Shared Narratives Research Articles

The political economy of universal health coverage: a systematic narrative review.

The uptake and implementation of universal health coverage (UHC) is primarily a political, rather than a technical, exercise, with contested ideas and diverse stakeholders capable of facilitation or resistance-even veto-of the policy uptake. This narrative systematic review, undertaken in 2018, sought to identify all peer-reviewed publications dealing with concepts relating to UHC through a political economy framing. Of the 627 papers originally identified, 55 papers were directly relevant, with an additional eight papers added manually on referral from colleagues. The thematic analysis adapted Fox and Reich's framework of ideas and ideologies, interests and institutions to organize the analysis. The results identified a literature strong in its exploration of the ideologies and ideas that underpin UHC, but with an apparent bias in authorship towards more rights-based, left-leaning perspectives. Despite this, political economy analyses of country case studies suggested a more diverse political framing for UHC, with the interests and institutions engaged in implementation drawing on pragmatic and market-based mechanisms to achieve outcomes. Case studies offered limited detail on the role played by specific interests, though the influence of global development trends was evident, as was the role of donor organizations. Most country case studies, however, framed the development of UHC within a narrative of national ownership, with steps in implementation often critical political milestones. The development of institutions for UHC implementation was predicated largely on available infrastructure, with elements of that infrastructure-federal systems, user fees, pre-existing insurance schemes-needing to be accommodated in the incremental progress towards UHC. The need for technical competence to deliver ideological promises was underlined. The review concludes that, despite the disparate sources for the analyses, there is an emerging shared narrative in the growing literature around the political economy of UHC that offers an increasing awareness of the political dimensions to UHC uptake and implementation.

Manipulation of translation in hard news reporting on the Gulf crisis: combining narrative and appraisal

This paper explores the manipulation of translation for propagandistic purposes in the Gulf crisis, which has led to the economic blockade of Qatar since June 2017. It focuses onAl-Ittihad, an Arabic daily newspaper owned by the United Arab Emirates. The data under analysis is extracted from a hard news daily section thatAl-Ittihadhas dedicated to Qatar since the outbreak of the crisis. Combining Narrative Theory with the Appraisal Framework provides an insightful account of the ideologically motivated manipulation and weaponization of news translation. Going beyond the reductive claim of domestication in News translation studies, this dual theoretical approach allows for further articulation of the socio-political context with translation strategies, by combining macro- and micro-analysis. This approach also uncovers the workings of propaganda inAl-Ittihad’s translational news reporting. From the transediting of foreign attributions to the intersemiotic design of the newspaper’s layout, translational news reporting involves embedding personal and shared narratives into the micro- and macro-levels of the hard news section to construe a negative evaluation of Qatar. Behind a façade of detachment and neutrality, hard news reports and the translation on which they rely feed into the propagandistic discourse of hawkish parties.

Black Woman at Work: A Narrative both Personal and Political

The story of Black/African descent women in academic leadership is laced with challenging and triumphant narratives, including mine. Here, I share narratives of family, research inquiry into relational aggression in academia, and my own experiences as a Black woman in the academy. Academic context and political timing play a large part in this writing. I use the work of Black feminists and thinkers critical of race and White supremacy in the United States to contextualize my personal narrative and articulate drawbacks and pathways to leadership for women generally, particularly Black women. Practical considerations for leadership development and mentoring are presented.

Stories that Change Our World? Narratives of the Sustainable Economy

Narratives are shaping our understanding of the world. They convey values and norms and point to desirable future developments. In this way, they justify and legitimize political actions and social practices. Once a narrative has emerged and this world view is supported by broad societal groups, narratives can provide powerful momentum to trigger innovation and changes in the course of action. Narratives, however, are not necessarily based on evidence and precise categories, but can instead be vague and ambiguous in order to be acceptable and attractive to different actors. However, the more open and inclusive a narrative is, the less impact can be expected. We investigate whether there is a shared narrative in research for the sustainable economy and how this can be evaluated in terms of its potential societal impact. The paper carves out the visions for the future that have been underlying the research projects conducted within the German Federal Ministry of Education and Research (BMBF) funding programme “The Sustainable Economy”. It then analyzes whether these visions are compatible with narratives dominating societal discourse on the sustainable economy, and concludes how the use of visions and narratives in research can contribute to fostering societal transformations.

