This document summarizes a project called "Listening to and Learning from Older People – A person-centred approach". The project tested a model of listening and learning from feedback provided by older patients in acute care wards. The model involved conducting one-on-one conversations with patients, discussing weekly topics, identifying problem areas, and holding social events. Preliminary findings suggest the methods were simple, low-cost, and improved delivery of person-centered care by reminding staff what is important. Ongoing learning and more flexible feedback systems are still needed. The document explores how interaction rituals between staff and patients can maximize quality of care encounters.

1. Listening to and
Learning from
Older People –
A person-
centred
approach
Professor Brendan McCormack
Head of the Division of Nursing; Head of
QMU Graduate School; Associate
Director CPcPR, Queen Margaret
University, Edinburgh.
Honorary Nurse Consultant
(Gerontology), NHS Fife
Professor II, University College of South
East Norway, Campus Drammen.
Extraordinary Professor, University of
Pretoria, South Africa.
Visiting Professor, Ulster University,
Northern Ireland.
Professor of Nursing, Maribor University,
Slovenia

3. “when I saw uncle Jack for the first time the reason I was shocked
by his appearance was that I expected – well, I suppose, the hero
from a schoolboy’s book. Once I had seen a photograph of him
radiant and splendid in his officer’s uniform. It had fallen out of
Aunt Kate’s prayer book and she snatched it from me before I
could study it in detail. It was a picture taken in 1917 when he
was a chaplain to the British forces in East Africa and he looked -
magnificent … the wonderful Father Jack of that photo was the
image of him that lodged in my mind.”

4. “…Taking an attitude of inquiry involves noticing our current state, gently
taking its messages and seeking to adjust it if appropriate . Our practices for
stepping aside into dancing with beauty are simple, when we can access them …
when we practice these approaches, and others, the world is a different place …
And they need repeatedly reascribing, the context does not seem to foster them,
sometimes they seem beyond our reach
Marshall & Reason 2006
Dancing with Beauty rather than
Fighting Ugliness

6. Vulnerability at the junctures of systems, care processes and nurses’ responses

7. The Mood versus the Beat of Nursing

8. “I don’t think it’s (the listen and learn
project) changed the way I feel about
older people in the ward, I think its
reminded me about what I used to
actually always think about… it has
reminded me about what is important”

9. Prof Brendan McCormack, Prof Jan Dewing, Fiona
Gilmour, Megan Dickson, Helen Riddell, Queen
Margaret University
Lesley Carter, Age UK
Listening and Learning Pilot Project
Real time feedback from older people in
acute care wards

10. AIM
To test out that listening, hearing,
acting and learning on feedback
from older people will lead to an
improvement in the delivery of
high quality person-centred care.

11.  Phase 1:
 Stage 1: Rapid Realist Review
(McCormack et al in press)
 Stage 2: Development of a model of listening
& learning for implementation in Phase 2
 Phase 2:
 Facilitating change and testing the model:
interventions in the pilot sites

13. METHODS
Listen & Learn Conversations 1:1
Topic of the Week
Hotspots/ Emotional Touchpoints
(Structured activity)
Time for Tea (social event)
Listen & Learn Letter

14. KEY FINDINGS
 Role of volunteers
 Benefits of ‘real time’ feedback
 Seeing the bigger picture through the small things
 Methods are simple and low-cost
 Need for ongoing learning
 Need for more flexible person-centred feedback
systems in organisations

15. Interaction Ritual Chains (Randall Collins)

16. Interaction Ritual Chains
nurses and care workers need to be
‘emotionally touched’ by their everyday
care experiences and the systems in
which we practice need to be structured
and managed in such a way that they
enable the quality of such encounters to
be maximised
(McCormack & Skatvedt, 2016)

17. “We all have something of each others lives in the
palms of our hands”
Martinsen 2006

18. Dance as if language had surrendered to movement – as if this
ritual, this wordless ceremony, was now the way to speak, to
whisper private and sacred things, to be in touch with some
otherness … Dancing as if language no longer existed because
words were no longer necessary