Adding Stories and Spielberg to Healthcare

Added on May 30, 2015

My wife and kids are avid movie watchers. So much so that they’ve been known to watch 30+ year old classics like Steven Spielberg’s "Raiders of the Lost Ark" (story by George Lucas and Philip Kaufman; Lucasfilm Ltd. 1981). Even if you’re not a movie fan, or “missed” Raiders of the Lost Ark, I suspect you’ve heard of Spielberg and that he is considered a master of making unbelievable situations seem believable, even real. Successful movies transport viewers to faraway galaxies, times or places, but they also provide important clues for those looking to improve safety in health care. Although recent estimates of preventable healthcare related deaths exceed 200,000 per year (James, John, A New Evidence-based Estimate of Patient Harms, Journal of Patient Safety, September 2013, Volume 9, Issue 3), many inside and outside of healthcare do not believe the numbers. Telling better stories and telling them more often may be one way we convince the doubters.

Spielberg

Spielberg’s movies tell a good story, at least in part, because he convinces the viewer that the story or situation is real. He leaves nothing to chance in this regard. Consider the descent of Indiana Jones (Harrison Ford) and Sallah (John Rhys-Davies) into the Well of Souls in Raiders of the Lost Ark. In this scene (inset left), Spielberg wants the audience to believe that Indiana Jones is really stuck, with no way out. To do this, Spielberg surrounds the protagonists with snakes: not just a few, or even hundreds, but thousands of snakes! The sight of these snakes evokes emotion in the viewer, in this case fear, which in turn affects how we interpret the scene. There will be no movie trickery here - his crew placed 2,000 live snakes on set for the scene.

Unsatisfied, and thinking that viewers wouldn’t be convinced, Spielberg increased the number, requesting an additional 5,000 live snakes for the final shooting! Rumor has it, he even closed the set until the additional reptiles were located, at considerable cost, both for the slithering props as well as the downtime of the set. (Herpetologists might point out that the ‘snakes’ in Raiders of the Lost Ark were actually legless lizards known as Scheltopusiks (Pseuopus apodus).

The story of legless lizards is relevant to patient safety because healthcare leaders have stories at their fingertips which are equally capable of changing thinking and behavior. Recently, in a presentation entitled, “Leading for Safety & Reliability – What a CEO should Do Every Day,” Laura Goldhahn, set the mark for how senior leaders use stories to motivate their organization. Laura is the immediate past president of Benefis Hospitals in Great Falls, Montana and she helped lead their safety transformation. “It starts at the top,” she said. Leaders, especially CEOs and Presidents, “must lead for safety, and to do this they must know what’s happening where patients receive care.” Leaders must know the stories of the people working on the frontlines, and more importantly, the stories of their patients. “It means routinely scheduling time to visit with managers, staff and especially patients.” Laura learns how her staff experience harm events by sitting with them after an event, not to question or admonish them, but to listen to how they experienced the errors which contributed to patient harm. Her most important thoughts, however, center on the patient. By talking with patients or their families, Laura learns the stories first hand. She then retells these stories to her staff, providing the facts which make the stories real and believable. Laura knows that health care workers don’t want to harm patients and that these stories will direct attention to patient safety and motivate her people to take patient safety seriously.

Spielberg measured the effectiveness of his snakes with a simple test: during screenings of Raiders of the Lost Ark, he sat in the back of the theatre and right before the scene, he crouched down on hands and knees, looked forward toward the front of the theatre, and confirmed that the audience lifted their feet in fear, many too scared to even scream! He was looking for their actions in the moment, not what they said afterwards. At that point, he knew his audience believed those legless lizards were real! By telling stories of patient harm, healthcare leaders will propel those around them into action, which in turn will save lives.

  • • As a healthcare leader, do you know the stories of your institution? Reach out and speak to the people we serve, and sometimes harm, our patients. In doing so, you will also see how harm events impact our staff. These stories will transform you as a leader.
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  • • How can leaders of safety change evoke the emotion of our healthcare workers? Spielberg used legless lizards, our patient’s stories are equally real and will motivate staff to action.
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  • • Where can you learn more about effective story telling? Andy Goodman’s book, "Seven Questions to Sharpen Your Stories" is a great place to start. However, making the effort to learn and then tell the stories of our patients is more important than the quality of the delivery. Start today, you don’t have to wait for a perfect story!