CAVE: Making Collective Virtual Narrative: Best Paper Award

CAVE is a shared narrative six degrees of freedom (6DoF) virtual reality experience. In 3.5 days, 1,927 people attended its premiere at SIGGRAPH 2018. Thirty participants at a time each saw and heard the same narrative from their own individual location in the room, as they would when attending live theater. CAVE set out to disruptively change how audiences collectively experience immersive art and entertainment. Inspired by the social gatherings of theater and cinema, CAVE resonated with viewers in powerful and meaningful ways. Its specific pairing of colocated audiences and physically shared immersive narrative suggests a possible future path for shared cinematic experiences.

Symbolic categories and the shaping of identity

PurposeThis paper aims to study the symbolic categorisations management accountants produce. It examines the categories they use to describe their work and analyses the meanings they attach to such categories. This aims at explaining how management accountants can follow a common occupational orientation despite the need to adjust their practices to the specificities of their local and organisational context. The author’s argument is that management accountants build symbolic categories to create a bridge between what they do and who they are. The author further argues that symbolic categories are needed to make sense of a practice in tension between a common aspirational orientation and heterogeneous local contexts.Design/methodology/approachThis paper draws on a multiple case field study conducted by observation and interviews in a range of organisations.FindingsThis paper examines the empirical diversity of management accountants’ practices and perceptions through the symbolic categories they produce. The author finds that categorisation work constitutes a central mechanism to build a shared narrative despite heterogeneous situations. The author further shows that through symbolic categorisation work, a variety of activities ranging from bookkeeping through managerial support to hierarchical surveillance and challenge in the name of the shareholder are subsumed under stable labels. This, he argues, serves to mask financial accountability, shareholder orientation and hierarchical control behind a narrative of “support” and “partnership”.Originality/valueThis paper contributes to literature on management accountants’ identity by showing the central role played by symbolic categorisations. It also contributes to literature in accounting more generally by showing how symbolic categorisation work blurs the lines between “operational support” and “shareholder value creation”. The same words are used to refer to activities that managers consider helpful to make operational decisions and other activities that increase shareholder control and surveillance and encourage managers to internalise the frames and objectives of shareholder value creation. Symbolic categories that include hierarchical financial accountability within a narrative of “support” and “partnership” masks “financialisation” behind a rhetoric of “business orientation”.

Official Media Discourse of ‘Active Longevity’: an Attempt to Popularize the Idea of the Inclusion of Older People into Society or to Conceal Undesirable Forced Choices

In the process of reforming social policies, various actors use media channels to convey their arguments to a wide audience and popularize certain ideas. Not only facts are transmitted, but also a certain image of social reality. This paper explores the main media narratives of the official discourse of ‘active longevity’ in Belarus in the period 2017-2018, with the aim to explore the meanings that they broadcast in society, and what the image of social reality they represent and construct. For the analysis of narratives, semantic content analysis is used, as well as qualitative discourse analysis of texts/articles of The Belarusian Telegraph Agency BelTA and The Belarus Segodnia (‘Belarus Today’) state publishing house incorporated five newspapers. Texts were sampled for the period 1 January 2017 to 31 December 2018. The transmitted narratives in the materials of the official media, together with the comments of journalists, show the activity of older people as a desirable version of reality, as well as their rarity and non-typicality for the contemporary Belarusian society. This conclusion suggests that in this discourse, exactly the official narrative of ‘active longevity’ is the counter-story, designed to overcome the dominant in society popular and most shared narratives. The understanding of ‘active longevity’ offered by official discourse seems to be a simplified version of reality, focusing mainly on categories of labour activity, utility for the society or not burdening the society. This counter-narrative does not re-humanize, but instead of empowering it makes other choices for understanding ‘active longevity’ invisible and insignificant.

Conversations about disasters: listening to Ecuadorian children

ABSTRACTYoung children aged 9–11 years, from a small coastal community in Ecuador, recount the everydayness of being prepared for the next earthquake. Their shared narratives contain distressing descriptions of their previous disaster experiences 18 months earlier in Canoa, April 2016: evacuation decisions, risk of separation from parents, witnessing injury and death of family members and peers in the 7.8 earthquake that took the lives of 63 members of their community and 675 in the general area. Listening to the children prompts consideration of how policies at the national level could be decentralized to identify locally relevant community-based risk assessment in isolated communities so that child-centred disaster risk reduction training might be taught at low cost in the community-based source of the school.

