Case Study: Improving person-centred care communication in health and social care settings

In January 2019 Healthcare Improvement Scotland welcomed Natalia Rodriguez to undertake a 3 month internship. Natalia is studying for a PhD with a focus on interpreting in mental healthcare settings at Heriot Watt University. During her time at Healthcare Improvement Scotland she worked within the Evidence and Evaluation for Improvement Team (EEvIT), supporting them to evaluate the ‘What Matters to You? Day’ (WMTY) initiative that is facilitated by the Person Centred Care Team. Natalia was happy to share information about her experience below. 

What attracted you to this internship?

When I first saw the advertisement for an internship position for PhD candidates with Healthcare Improvement Scotland (HIS) I was both thrilled and hesitant about applying. On paper, I was a good candidate, but I wondered if my academic background would be the right fit for the organisation. On the other hand, I was sure that it would be a great opportunity for me and that I definitely wanted to put my research skills to use in public healthcare. 

My PhD had already given me the chance to witness the work of the NHS first-hand. For data collection purposes, I observed consultations conducted through spoken-language interpreters in two psychiatric wards within NHS Lothian for over a year. During this time, I not only collected data but also learnt lessons about human resilience that I will always carry with me. Having finished the data-collection work in December, I have now a year of funding left to convert my data into a thesis. So, the chance to work with HIS in this transition stage could not have come at a better time!

What did you do?

During my time at HIS, I supported the Evidence and Evaluation for Improvement Team (EEvIT). Specifically, I supported EEvIT to evaluate the ‘What matters to you? day’ initiative that is facilitated by the Person-Centred Care Team within HIS. For this purpose, I conducted primary and secondary research to produce an evidence report called: “‘What matters to you?’ Embedding the question in everyday practice: a multiple case-study”.

Did the internship meet your expectations?

It definitely exceeded my expectations. When I applied for the post, I was expecting that I would be doing some kind of work for a public health organisation, which in itself was to enough to make me feel excited. What I did not know then was that I would be applying my whole range of research skills to explore a topic fully in line with my PhD aims. I really was not expecting that before I started.

How did you utilise your research skills and knowledge during the internship?

There was clear common ground between my PhD topic and the aims of my internship project, which made it possible for me to use my knowledge and apply the research skills required to fulfil my internship aims. My PhD is about how linguistically and culturally diverse patients access healthcare services when they do not share a language with the service provider. During my internship, I evaluated the impact of a campaign that aims to promote a communication model in which patients and practitioners are encouraged to interact as equal partners in the planning of care. Methodologically speaking, for my PhD I have adopted a single case-study research design and for my internship, I adopted a multiple-case study design. In summary, my knowledge on the topic and the methodology required to explore was useful as a starting point, but the internship aims required me to take my expertise a step further.

What transferable skills did you learn?

Communicate clearly with a wide audience. During my internship I worked with a multidisciplinary team made up of health service researchers, a health economist and an information scientist. During data-collection, I interviewed people with a wide range of backgrounds including consultant, nurses, health service managers, etc.
Developing appropriate timescales and sticking to them which was key to success as I was fully responsible for the development of the project.
Being flexible: we had to consider different study designs as we depended on data availability.

How did you find coming back to your research after the internship?

I feel more confident now when approaching my PhD dataset. I did my internship during a transition time, right in between finishing data collection and starting data analysis and subsequent reporting. During my internship, I had to analyse and report data and that gave me a small-scale taster of what would come after. A team of health service researchers supported my work and provided guidance at all times so that I could fulfil my internship study aims. I am going to keep using that guidance to safeguard rigour in my own research work. I feel that I have more research tools and resources now.

How has it impacted your professional and personal development?

I am not sure about what type of work I will conduct after my PhD but public health and social care provision is definitely a research and personal interest that I am going to carry with me for life after my internship.

I do believe that my internship will help open up a new range of future possibilities that I would have never even thought about until now. The National Health Service is such a complex organisation that encompasses so many different departments, teams and staff with different backgrounds. Particularly, Healthcare Improvement Scotland contains different portfolios that have different objectives but pursue the common aim of driving improvement in the provision of health and social care services. This is an excellent area of work and definitely worth considering in the future.

What advice would you give other PhD students thinking about an internship?

1- Be more confident in their own potential contribution to the hosting organisation. I think that they might find it refreshing to work with someone new who brings a unique set of research skills to their organisation. 2- Remember that you do not need to know everything from the beginning as people want you to do well and will train you and you learn on the job 3- Your co-workers are engaged in their own routine so speak up if you need anything from them as they may not be used to having an intern. It is important to be self-directed (within limits and guidance)

Are there any outputs from the internship that you would like to share?

It was key for me to meet other people in the organisation outside from the team that I was allocated to work with as that provided me with unintended benefits. E.g. I was able to meet the Equality and Diversity advisor from HIS whose work is closely connected with my research interests and PhD aims. Because of his support, I was able to provide some feedback on a policy document draft around my area of expertise (healthcare interpreting) that will soon be published. That was not part of my internship aims but I definitely count that as one my main internship accomplishments.

"It has been an absolute joy working with Natalia. She has been a breath of fresh air. She picked it up quickly and I didn't feel that I had to direct her too much. I think we really lucked out on Natalia's skill set."

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