Over the course of the 4-week improvement cycle, staff may encounter learning moments or empowerment opportunities (individually or as a group) when the light bulb goes off in their heads and they fully grasp the context and meaning that the Story Simulation illustrates for improving a variety of safety and patient satisfaction behaviors.

Here are some examples of insights that your team members may have:

• I need to refer to my patients by name, not just room numbers.
• I am empowered to ‘speak up’ for the well-being of my patients.
• I can bring a concern to another team member, even a senior member, without them thinking I am trying to subvert their decision-making authority.
• Earlier is better for a team when planning for emergent c-sections.
• My team members respect me more when I communicate effectively.
• I’m not in this alone, I have a whole team to help support me and our patients.
• When I do something meaningful and personal for our patients, I feel more fulfilled.

By leading staff to these self-discoveries, the impact of the Story Simulation can be greatly increased and the individual transitions from being a participant to become an advocate for improving team effectiveness while providing safer patient care. Specific learning outcomes for each Story Simulation are contained in each story-specific Discussion Guide.

There are 2 different periods for the participating unit leader to observe staff behavior and monitor change during the recommended StoryCare’s 4-week improvement cycle. One is between the Kickoff Meeting and Halftime Huddle, and then in the last 2 weeks between the Halftime Huddle and Goal Line Gathering. Each customized Story Discussion Guide contains specific Monitoring Behaviors unique to each story.  These opportunities to observe change should be done during your normal daily routine in the unit.

You may be wondering how you can best evaluate whether your team is making meaningful changes to meet the goal of improving team performance for your patients. Here are some things to look for and how to involve your team in the journey of improving patient care in all its dimensions.

After the debrief of the StoryCare Simulation Kickoff Meeting, staff will be identifying opportunities for making improvements. During this time, provide guidance and encouragement to staff as they grapple with making changes.

After the Halftime Huddle, staff will be honing in on a few key behavior changes or new techniques as identified during the latest group discussion. Here are some simple questions of your staff as you round daily to engage them with the themes and principles embedded in the StoryCare stories.

• What’s going well with communication on the floor since we discussed that last story?
• Have you given any thought to how we could improve the bedside handoff since we discussed it in the meeting?
• I was wondering if you’ve thought of any ways to better involve patients in their care plan? If there were no barriers around here to doing so, what would you do?
• Have you had any opportunities to step outside of the line of your usual duties to do something special for a patient or family member? How did they respond?
• Have you had a chance to anticipate a patient’s needs before they even rang the call bell or asked for something? If so, how did you do that?
• What have you been able to do to help your patients feel a little less like a patient and a little more like a member of our care team?

Another important way to discover what your staff is doing new is to just sit back and watch. You’ll see the opportunities that they either embrace or miss. If they embrace them, that’s your chance to appreciate them for what they did. If they missed an opportunity, pull them aside in the hall and let them know what a good job they’re doing. Then pose a simple question in this manner: “I was wondering what would happen if . . .” and fill in your suggestion. Then, ask them what they think of that idea. Make it short and sweet—you’re planting seeds that hopefully will take root.