Introduction

Visual photographic approaches have steadily gained momentum in health services research in the last 20 years; however, its use in quality improvement (QI) is sparse.1 Currently, the traditional A3 QI story board is an integral component for sharing health service improvement efforts. Named after the A3 international paper size of approximately 11″ × 17″, this one page/poster provides a visually concise synopsis of the problem, the root causes identified, the resolution and metrics that indicate resolution effect.2 The benefit of the A3 QI storyboard approach is in the thinking and behaviours it stimulates along with facilitating dialogue.3 Photovoice is a visual participatory method in which photographic images are taken to strengthen and supplement the more robust metrics involved in QI.4 The photographic image triangulates with the conventionally generated quantitative and qualitative findings to create a more comprehensive QI story.5 6 In QI studies that have used photographic images, the rationale for inclusion are, first, to alleviate challenges related to change acceptance as healthcare employees may gain a better understanding of why the improvement is a priority. Second, to facilitate collaboration between different stakeholder groups, and lastly the photographs may lead to a more direct understanding of people, their life experiences and perceptions enabling others to empathise and understand the QI effort.7

Within the setting of healthcare, engaging providers and patients, obtaining their buy-in and understanding their unique perspectives/experience are essential to improve the quality of care.8–10 Here, we describe an initiative that undertook …