Until a few weeks ago, mornings at my house were quite the circus. Despite several “wake up -- we have to leave in 45 minutes, wake up -- we have to leave in 30 minutes …” calls, my children, ages 9 and 6, would wake up 15 minutes before we had to leave the house for school. Inevitably, this led to breakfast in the car, and spilling half of it, leaving their lunch boxes at home, and of course being late for school.
Seeking a solution to the chaos, I bought them a Lego Emmet alarm clock that sings the “Everything is Awesome” song from the Lego Movie. The children were thrilled at the prospect of waking up to their favorite song in the morning. That night, we set the alarm for 7:15 a.m., expecting to have our first calm departure for school at 8 a.m. To my dismay, the next morning was no different from the previous mornings. My children were fast asleep while the alarm clock declared the awesomeness of the situation. On the way to school, and yes, we were late again, I asked the children to think about why the alarm clock solution didn’t work. My 6-year-old chimed in from the back to say they couldn’t hear the alarm -- the volume was too low despite being turned up to the maximum. My 9-year-old suggested we buy another alarm clock with a louder alarm. So, I got them a louder alarm clock.
I used this experience as a teaching opportunity and asked them how they will know if their solution is a success. My 9-year-old responded to say it will be a success if they wake up when they hear the alarm ring. After some discussion, and a very simplified explanation of process measures and outcome measures, they decide success would be defined as ‘going to school on time.’ With some help, they tracked the number of times they woke up early, the number of times they got to school on time and the number of times mom didn’t yell at them. I guess this could be considered a balancing measure! They did this for a week and with some effort, I am proud to say mornings at our home are no longer chaotic but calm and peaceful. Well on most days—they are children after all!
Thinking more about why this exercise was a success -- it was because the people who were the most impacted by the problem were the drivers of the change. In health care, there is an increasing realization that to improve outcomes, the health care system must begin to include the patient voice. To do this, we need to be asking patients, the users of the system, the question “What matters to you?” and not “What is the matter with you?”
For those of us working on solutions to better health care, we should ask ourselves what we can do to support a patient-driven revolution in health care.