'As soon as you've been there, it makes it personal': The experience of health-care staff shadowing patients at the end of life

Abstract

Background: Patient shadowing is an experiential technique intended to enable those who shadow to understand care experience from the patient's point of view. It is used in quality improvement to bring about change that focuses on what is important for patients.

Aim: To explore the acceptability of patient shadowing for health-care staff, the impact of the experience and subsequent motivations to make improvements.

Method: A qualitative study with a diverse sample of 20 clinical and non-clinical health-care staff in different end-of-life settings. Data were analysed thematically.

Results: Anticipated anxieties about shadowing did not materialize in participant accounts, although for some it was a deeply emotional experience, intensified by being with patients who were at the end of life. Shadowing not only impacted on participants personally, but also promoted better insights into the experience of patients, thus focusing their improvement efforts. Participants reported that patients and families who were shadowed welcomed additional caring attention.

Conclusion: With the right preparation and support, patient shadowing is a technique that engages and motivates health-care staff to improve patient-centred care.

Keywords: end-of-life care; patient experience; patient shadowing; patient-centred care; quality improvement; staff experience.