Why are patient stories valuable in health care?

Martha Hayward, IHI Director of Public and Patient Engagement

One of the things that we do a lot of in the area of patient- and family-centered care and in changing culture is storytelling. Everybody thinks they’re a great storyteller — I’m sure you have an Uncle Martin who loves to tell a good story — but one of the things that I want to ask you to do as you’re listening to this is think about stories that are told in your own family. Just for a minute, think about that.

What do those stories say about the culture of your family? Interesting.

I’ve got one story that I’ve always wondered about because it involves my family leaving me behind at a campground, and when I was crying, my sister thought I was a dog. I don’t know what that says about my family, but it’s a story told many, many times.

What I want to talk about is why we tell stories, and where we may do it, and when is the optimal time to tell stories.

So, stories really help us to connect to the process — the processes that we’re involved in day to day. What stories do, is they connect our heart to our work. It’s an incredible way to engage patients and staff, family, and clinicians — to engage everybody around a single thing. It really helps us. The most beautiful thing to watch when a story is told in a really meaningful way is that people return to why they’re doing the work that they’re doing. It gives real meaning to the work that they’re doing.

It really models a kind of safeness in being vulnerable, which is something [that] as professionals we are not always comfortable with, but in health care more than anything, there are times when we really are feeling vulnerable.

Where we tell stories is as important as the stories themselves. Three places that I’d like to talk about are the clinical interaction, the team interaction, and at leadership moments.

The clinical interaction: Often times if a clinician — a nurse or a doctor — shares a story with a patient or family about a similar patient or family — without breaking any HIPAA laws — what you’re demonstrating is the kind of relationship that they can expect from you. You could perhaps be showing them a vision into their own future. It’s a wonderful way to make a connection and build trust.

In team interactions more than any other place I think I’m aware [of], I think medical teams are faced with many difficult decisions and actions in the course of a day — and a story told at a team moment can really bring people together and help people to understand: “How do we forgive? How do we accept what we’ve seen and done? How do we move on?” Some of these things are very difficult to do, but telling stories — warm stories, difficult stories — all of them are ways of saying, “This is who we are as a team.”

Most importantly in leadership, storytelling is key to building and creating culture. When leaders tell stories, they are telling the world who their organization is. They’re saying what is important to their culture. [Storytelling] really offers a reference point and models the real meaning and work.

Also, [there’s a question of] when: We often have people ask, “When might we tell stories?” Well, one great place to do this is opening your board meetings. We all know, for those who have sat on boards, the board tends to move right to the finances. But if everything is based on a story — you have to be very careful about choosing your story because you want stories that evoke people and really speak about the culture, but you don’t want people to feel helpless or overwhelmed, so do be careful about how you choose your story — staff meetings are fabulous times to share stories.

You may wonder, “Well, are we going to have somebody come in, a patient or family member come in and tell a story?” You could. You could also share videos. There are fabulous videos on YouTube and videos that you may make. There’s somebody on your staff who loves recording videos. Get them out there, and get some patient and family stories that you can share at staff meetings.

This quote that I leave you with is probably one of my favorites because throughout life, we often think we have to change everything around us in order for our worlds to change, but, as you mature, you realize — and this quote is so very true — that it’s not about new places, it’s about seeing things through new eyes. That’s what stories do for us — they let us see through the eyes of others.