Eliciting the patient perspective: Using design-thinking methodology to assess the utility of incorporating narrative medicine tools in inpatient cancer.

Abstract

e23212 Background: Integrating narrative medicine (NM) into oncologic care presents a promising opportunity to enhance patient-centered care by addressing the emotional and psychological challenges faced by cancer patients. Although studies have demonstrated the positive impact of NM in outpatient settings, its perception and utility in inpatient settings remain underexplored. Methods: Using design-thinking methodology, we conducted a quality improvement project to assess how NM techniques can be used to better understand patients’ illness experience and enhance their inpatient cancer care. This human-centered approach allowed us to examine the needs and viewpoints of our stakeholders, which included patients admitted for chemotherapy to the Leukemia and Lymphoma Center at Kaiser Permanente East Bay and the center’s nursing staff. The process began with immersion into the care unit and informal interviews to gain inspiration for potential NM activities. During the ideation stage, participant feedback was integrated to develop a prototype of a NM exercise that allowed for patients to reflect on their care and work through their emotions. Implementation focused on live prototyping to promote patient engagement in their care, as well as collaboration with nursing leadership to assess feasibility of embedding NM activities into the existing inpatient workflow. Results: We elicited the interest of 6 out of 12 patients (50%) who participated in the NM activity; these patients not only endorsed a positive experience but also reported feeling more empowered to be actively involved in their cancer care. Interestingly, nursing staff were considerably more optimistic and in favor of NM tools, noting 11 out of 12 nurses (92%) who predicted that such tools could improve patient care by fostering therapeutic relationships and serving as an outlet for patient healing. Conclusions: Narrative medicine (NM) offers a way to enhance inpatient cancer care by addressing patients' unique experiences, emotions, and survivorship goals. Through a design-thinking approach, we found that while NM can be valuable, its effectiveness varies among patients. By engaging both patients and clinical staff, we identified differing levels of interest, emphasizing the need for NM to be a flexible, patient-driven tool rather than a universal intervention. Future efforts should focus on addressing barriers to patient engagement and developing practical strategies that consider patient vulnerability and workflow constraints, to seamlessly integrate NM interventions into inpatient cancer care.