1939: Hollywood's Greatest Year by Thomas S. Hischak (review)

Reviewed by: 1939: Hollywood's Greatest Year by Thomas S. Hischak Douglas Long Thomas S. Hischak, 1939: Hollywood's Greatest Year, Lanham, Md.: Rowman & Littlefield, 2017, 412 pages, ISBN 978-1-4422-7804-2. Unlike other books on the "golden" film year of 1939, Thomas S. Hischak's 1939: Hollywood's Greatest Year discusses the majority of films from that year–not just the classics–in a daily format, mingling movie releases with news of the day. Such tight ordering of his subjects has served Hischak well in earlier books including Through the Screen Door: What Happened to the Broadway Musical When It Went to Hollywood (2004) and American Literature on Stage and Screen: 525 Works and Their Adaptations (2012). In 1989, Ted Sennett wrote Hollywood's Golden Year, 1939: A Fiftieth Anniversary Celebration, which presented the classic 1939 films (Gone with the Wind, The Wizard of Oz, Mr. Smith Goes to Washington, Stagecoach, and so forth) chronologically with each month given historical context. For the 75th anniversary in 2014, Mark A. Vieira took a similar approach with Majestic Hollywood: The Greatest Films of 1939, adding some minor classics to the mix (Five Came Back, Tower of London, Fifth Avenue Girl), along with an introduction that explains some reasons for the year's remarkable cinematic output. Also published in 2014, Charles A. Adams' 1939: The Making of Six Great Films from Hollywood's Greatest Year unfortunately includes enough inaccuracies to compromise its value as a resource. In 1939: Hollywood's Greatest Year, Thomas S. Hischak takes a more granular approach. Like Sennett and Vieira, he works chronologically, but his daily entries include at least a paragraph on each American film released that year, plus several foreign films. Within each entry is news of the day, especially concerning the build-up and onset of the war in Europe. Often, Hischak notes connections between world events and films released concurrently. For March 31, for example, after noting that Great Britain and France allied with Poland in case of Nazi invasion, Hischak writes, "Ironically, on that same day a Polish film premiered in America." [81] And as Hischak points out, On a heym (Without a Home) is performed in Yiddish, making the irony even starker. A prologue discusses New Year's Eve 1938 while the epilogue chronicles New Year's Day 1940. As Hischak notes, the end of 1938 found Americans still coping with a Depression which wouldn't be fully "licked" until World War II, [xv] which was under way by the beginning of 1940 (though the U.S. remained neutral). Since the lens for this historical context is cinema, Hischak reminds us that the movie theatre experience in 1939 included "…the main feature film, a second feature (usually a low-budget B movie), a newsreel, a cartoon, and perhaps a short subject or travelogue." [xvi] The book's epilogue suggests some reasons 1940 didn't follow on 1939's avalanche of high-quality films, including the loss of European markets due to the war and the scarcity of good film stock, especially color, which was more popular with audiences than ever. Hischak sometimes provides updated historical context for a film. For example, for the Ronald Reagan action film Secret Service of the Air (March 4), Hischak writes, "Perhaps the most interesting thing about this B movie is the still-timely subject of Mexicans crossing the border into the states." [58] He also occasionally applies modern social mores to the film assessments. Of Torchy Blane in Chinatown (Feb. 2), he writes, "Feminists might find the film off-putting, but it is the stereotypic Asians and African-Americans that date the movie more." [29] The dual reporting about history and film presents a shared narrative that sometimes blends even when Hischak doesn't draw the connections for the reader. For example, the almost daily chronicling of the [End Page 84] growing Nazi threat in Europe shares space with an endless cycle of B-westerns. The resulting feeling is that in 1939 the world was falling apart, but the cavalry was on its way. The stampede of B-westerns helps the reader appreciate even more the elements that made John Ford's Stagecoach...

A Narrative Inquiry Into Global Systems Change to Support Families When a Parent Has a Mental Illness.

