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Showing the Unsayable: Participatory Visual Approaches and the Constitution of ‘Patient Experience’ in Healthcare Quality Improvement

Authors
  • Papoulias, Constantina1
  • 1 King’s College London, Service User Research Enterprise, Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK , London (United Kingdom)
Type
Published Article
Journal
Health Care Analysis
Publisher
Springer US
Publication Date
Oct 16, 2017
Volume
26
Issue
2
Pages
171–188
Identifiers
DOI: 10.1007/s10728-017-0349-3
Source
Springer Nature
Keywords
License
Green

Abstract

This article considers the strengths and potential contributions of participatory visual methods for healthcare quality improvement research. It argues that such approaches may enable us to expand our understanding of ‘patient experience’ and of its potential for generating new knowledge for health systems. In particular, they may open up dimensions of people’s engagement with services and treatments which exceed both the declarative nature of responses to questionnaires and the narrative sequencing of self reports gathered through qualitative interviewing. I will suggest that working with such methods may necessitate a more reflexive approach to the constitution of evidence in quality improvement work. To this end, the article will first consider the emerging rationale for the use of visual participatory methods in improvement before outlining the implications of two related approaches—photo-elicitation and PhotoVoice—for the constitution of ‘experience’. It will then move to a participatory model for healthcare improvement work, Experience Based Co-Design (EBCD). It will argue that EBCD exemplifies both the strengths and the limitations of adequating visual participatory approaches to quality improvement ends. The article will conclude with a critical reflection on a small photographic study, in which the author participated, and which sought to harness service user perspectives for the design of psychiatric facilities, as a way of considering the potential contribution of visual participatory methods for quality improvement.

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