RIPPLE Video – patient experiences

Hot off the press, here is a twenty minute video of the University Hospital Coventry and Warwickshire NHS Trust RIPPLE Project, introduced by Colin Gelder (who specialises in Asthma, COPD and other Airway Diseases. He also runs the new Community COPD Team.) and nurse Charlotte.

I was lucky enough to be invited to facilitate the early workshops from which emerged the ideas for this project.

The RIPPLE Project is a study we have put together looking at the effects of using Asset based Community Development to address anxiety and social isolation in chronic obstructive pulmonary diseases (COPD). – Dr Colin Gelder – Consultant

RIPPLE is an acronym meaning

Respiratory

Innovation

Promoting a

Positive

Life

Experience for COPD patients

After the first five minutes of the video you will hear, first-hand, the personal experiences of some of the community members.

While you watch these amazing accounts of just what the project has done for them, imagine each short story as a narrative fragment, signified (indexed against an appropriate set of parameters) by the teller and plotted on a sensemaker narrative landscape so that you could see the patterns across the community/county/society and drop in on any aspect that attracts your interest.

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At the Heart of Health

NESTA REPORT

I was very excited to hear that the RIPPLE Project, which emerged from a couple of workshops I facilitated in 2014 for the University Hospitals Coventry and Warwickshire NHS Trust (in partnership with Coventry University, the British Lung Foundation and local voluntary sector groups in Coventry), is beginning to gain momentum as a prime example of a “Person- and Community-centred approach for Health and Wellbeing.

Yesterday I facilitated a similar workshop in Wolverhampton of 45 patients, matrons, GPS, Hospice workers, Chaplaincy, fire service, community trust, Age UK & voluntary sector to bring together a community (and their assets) as part of a bid to become part of a second tier of six further similar projects in the West Midlands.

Anyway we found out that on Tuesday NESTA, the independent charity that works to increase the innovation capacity of the UK, had published its latest report entitled At the Heart of Health – Realising the value of people and communities, and that the RIPPLE Project was being held as a great example of enabling group activities that can be beneficial to support health and wellbeing.

What they highlight about the RIPPLE Project is:

Group activities in practice: RIPPLE – Respiratory innovation: Promoting a Positive Life Experience

People with Chronic Obstructive Pulmonary Disease (COPD) experience chronic ill health and are at risk of early death. The symptoms of COPD, including breathlessness and coughing, can lead to and amplify anxiety, low self-esteem and social isolation. These in turn lower mental wellbeing and can result in both poor self-management and a lack of engagement with key treatments, such as smoking cessation and pulmonary rehabilitation. People can become trapped in a negative cycle where poor self-management leads to worsening symptoms.

As part of the Health Foundation 2014 Shine Programme, University Hospital Coventry and Warwickshire NHS Trust took a whole systems approach to this challenge. A broad partnership was set up involving local patients and carers, primary and secondary care clinicians, academics, public health professionals, and third sector organisations to discuss and develop innovative solutions to the social isolation and anxiety observed in individuals with COPD.

After consultation with people living with COPD, the partners decided that an informal community-based clinic would act as a catalyst for increased involvement. This evolved into a group model which blended informal clinic and education sessions with social activities such as bingo, quizzes, singing and seated yoga every Monday afternoon in a community centre.

Results included:

  • Reduced social isolation and anxiety.
  • Increased mental wellbeing.
  • Improved confidence in ability to self-manage.

Preliminary evidence – involving a small number of patients – suggests that attending the RIPPLE programme regularly may reduce the number of unplanned hospital admissions. The patients involved in RIPPLE are chronically ill and as such, you would normally expect their condition to deteriorate, leading to an increase rather than a decrease in hospital admissions. The RIPPLE team has secured additional funding through the Health Foundation’s Spreading Improvement programme which will allow these findings to be further explored.

“Coming here, well, it’s given me a social life I didn’t have before…I feel like a fraud coming here now because I feel so good.”

A couple of other quotes from the report which is probably obvious why they appeal to me are:

In essence, asset-based approaches for health and wellbeing seek to create approaches that are participatory, enabling people to lead action for health, and are underpinned by a focus on what makes us healthy.

As with many community-centred approaches, this is an area where practice on the ground is ahead of the academic research. There is a lack of systematic or review-level academic evidence about asset-based approaches for health and wellbeing.

To date, evidence of effectiveness on asset-based approaches in the UK is limited to a few local, emergent solutions within particular contexts, with little practical guidance on how to put them into practice at scale.

The entire NESTA report can be accessed and downloaded here and is highly recommended.

Storytelling For Problem Solving & Better Decision Making

I have just been confirmed as speaker and seminar facilitator at the next NETIKX event in London on Tuesday afternoon 22nd March 2016. My challenge for the day is to demonstrate just what Participatory Narrative Inquiry methods can bring to resolving issues and problems and improving decision making.

NETIKX

If you have never heard of them before NetIKX is the Network for Information and Knowledge Exchange and with a membership fee of only £60 per annum which includes free admission to this and another five similar events over the year, you would be a fool not to join immediately. At London prices the wine alone is worth it.

Review your Flood Plan & lessons learned now

Special 2016 fixed price offer

A fully facilitated Flood Review and Action Planning workshop

floodpic

Have you and your community been flooded, are you worried about the risk of flooding in the future or just wish to make sure you are prepared for the worst?

