I've been collecting stories of Most Significant Change as part of the evaluation of a systems-change initiative in the healthcare sector.  It's innovative, complex and it's the first time anything of this scale is being attempted by my client. 

The Most Significant Change method calls for collecting stories within a certain domain of change, so we've been focusing on the area where there has been the greatest impact since the inception of the initiative in the fall of last year.  Stories have come from physicians, patients, partners and allied health professionals.  Up until now I was recording the stories, but there still wasn't clear buy-in about the process of using stories as part of the evaluation.

The magic happened last week when we went through the story selection process.  For the first time, the Evaluation Working Group had the opportunity to hear the stories of Most Significant Change in people's lives, and they realized what a difference they were making.  Not only did the stories show the incredible challenges of patients seeking care for complex conditions and care providers struggling to support patients who had social barriers clearly impacting their health but outside of the realm of what they could address, but they got to see how the changes came about and why they were significant to the storytellers.  The group discussed at length the significance of each story and it didn't take long before they identified themes in the stories that reflected their original motivation for getting involved in the initiative. 
As the conversation touched on the raw experiences of the initiative, there was an opportunity for deep reflection.

This was one of the most satisfying meetings I've had all year.  There was a "click" where the hard data started to take on faces and experiences, guiding us through the journey of change that has been happening.  The stories illustrated the change in a way that made our survey statistics and care data come to life. 

Here are some things to consider when using Most Significant Change:

1. Stories help illustrate the context.  It's complementary, though, and is most valuable when presented with hard data that shows the bigger picture.
2. Gather stories from a diversity of respondents.  The target interview groups should ideally be identified as part of the evaluation plan.
3. Be ready to facilitate!  The selection process is rewarding but needs guidance to maintain a safe, open space and help nudge the group towards a decision using a process they feel comfortable with.

Enjoy the process!

 


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