8. Interviewing and filming patients
This stage involves creating a comfortable environment for patients to share their stories of services, and capturing those stories effectively, to provide rich information that will guide improvement.
The interviews should take place within a couple of weeks of the recruitment process, in a location where the patient feels comfortable. This may be at a hospital, community centre or in their home. Beforehand, send out notes to help them prepare, see our example interview schedule. When the person arrives, welcome them, help them feel comfortable, and take time to develop a rapport. Make sure there are comfortable seats, refreshments, tissues, and plenty of privacy. Patients will be asked to consent to the clips that will go into the final version, so encourage them to be completely open at this stage.
The interview itself usually takes between one and two hours. Each individual film is then edited down for the final compilation film, which is half an hour long. In previous projects this has been divided between 11-12 interviewees, but this can vary. Try to let people tell their story in their own way, but prepare a list of questions for any interviewees who need more structure. While you’re listening, make a note of comments that require clarification or more detail. The interview also forms the start of the editing process, as the interviewer may also be involved in editing the film. So, as the patient is talking, listen out for key points and ‘touch points’ – themes that particularly resonate, and that may have also arisen in interviews with other people.
A recent evaluation in two Intensive Care Units and two lung cancer services has tested an accelerated version of EBCD, which uses existing ‘trigger’ films in the place of new patient interviews, with positive results (see Section 15, Adapting the approach to your budget and accelerated EBCD.
- Realistically, you can conduct only two, or at most three, interviews in a day. Be aware that it can be emotionally draining for the interviewer as well as the interviewee. Always check on the day of the interview that the agreed time is still convenient for the patient. Bear in mind that patients may have to cancel at short notice – for example, due to sickness.
- Let the patient decide where the interview will take place. This is very important as the aim is to make the patient as comfortable as possible. Factor in the time that the interviewer will need to take to travel to and set up each interview. If you are travelling to a patient’s house, inform a colleague of your planned movements. (For more guidance on personal safety issues see the Suzy Lamplugh Trust website).
- If people are travelling to the venue, offer to pay their travel expenses, and make sure they are clear about directions and travel arrangements. You may also decide to give people vouchers or payment for their time.
- As the video is single-shot footage, showing only the person’s head, it may be possible for only one team member to film while interviewing using a tripod. If the interviewer is not confident with the technology this could be a distraction, so make sure they spend some time practising and preparing. If a separate cameraperson is involved in the process, ask them to stand some distance from the interview so that it is less intrusive.
- It is a good idea for the person doing the filming to have training in filming skills so that they can get the angle, framing and lighting right.
- The audio quality captured by video recorders can be variable. If you are worried about the quality of your equipment, take an audio recorder as well. Always do a quick test in the room, to make sure that the recording level is adequate for the background noise levels and for your participant’s natural speech volume.
- The interviewer does not need formal training, but must be empathetic, sensitive, non-judgemental, and able to inspire trust. They also need good knowledge of the patient pathway so they can re-order events into the correct chronological order where necessary when editing.
- Throughout the interview, remember that the patient is being filmed, so do not interrupt them. The more the interviewer speaks, the harder it is to edit a clear message from the patient, so try not to make encouraging noises, and remember to turn off all phones. If there are animals or children in the room or some other noise interruption, you may need to ask the patient to repeat themselves.
- Respect patient and staff privacy and confidentiality, and ask patients to try not to use names of staff when describing services. Anything that slips through will be anonymised in the editing process.
- Patients may be nervous before the interview and distressed afterwards. Invite them to bring along a friend, family member or carer for moral support, and schedule in time beforehand and afterwards for a supportive debrief.
- Arrange psychosocial support from within the clinical team or from outside services in case issues are raised that require the patient to have some support. Examples might include a patient-support phone line or staff within the clinical team. The interviewer should also have adequate support too – for example, the opportunity to debrief with a colleague.