Shadow the target group

Once the care process is understood, it is important to ascertain how this process is perceived by the patients themselves. A process may be experienced quite differently by patients in reality compared with how it appears on paper. Experiencing care processes is most easily undertaken through shadowing a patient or staff journey (depending on the target participant group). For example, sitting in a hospital waiting area can reveal what factors lead to it being a relaxing or daunting experience; or seeing people attend weekly clinics can show whether patients are likely to find a further weekly arts activity an enhancement or an exhaustion. Although it may not be appropriate to shadow an entire care process, as it may take several months for a patient to follow a full process, shadowing sections of the care process that have been flagged as potentials for an intervention from the care process analysis can be a valuable task.

As Kolb’s Reflective Cycle demonstrates, the key aspect of this step of the process is in ‘feeling’. A useful tool that may help with shadowing is ‘thick description’. Developed in the mid-twentieth century as an ethnographic tool, thick description involves observing and recording in fine detail what is noticed, including factual details as well as contextual details about the environment in which the observations are made and sometimes even interpretations of how details make the observer feel.(6) The more details that can be provided, whether they seem relevant at the time of writing or not, the richer the body of data there will be. Essentially, this enables an experience to be recorded, but it also means that small details that might not seem important at the time of shadowing can later be revisited and better appreciated. For example, through thick description, it might be that the person shadowing a waiting area in a hospital writes down three times over the course of a day that they were startled by an unexpected noise, or they overheard another patient’s conversation with a doctor. These small details might be easily forgotten over the course of the day, but if they are recorded along with other information about the waiting area, when they are returned to, it may become clear that some sort of arts intervention that directs patients’ attention away from background noise and towards a more pleasant stimulus may reduce waiting anxiety, provide extra privacy for staff and patient conversations, and ultimately improve the experience.

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