If you want to inform and influence government policy, funding, national and local action, it is essential to get together and explore options and ideas as soon as possible.

Drawing on my experience of Knowledge Sharing and Inventive Problem Solving I have put together a facilitated workshop that can easily be adapted to suit the specific needs of your community/organisation or local authority.

All you need provide is the participants, a room/space and refreshments.

Whatever your stage in the cycle I can deliver a workshop to meet your current needs.

Consider which of the following you would wish to focus on and email me now for a price and further details.

1. Lessons learned – sharing and capturing stories and insights before they are forgotten.

2. Creating a flood plan (including resource map)

3. Problem solving

4. Creating a flood risk plan

5. Building local cohesion before the next flood.

Putting the workshop together was inspired by this slideshare pack of Analytics to advise a business in Leeds created by Ian Abbot Donnelly, a good friend of mine.

contact details

Ecology of Knowledge Menu V1 front

I have finally managed to create a menu of services that I am happy with. Click on either image to enlarge. The PDF version can be downloaded here, a version complete with prices is available on request..

Ecology of Knowledge Menu V1 no pricesand yes, before you ask, I do have 25 years experience of providing discos and music quizzes so why not end (or punctuate) your event with a participatory musical high.

convincement book

I have to admit to not really knowing much about the Quaker movement apart from the porridge and the numerous meeting rooms I have visited around the country.

I managed to pick up (in a charity shop in Whitby for £1) an interesting book called ‘ A great Convincement’ by Monica Ventress who chronicles the story of the Quakers in North East Yorkshire (a place I do know a lot about).

Apart from discovering that I was unknowingly an Anabaptist, I just love this description of the emergence of the Gurteen knowledge cafe (the thought that David Gurteen might be a time-lord and had gone back to the 1600s as an experiment did cross my mind):

An essential of the sectarian position was that the sermon should be followed by discussion: that worship was not a matter of passively hearing the Word preached by a learned minister, but in participation by the congregation after a gifted member had opened up a subject for discussion. As time went on the practice of interrupting the parson in his pulpit, became a common occurrence. Disrupting services had been made a secular offence by an Act of Parliament in Mary’s reign (1553-1558). The Quakers always claimed a legal right to speak after the sermon was over.

The book goes on to detail the numerous penalties and imprisonments of people who interrupted services, held or attended Quaker gatherings and is genuinely shocking that these practices were seen as so threatening at the time.

I was then reminded of a Quaker based method called the Clearness Committee’ and is described in Joanna Macy’s wonderful book “Coming back to life” which explains how to seek clarity in important decisions, especially around marriage.

After the focus person summarizes the issue, members of the committee (ideally five or six trusted individuals) assist her by asking questions rather than giving advice or problem solving. Honest, caring queries, arising out of prayerful silence, help the focus person see herself and her situation in a new light and unblock her inner wisdom and authority.

A more complete and detailed explanation of the method can be found here where they explain that:

Behind the Clearness Committee is a simple but crucial conviction: each of us has an inner teacher, a voice of truth, that offers the guidance and power we need to deal with our problems. But that inner voice is often garbled by various kinds of inward and outward interference.

I am really looking forward to giving this approach a try at my next problem solving workshop and/or community building masterclass.

Finally in looking to see what was on the internet about this method I came across this really interesting and very relevant slide pack on the use of dialogue by the Quakers on Slideshare by Thomas J Neuville in the U.S.

I am particularly interested to discover the origins of slide 12 and its relationship to cynefin and theory U.

Save the World – A Community workers Masterclass

The RiPPLE Project

Building a community around the local support of COPD in Coventry

Over the years I have worked with many communities, enabling them to make sense of their different perspectives on today, the past and their shared futures, and in doing so, map their narrative landscape.

I have helped them experience their shared Ideality and the benefits they hope to achieve, map their resources and model their current system.

I have begun to catalyse creative and inventive ideas, plotted on cynefin to make sense of complexity and then assessed against their benefits.

I have facilitated problem solving, peer reviewed feedback and storyboarding of these ideas to nurture them into viable, inspiring experiments and projects that gain maximum buy-in.

I have shown them how to use a Kanban to open up their action planning and how to avoid damaging target setting but instead measure the impact of their actions so that they can get “less stories like that and more stories like this”.

During the course of this I have studied Theory U, Asset Based Community Development (ABCD), Participatory Narrative Inquiry (PNI), Cognitive Edge, TRIZ and the work of Steve Denning, Joanna Macey and the Tales2Sustain storyworkers to name just a few of the giants upon whose shoulders we must stand.

I now feel the time is right to give back and share this joined-up, ‘best of the best’, portfolio of knowledge and understanding in the hope that it can be focussed on building local communities resilient, adaptable and sustainable in the face of Austerity, cut backs and 360 degree threats to the environment.

I have therefore set up, as an experiment, the first of what I hope will be many, ‘Change the World, one community at a time’ masterclasses on eventbrite.

This first event will be held in central Peterborough on 15th September. Early bird tickets are available until 15th of August for only £89 for a full day.

If you are interested, and I hope you are, please sign up as soon as possible, and come and join us to share what you know, gain what you need to know and perhaps even learn some things you didn’t even know you needed to know.