first time Understanding what really happens Inspiration new ideas Challenging perceptions Observation lets you find out what people really do and need

28 Capture Capture Why do we need to observe? People do not always do what they say they do People do not always do what they think they do People do not always do what you think they do People cannot always tell you what they need The next time you go into the office imagine looking at it for the first time... Think about how these factors impact on your experiences

29 Understand Journey Mapping

30 Mapping the journey brings staff and patients together to focus their improvement efforts where they matter most.

31 Film: Understand FILM Understand

32 Understand Understand Emotional mapping Informed relieved It took ages to find a car parking space and then I found it was a 15 minute walk to the outpatients clinic. How frustrating! The room was cluttered with out of date magazines and notices on the walls and I was already feeling really nervous I wasn t sure where to go the signs were difficult to follow Patient arrives at car park Patient navigates to clinic Patient arrives at clinic Patient registers with reception Patient waits to sees consultant pleased Patient sees consultant Patient navigates to department Patient goes to different department for investigations (X-Ray Pathology) frustrated worried nervous upset anxious unsure

33 Understand Understand Emotions and touchpoints The ebd approach is driven by consideration of the moments of engagement. moments of engagement e.g. finding a car parking space how people feel through their journey e.g. scared

34 Understand Understand Film: Journey FILM Understand

35 Understand Understand A typical process map Arrive at reception Waiting See Doctor X ray See Doctor Surgeon Discharge

36 Understand Understand Identifying Touchpoints Had Accident Drove to A&E Arrive at hospital Arrive at reception Waiting See Doctor X ray See Doctor Diagnosed Waiting Surgeon Discharge

37 Understand Understand Identifying Emotions informed understood relieved reassured fun supported easy safe reassured impressed supported Had Accident Drove to A&E Arrive at hospital Arrive at reception Waiting See Doctor X ray See Doctor Diagnosed Waiting Surgeon Discharge scared in pain unsure nervous in pain apprehensive impatient forgotten

38 Understand Understand Identifying Emotions understood impressed relieved supported reassured X ray See Doctor Diagnosed Waiting Surgeon Discharge in pain apprehensive forgotten

39 Improve Creative Thinking

40 Working closely with patients, carers and staff in designing better experiences for all.

41 Film: Improve FILM Improve

42 Imrpove Improve Turning experiences into actions a natural way to progress the relationships between patients and staff that have already emerged in the ebd approach The ebd approach is about working closely with patients, carers and staff in designing better experiences. This method of co-design is used because it is: a way to reduce the workload on staff; with patients and carers taking many of the improvements on themselves a way to keep up the momentum of change - where patients are part of the change team, they add further enthusiasm, drive, energy and a level of expectation.

43 Imrpove Improve Using Creative techniques Working with patients as genuine partners can create some apprehension, but it has the potential to transform health services. Creative techniques can support partnerships as they... Build relationships between people Help you to think differently Approach challenges in a different way

44 You need lots of ideas, to be able to throw away the bad ones. This activity will help you to think of lots of ideas to a challenge. This creative process is something that you can use in your own brainstorming sessions.

45 Different ways of getting to work

46 1:00

47 Different ways of reducing waiting times

48 1:00

49 Now think of how Virgin or McDonalds would do it

50 1:00

51 Imrpove Improve Developing ideas Once ideas are discovered, patients, staff and carers work together to: Select Build Refine Test Implement More tools are available to help teams, using the ebd approach, to stretch their thinking about potential solutions, for example, The Thinking Differently Guide

52 Measure Defining Measures

53 Measure Measure Measurement will help you understand the difference your work has made.

54 Measure Measure Film: Measure FILM Measure

55 Measure Measure To help us think about measurement, we re going to look at Alice s life

56 Measure Measure Alice's vision and measures Alice's yearly vision: VISION 1: fitness VISION 2: happiness VISION 3: love 1. Fitness Measures: no of swims per week no of runs per week no of walks per week no of yoga sessions per week

57 Measure Measure Setting Aims no of runs per year no of walks per year no of yoga sessions per year no of swims per year Last year (current) Next year (aims)

58 Measure Measure Results no of runs per week no of walks per week no of yoga sessions per week no of swims per week Week Week Week Week

59 Measure Measure Your Measures What do you currently measure that relates to patient experience? Measure 1 Measure 2 Measure 3 Measure 4 Measure 5 Measure 6

60 Measure Measure Film: Conclusion FILM Conclusion

61 The ebd approach is about sharing and understanding the experiences of patients, carers and staff together to design better services.

62 For more tools and information on the ebd approach visit:

63

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