‘Our methods let us put ourselves in the shoes of our patients and their family’

‘Design thinking’, ‘agile’, ‘future thinking’, ethnography... These methodologies seem, perhaps at first, unrelated to healthcare, but they have been key aspects of the work done by the SJD Patient Experience Department. Joan Vinyets, Department Head, recounts how this working method was implemented at the hospital and why this new model was chosen for providing care and attention to families and patients.

How would you rate this patient- and family-centred care model in the years since its launch?

I would rate it very highly, because you realise that, by involving patients and families, it allows you as a hospital to improve each and every day.  

Seizing this opportunity to improve has been hugely useful for designing a comprehensive care model centred on the needs of patients and their families. This care model at the SJD Barcelona Children's Hospital does not just focus on the biomedical aspects of care, but also on the experiences of patients and their families. This is the dual perspective our team is able to offer.

I see the Patient Experience team as facilitators, especially considering that the patient- and family-centred care model involves more than 3,000 staff members at the SJD Barcelona Children's Hospital. 

At what point did you realise that innovation would be the cornerstone of your department?

From the very beginning, management has been aware of the fact that researching the patient experience can be a huge source of innovation. It allows us to identify latent, non-expressed needs of patients and their families and convert them into innovative opportunities that really enrich our care model. As such, we could say that innovation is an intrinsic part of the vision and methods used at the Patient Experience Department, because it facilitates a sound approach to research with active, direct participation of all healthcare staff, identification of uncovered needs, and the collaborative design of innovative solutions.

What projects or initiatives would you highlight that have involved this innovative new approach?

There are countless projects. I think that we must first note that these innovative projects are not just the result of the work done by the Patient Experience Department. As I mentioned previously, our role is to be facilitators, and the projects we run are fruit of the collaborative effort between various healthcare and non-healthcare teams: infrastructure, user services and procedures, the technology team, the data team, the Escola de Salut (School of Health), marketing, etc.

If I had to mention one project in particular, it would be the project to renovate the Women's Area—a one-of-a-kind initiative to provide more comfortable spaces. I would also highlight other newly renovated spaces in the hospital, such as the Outpatient's Department—hugely innovative both for staff and for patients and their families—or the neonatal ICU, where medical staff really went the extra mile to provide spaces where families could be there with their children. I would also mention all of the training programmes at the Escola de Salut.

We are leading the charge in innovative new technology. It is an essential aspect to implement, given the way the profile of families and patients is changing. We also have another highly innovative project—the transition to adult hospital programme, led by Esther Lasheras.

Are there any other projects you would care to mention?

We are currently also working with the Diagnostic Imaging Department—and this project will have a huge impact. It is being reworked based on evidence from studies we have done, such as rethinking how we ought to approach factors like atmosphere, information and education to help reduce patient anxiety—not just prior to the test but also when patients are preparing at home.

There are also more transversal, transformative projects in the pipeline—co-designing a care model that offers more emotional support, for instance, or what the care model and facilities at the new Precision Medicine centre should be like.

‘Design thinking’ is one of the better known methods, but which others do you use?

I always say that there are no right or wrong methods, and the best way to work is to have a well stocked toolbox to choose from. So, as well as ‘design thinking’, we use methodologies that stem from the worlds of anthropology and ethnography, meaning in-context observation, in-depth interviews, etc. We also use more projective tools and resources. So it is a combination of tools from the world of empathetic qualitative research, the creative world and other projective techniques. And here, like always, the key is to use the right combination of available tools and to be innovative in their use, combining and evaluating different methods—all based on the task at hand. For example, the work we do with the procedures team, complementing their Lean methods with ours.

Do you also use quantitative tools alongside the qualitative ones?

Yes, with the qualitative tools we can identify key points, but to find out whether they are truly relevant or not, we need quantitative methods. For example, a questionnaire or another similar resource that can reaffirm what you have identified via the qualitative perspective. As such, the work done by the User Support Department regarding surveys and questionnaires is hugely important, turning them into a fundamental research tool.

To identify which tools or methodologies could be of use is essentially a matter of trial and error—seeing what works and what does not. For instance, right now we are also considering how we could use LEGO Play products in research projects involving our youngest patients.

What are the advantages of these methodologies for the patient experience?

No matter the area, these methodologies offer a new way to approach your daily tasks and see what can be improved. I always like to compare them to buying a new pair of sunglasses. When you put them on, it's like the filter on the lenses helps you see things in a different light. 

At the Patient Experience Department, our methods let us put ourselves in the shoes of our patients and their family. The healthcare sector is largely dominated, or conditioned, by scientific-technical perspectives—which is that of healthcare professionals, be they medical or nursing staff. Suddenly, these methods allow you to complement that biomedical perspective with a more human-centred viewpoint. 

