Background
The priority given to patient-centred care in recent years has included a requirement for healthcare organisations to collect patient experience data, and to improve patients’ experience of care. Shadowing is an experiential technique intended to enable healthcare staff to collect information in a way which will aid them to understand the experience of care from the patient’s perspective. It has been introduced recently to quality improvement projects, but accounts of healthcare staff who undertake shadowing have not hitherto been explored.
Aim
To explore the experience for healthcare staff of shadowing their patients and their motivation to make improvements.
Method
An exploratory qualitative study with a diverse sample of 20 clinical and non-clinical healthcare staff in different end of life settings, including acute hospitals, community and mental health, and care and nursing homes. Data were analysed using Thematic Analysis (Braun and Clarke, 2006).
Results
Participants’ accounts of shadowing revealed that their initial anxieties about aspects of shadowing did not materialise, although for some it was an ‘unusual’ experience, placing them in a novel relationship with patients. For some participants, shadowing had a powerful personal impact, intensified by being with patients who were at end of life. Shadowing promoted better insights into the experience of patients and their families, thus motivating participants to focus their improvement efforts. However, most participants were unaware that they were bringing their personal and professional lens to what they observed, which may influence their interpretation of the patients’ experience.
Conclusion
The challenge to taking up shadowing is not primarily logistical but emotional. Healthcare staff need to be supported to be aware of how shadowing may affect them. It may involve the need to manage their emotion, and to be reflexive so that appropriate service changes are made for patients and families