The issues that confront families when a parent experiences mental illness are complex. This often means that multiple service systems must be engaged to meet families’ needs, including those related to intergenerational experiences of mental health and illness. A multisystem approach to public mental health care is widely recommended as a form of preventative intervention to address the effects of mental illness and its social, psychological, and economic impact upon parents, children, and families. Globally, a multisystemic approach to care requires a change in the way systems are currently organized to support families, as well as the way systems are interacting with families, and with each other. This qualitative secondary analysis emerged from a primary study examining global systems change efforts to support families, including components of change that were common and considered successful in different countries. A narrative inquiry method was used to re-analyze the data by compiling the stories of change described by individuals from participant countries. The data were interrogated to ask questions about story content, and to identify who was telling the story and how they described important changes across different geographical and cultural contexts. The individual stories of 89 systems change experts from 16 countries were then compiled into a shared global narrative to demonstrate international progress that has occurred over time, toward multisystemic change to support families where parents experience mental illness. While the global narrative demonstrates considerable overlap between pathways toward change, it is also important to document individual stories, as change pertains differently in different contexts. The individual stories and the global narrative illustrate how countries begin a journey toward change at different time points and may have various outcomes in mind when they commence. Study findings raise questions about the extent to which systems change can be standardized across countries that have unique social, cultural, political, and economic features. This study provides several potential points of reference for countries considering, or currently undertaking systems change to support families where a parent has a mental illness. It also provides an important story about international efforts undertaken to improve outcomes for families.

Identifying the narrative used by educators in articulating judgement of performance.

IntroductionModern assessment in medical education is increasingly reliant on human judgement, as it is clear that quantitative scales have limitations in fully assessing registrars’ development of competence and providing them with meaningful feedback to assist learning. For this, possession of an expert vocabulary is essential.AimThis study aims to explore how medical education experts voice their subjective judgements about learners and to what extent they are using clear, information-rich terminology (high-level semantic qualifiers); and to gain a better understanding of the experts’ language used in these subjective judgements.MethodsSix experienced medical educators from urban and rural environments were purposefully selected. Each educator reviewed a registrar clinical case analysis in a think out loud manner. The transcribed data were analyzed, codes were identified and ordered into themes. Analysis continued until saturation was reached.ResultsFive themes with subthemes emerged. The main themes were: (1) Demonstration of expertise; (2) Personal credibility; (3) Professional credibility; (4) Using a predefined structure and (5) Relevance.DiscussionAnalogous to what experienced clinicians do in clinical reasoning, experienced medical educators verbalize their judgements using high-level semantic qualifiers. In this study, we were able to unpack these. Although there may be individual variability in the exact words used, clear themes emerged. These findings can be used to develop a helpful shared narrative for educators in observation-based assessment. The provision of a rich, detailed narrative will also assist in providing clarity to registrar feedback with areas of weakness clearly articulated to improve learning and remediation.

Un suelo que no deja de moverse. Temporalidades no-humanas de Nuno Ramos

Perhaps some of the most significant investigations in contemporary literature and art from Brazil revolve around the question of temporality , the threshold between the living and the dead and the ways in which conflicting temporalities and anachronism articulate a critique of the present. In this context, Nuno Ramos’ installations and writings, working on the unstable terrain between the living and the dead, the organic and the inorganic, the fossilized and the spectral, represent a decisive intervention. In Ramos’ works memory is never entirely human; it is irreducible to the domain of subjectivity nor to the shared narratives of the collective. From books such as Cujo or Junco to the the fossilized matter present in many of his works, the relationship between life and death is both political, technological and non-anthropomorphic —it is, in other words, biopolitical. This paper analyzes the ways in which the configuration of such critical perspective in Nuno Ramos’ work interrogates and reformulates the ways in which temporality and the political interface there where the very notion of life — the bios that articulates the biopolitical— is at stake.

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“So Now, I Wonder, What Am I?”: A Narrative Approach to Bicultural Identity Integration

Individuals socialized in multiple cultures actively construct their bicultural identity in the context of relevant life events. However, the content and meaning of these experiences, as subjectively constructed and understood by the individual, remain largely unexplored in relation to biculturalism outcomes. Using a narrative approach, two studies of U.S. biculturals examined how memories about the experience of being bicultural (“bicultural memory narratives”) related to bicultural identity integration (BII). BII describes having cultural identities that are blended and exist harmoniously within the self (vs. having dissociated and conflicting identities). In Study 1, bicultural college students shared two bicultural memory narratives, which were coded for the past event valence, exploratory processing, and ending valence (positive vs. negative ending). Most reported memories about at least somewhat negative experiences, and yet narrating those events with positive endings was predictive of higher BII, even after controlling for other factors, such as trait affect. In Study 2, second-generation bicultural adults ranging in age from 18 to 62 shared narratives about memories of bicultural conflict, which were also coded for exploratory processing and positive resolution. Similar to Study 1, positive resolution predicted higher levels of BII, independent of other factors. Bicultural identity conflict was found to decrease with age across adulthood. Findings for exploratory processing were inconclusive and suggest that its role in BII may fluctuate over time and be dependent on several factors, including age, type of memory, and time spent exploring bicultural identity.

