22 Aug

Wardipedia – Imagination

What’s it like for the patient?

Addressing 200,000 civil rights campaigners on August 28, 1963, Martin Luther King did not say: “I have a strategic initiative.” Imagination is the invisible but powerful engine of ward staff’s empathy, creativity and effectiveness. Staff have to continuously and energetically consider what it’s like for patients.

It is her imagination that enables a healthcare assistant to understand why a 93 year old patient with dementia makes racist comments, how a young man with severe psychosis may nevertheless be able to safely chat with friends on Skype, or that a pet rabbit dying is devastating for this middle-aged banker. Ward staff continuously use their imagination to see things from each patient’s unique perspective and to create skilfully-tailored responses to help them recover. The hundreds of examples of fantastic patient experiences in IMAGINE are testimony to the ability of ward staff to put themselves in the patient’s shoes. The corresponding need for ward staff to have imaginative faith in their own qualities and resilience is nicely described by Michael Jordan: “You have to expect things of yourself before you can do them.”

IMAGINE has several loving references to Fred Lee’s If Disney ran your hospital. Lee was a senior exec in Disney and a major US hospital, so the concept isn’t as, yes, Mickey Mouse as might first appear. The book provides inspiring examples of obsessive attention to the customer experience through the equally full-on trusting, equipping and supporting of staff. These two sentences transformed Wardipedia, as we instantly adopted the imagination concept as the resource’s new framework.

Imagination creates empathy, which leads to compassion. Values and ethical beliefs alone cannot do this because in them is not where human passion resides.


The 11 Imagination ideas

1. Consultant appointments. Time’s up for ward rounds.

So much more civilised and effective than the dreaded ward round.

2. One ward, one consultant. Go one better

Mono-consultants based on the ward know and support patients and staff.

3.Therapeutic liaison worker. TLC from the TLWs

A specialist role for HCAs, co-ordinating and providing meaningful therapeutic activities.

4. Ladder of priorities. First things first

It could go something like:  1. Safety   2. Empathy   3. Activities   4. Paperwork. SEAP.

5. Relational security. Safety through trust

Trusting, human, honest, boundaried, respectful relationships create safe wards

6. Animals. Furry, fluffy, feathery, finny friends

A women’s secure unit introduced a pet bunny and rates of self-harming fell by 50%.

7. Mentalising. Mind awareness

Being aware of our own and others’ thoughts and feelings.

8. Community meetings. A meeting of minds

Daily ward meetings – everything flows from this.

9. Engagement. Time well spent.

Observation is so last century. Therapeutic alliances need the nourishment of engagement.

10. Creative communicating. It’s all improv.

Imaginative communication without words, through mime, gesture, drawing, pointing, showing…

11. Peer supporters. He ain’t heavy.

Inspiration, practical advice and an egalitarian empathy. The benefits of employing peer supporters.