This perspective allows you to pick up on human needs that go beyond treatment. With that, I mean emotional, spiritual and cultural aspects that are hugely important in the hospital, especially in such a culturally diverse environment with complex, vulnerable patients.

We are also able to discern when patients and their families need more support. You learn the best way to communicate with them. They teach you how important it is not to forget about siblings, for example, or the best way to break news and offer the emotional support they need.
With these methods, we also want to encourage patients, families and staff members to get involved and offer ideas that could help design fresh solutions and drive new innovative procedures.

And what was it like actually implementing these methodologies in the hospital? 

Firstly, I would like to recognise the leadership of Manel del Castillo in Management, who has always prioritised the patient experience. Then there is also Mercè Jabalera and David Nadal who, as the team leading the Patient Experience and Quality Management Departments, have promoted the work we do as a key aspect of quality healthcare.

I would also like to recognise Miquel Pons from the Medical Management team, who always says that the patient experience is a tool of mass transformation, or the Nursing Management team, headed by María José Tojo, that truly believe in the importance of the patient experience and promote it in their own care model and daily work.

The key to leading a transformative process such as this one is for there to be a leadership team that sees the value of what is being done, and that, consequently, provides the resources needed for it to be possible. 

Implementing all of these changes has been a long process, one which is still ongoing. First we started making staff aware of this new approach and way of understanding the care of patients and their families, as well as their central role in it, and we gave them examples of the new methods of working that were to come.

How has the SJD team made these new methodologies their own?

We have been able to identify key staff members who, on their own initiative, help train others in these new methods. These staff members also develop projects and training sessions for their colleagues. A good example of this is the Emergency Room and ICU teams, who take the lead with actions and projects in their respective departments and units to improve the experience of patients and families.

This process of raising awareness among staff members and making the new methods more visible requires its own educational strategy. You have to find staff members who can help encourage their colleagues to use these new methods. Colleagues like these are the true architects of change at our hospital.

This coming January, you will be offering a course based on all of the knowledge that has been amassed at the SJD Barcelona Children's Hospital. Can you tell us more?

It is an online course that starts on 21 January. Its aim is to cover the needs of the entire healthcare sector, not just our hospital. This means educating healthcare staff on the importance of the patient experience, letting them see its usefulness, value and impact first-hand. It is aimed at professionals working in hospitals in Spain and Latin America. The idea is to make it as open as possible, suitable for any staff member working in a healthcare facility—not necessarily just doctors and nurses.

We explain the basic concepts of patient experience, as well as the tools and methodologies that can be employed. We also cover real challenges taken from our experience at the SJD Barcelona Children's Hospital, which, in this respect, has really been a pioneering facility.

The course has also been made possible by a world-renowned institution in the field of patient experience—the Beryl Institute in the United States. We have a signed agreement with them allowing us to benefit from their works, publications and other resources. 

What would you highlight about the course methodology? 

A key aspect has been being able to design and develop the course alongside experts from the Pediatrics Classroom, applying new tools, methods and teaching resources to offer an innovative, agile and inspiring learning experience.

We also wanted to include the perspectives and testimonials of various hospital staff members, both nurses and other clinical professionals. These are complemented by case studies and projects where we explain the basics of patient experience and the tools we use.

In addition, we also wanted to incorporate simulation techniques that the hospital already uses in training sessions. The idea is to cover specific content and tools in each module, and from there, participants in the course will have to solve a problem based on real-life situations that could occur in a healthcare facility.

To finish up, let’s talk about the future. What do you think are the challenges the Patient Experience Department will have to overcome to improve?

There are many challenges in store for the future. One is how we will restructure the adolescent patient care model. At times, the hospital focuses too much on pediatric patients, so perhaps the experiences of our adolescent patients are not quite optimal. 

Another challenge we are working on is improving our communication and reporting methods, taking into account the spaces where we interact with patients and their families and the ways we communicate or the various channels we use. We must think about how the exchange of information ought to be, as well as our interactions with and knowledge of patients and families. This will allow us to have a positive influence on them participating in decision-making that could impact their care.

Finally, obviously, people talk a lot nowadays about artificial intelligence, ChatGPT, etc. We have to be able to aid research and define the role that technology plays in it, in particular, thinking of the new devices that the hospital wants to launch. From here, we have to see how to expand on and apply these new technological opportunities beyond the hospital environment, as well as do it in a significant way for patients and their families. We must provide compassionate care to each patient based on their own circumstances and environment, avoiding a technocentric approach. We do this by having the patient with us at the table as we work together on the model.