Assange vs Zuckerberg: Symbolic Construction of Contemporary Cultural Heroes

Myth is a meta-language that shapes our cultures and the way we individually and collectively make sense of reality. This paper presents the methodologies of French anthropologist and sociologist Gilbert Durand as a way to unveil how ancient myths contribute to the symbolic construction of societal leaders in times of crisis. To do so, it analyses the controversy of the selection of Time magazine’s Person of the Year, which confronted the figures of Julien Assange and Mark Zuckerberg. The myth analysis of their Wikipedia biographies will show that despite the fact these two personalities are considered almost opposites, the structure of the collective shared narratives about each of them follow the structure of the myth of Hermes, one shaping the grand narrative of the postmodern era. Realizing why and how the myth of Hermes promotes our contemporary leaders, sometimes apparent antagonists, contributes to better understanding of the unconscious drives of their symbolic construction, and enabling critical engagement with the rationales of their emergence.

It’s all about Whanaungatanga: Alcohol use and older Māori in Aotearoa

This study explored the socially shared meanings of alcohol use among Indigenous older Māori in Aotearoa (New Zealand). Using a Māori-centred research approach, hui (meeting/s) were held with five kaupapa whānau (groups with a common purpose), comprising older Māori ( n = 19), who shared their perspectives of alcohol use. Kōrerorero (discussion) from each kaupapa whānau was used to configure a shared narrative of older Māori alcohol use. Alcohol use is understood in the context of whanaungatanga (maintaining relationships) which was identified as the primary driver for older Māori engagement in alcohol use environments. However, participants argued that alcohol is not necessary to experience whanaungatanga and alternative options for alcohol free events that support whanaungatanga were shared. These findings highlight the importance of whanaungatanga among Māori and suggest the need for events and activities that support whanaungatanga, rather than alcohol use, to enhance the health and well-being of older Māori.

Disciplining the State: The role of alliances in contesting multi-level agri-environmental governance

This study evaluates the development of a national agri-environment scheme under the Common Agricultural Policy (CAP) on “commonage” or collectively owned land in the Republic of Ireland. In doing so, it explores the role of alliance building in reasserting marginalised narratives in multi-level agri-environmental governance processes. To this end, process tracing analysis is carried out on government policy documents and reports; interdepartmental exchanges; parliamentary testimonies; and media reports relating to the policy development process. This allows, firstly, for the tracing of the historical emergence of collectively owned land as a differentiated agricultural space. Secondly, it explores how a specific governing device – Commonage Management Plans (CMPs) – emerges in national debates as means of regulating these spaces. Finally, it provides insight on how alliances comprised of commonage farmers, farm extension professionals, and politicians at national and international levels successfully challenged aspects of the proposed CMPs. This illustrates how marginalised, but capable actors may navigate multi-level governance structures to influence state institutions and policy outcomes. We thus make two main contributions. First, we foreground the role of alliances to provide an illustration of how marginalised actors may gain influence in multi-level governance processes. We demonstrate how these alliances are built around specific shared narratives and operate with cognisance of the power dynamics in which they operate. Second, we highlight how both consultation and contestation contribute to co-producing policy design outcomes. However, the case study indicates that more extensive participative policy making could address such contestation more effectively.

“Do You Remember Going to the Beach?”: References to Internal States in Polish and American Mother-Preschooler Shared Narratives

Abstract The present study examined references to cognitive states and emotions in narratives produced by mothers and preschoolers (aged 3 or 5 years) in Polish and American families. Participants were 32 mother-child dyads from Poland and 32 mother-child dyads from the United States. The two samples were matched with regard to child age, child gender, maternal age, and maternal education. The mother-child dyads were asked to tell three personal narratives. The co-constructed narratives were coded for mother and child references to cognitive states and emotions. Polish mothers were found to include significantly more references to cognitive states in their narratives than American mothers. Results also revealed significant correlations between mothers’ and children’s references to cognitive states across both samples. Related to child development, 5-year-olds produced significantly more tokens in the narratives than 3-year-olds. This study shows that mothers’ use of cognitive state terms in shared narratives with their young children differs across two Western cultural contexts. The results of this study are discussed with regard to two themes in developmental psycholinguistics: relations between maternal and child language use, and cross-cultural variation.

