How the Client Experience Shapes our Work

Relatively new to Canada, experience-based design (EBD) has been used for years in the United Kingdom to bring the patient perspective to health care planning.

In its purest form, EBD requires us to consider a client’s current experience and identify opportunities for improvement.  It tests our assumptions about many aspects of our work: the functioning of processes, the effectiveness of programs, clients’ needs and desires.   Listening, really listening, to our clients even challenges assumptions we didn’t consciously know we had. 

And when we’ve heard the feedback, EBD then calls us to use the client’s voice to influence our efforts going forward.

As EBD champion Ted Ball recently wrote, “Given the importance that Health Minister Deb Matthews has placed on The Excellent Care for All Act, the ‘patient experience’ will increasingly become an issue that healthcare leaders need to learn about, and help promote.”

It sounds simple, and yet it’s amazing how often the client experience is measured after a program or process is developed, rather than considered during the development phase itself.

At the Central West CCAC we’ve been using actual client experiences, both positive and negative, to shape how we develop programs and processes.  We seek to capture their experiences in multiple ways, including through surveys, focus groups, multidisciplinary education classes, and home visits.

One recent example illustrates the value of such a strategy.  Our organization is testing the provincial Integrated Client Care Project (ICCP), an exciting initiative that seeks to improve care through greater integration and an enhanced focus on client outcomes.

For our ICCP project focussed on wound care, we ran two focus groups comprised of wound care clients and their caregivers.  The first concentrated on what tools would be helpful at the point of discharge to help clients avoid hospital readmission.  The second asked what other supports would be valuable to our clients through their recovery journeys.

The results were fascinating.  Listening to their stories, staff gained a fuller appreciation for the many facets of our clients’ lives: they weren’t just people with wounds, they were also mothers, fathers, children, friends, employees, and contributors to our communities.  When we started to really listen, we found that many clients were faced with vocational issues because their wounds prevented them from actively participating in workforce.  As a result, they were unable to financially contribute to their family’s resources, which impacted their feelings of self-worth and affected their relationships.   The system impact also became clear, as some ultimately turned to social assistance – and what began as a conversation about leg wounds turned into something much more profound as we used our clients’ experiences to inform our work around system navigation. 

For me, client stories are a grounding force.  It’s sometimes said that care providers are afraid to ask our patients or clients what they need, because we fear that we may not have the adequate resources to meet those needs.  However, our experience with EBD has taught us that complaints are gifts – and we often find that the client experience can be improved by making changes that cost little to nothing.

Going forward we will continue to incorporate EBD into our work, including into the palliative care component of the ICCP project.  In a future post, I’ll share how we also use the data from our annual client and caregiver experience evaluations to drive change and innovation – and to listen, really listen, to our clients.

I would love to hear how others are incorporating experience-based design into their daily work.  If you are so inclined, please share your comments below or feel free to contact me directly.


The purpose of this blog is to encourage discussion.  If you repost the content, please let me know!

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2 Responses to How the Client Experience Shapes our Work

  1. Gladys Boateng says:

    Hi Cathy,
    I love your blog. What an innovative idea. I am being informed of the positive contribution that your organization is making to your community and the health care system. Thank you and congratulation to you and your team.

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