Latino Outdoors: Using Storytelling and Social Media to Increase Diversity on Public Lands

In 2013, for the first time in United States history, more than 50% of children younger than age one were minorities. Latinos are the nation’s largest-growing minority group, and by 2050 are estimated to comprise 28% of the total U.S. population. Despite the exponential growth of minorities generally and Latinos in particular, landmanagement agencies have been slow in responding to these major racial and ethnic demographic shifts, particularly within the context of outdoor recreation activities. The purpose of this article is to show how Latino Outdoors is providing diverse and family-focused outdoor-recreation opportunities by using storytelling and cuttingedge social-networking technology to build avenues for access to public lands and a Latino-centered message of environmental awareness and belonging. In the past four years, Latino Outdoors grew from one person to 180 volunteers, 44 of whom function as volunteer leaders, and two paid full-time employees, all of whom have together organized outings in 14 states across the country. Storytelling and social media work as mechanisms to communicate the value of nature and interaction with the natural environment as part of a modern Latino identity. Engaging with cultural and ethnic diversity, Latino Outdoors and its partners have built a national network that values and advocates for the wealth of experiences that the environment and recreation can provide to the over 57 million Latinos in the United States, who are underserved by public land-management agencies. Through its use of storytelling and its online presence, the organization is creating a space for new social and cultural meanings of the outdoors using counternarratives that question normative American outdoor experiences that privilege an able-bodied white middle-class user. Latino Outdoors’ staff promotes shared narratives in the conversation about the nation’s changing meaning of outdoor experiences within an increasingly diverse society. A storytelling focus could be applied within recreation programs for the purposes of creating more culturally sensitive services, understanding land-use differences both within and across racial/ethnic groups, and developing mechanisms for collaborative goal setting that includes diverse community voices. Subscribe to JPRA

“Looking from the other side”: Using Design Thinking for Strategic Projects at the Basque Health Service

Introduction and description of the practice implemented: The Basque Country has been implementing integrating care policies since 2010 (1). One of the cornerstones of this strategy has been the launch of 13 Integrated Health Care Organisations (IHOs) to integrate under the same structure Primary and Secondary Care Services (2). Nevertheless, structural integration does not deliver better care by its own; and in 2015 the Basque Health Service (BHS) launched a project called IntegraSarea (Network for Integration in Basque) to facilitate cultural change and to create a shared narrative of what integration means based on a People Centred Care approach (3). More than 100 people including managers, patients, carers and health professionals across the Basque Country have been part of this network and the rest of the health workforce (30.000 people) is informed via newsletter, fb and twitter in order to have the maximum amount of people onboard. In this context Design Thinking was chosen to be the method used to help health professionals think “out of the box” and analyse the challenges the health system faces from a user/patient perspective. To reach this goal, four different workshops involving more than 100 people were conducted. Methodology: (Theory of change) Design Thinking (DT) is a methodology that originates from Service Design and was first used in urban planning in 1987 (4). Nowadays the shift to the customer-in-the center of the process is one factor that has motivated companies and other institutions to use Design Thinking as a method to improve and re-design processes from a user perspective. Although the term has changed across time (5) it is widely accepted that DT is a methodology for problem-solving and has five basic steps (see figure 1): empathize, define, ideate, prototype and test. Its use in the health sector is still to be developed and has a huge potential since there is often a gap between patient experience & expectations and the care provided. The latter can be outstanding following traditional indicators of efficacy and efficiency (ie: hip replacement with no complications) and the former could still be bad (ie: despite replacement patient cannot walk due to pain). In the Basque context DT has been fully applicable since the challenges the health sector faces demand multidisciplinary teams and consensus to be successfully implemented, and these are two aspects that DT helps to build. Discussion: Four workshops were designed based on three key areas (Person Cantered Care, care pathways and community networks). After an introductory session on DT, each participant had to carry out fieldwork using different qualitative and ethnographic techniques to identify improvement areas from a patient perspective. This has allowed each Organisation in the BHS to have several of its professionals trained on this methodology, which will have a snowball effect in the future. Moreover, it should be emphasized the importance of inviting patients/users into internal strategic and training projects, which brings in different views and also challenges the status quo of everything for the patient without the patient. Conclusion: The methodology has been strongly accepted by the participants of the workshops like a valid instrument to identify the gaps between patient experience & expectations and the care provided. The Final Report of the workshops details all 52 actions that are proposed to tackle the improvement areas identified and will be presented at the Conference.