27 May 2020 2 min read

Not Quite Right: Encouraging discussions around healthcare improvement using video

At THIS Institute we’re always looking at ways to make sure that our materials are as helpful and relevant as possible. Last year, we created a video: Not Quite Right. And now we’re releasing an online downloadable facilitator’s guide, to support anyone who wishes to use the video to promote discussion and reflection about the issues that it raises.

Fundamentally, Not Quite Right focuses on two key questions: why do we need evidence to improve healthcare, and how do we know if we’re improving healthcare? The video follows the journey of a stroke patient, Chris, as he navigates the healthcare system. Along the way, Chris encounters various issues with the system that impact his care.

Chris and other characters face issues that have an all-too-familiar ring: missing equipment, interruptions, and a lack of communication between primary and secondary care, to name a few.  Some of the systems and processes that have been designed to help diagnose, treat, and keep Chris safe aren’t always supported by high-quality evidence. Sometimes what looks like a logical improvement on the surface, turns out not to be an improvement at all.

For instance, when Chris’ wife is confused and distressed upon finding her husband in the stroke unit, a nurse wearing a ‘Do Not Disturb’ tabard kindly explains what is going on. These tabards may seem a practical way to reduce interruptions for nurses during drug rounds, but a study shows that they are ineffective and unpopular with nurses[1]. In the Not Quite Right video, we watch the nurse take off her tabard after she sees the impact it has on Chris’ wife, who feels guilty about interrupting her.

Our new facilitator’s guide, created by Bill Lucas at the University of Winchester’s Centre for Real-World Learning, provides a handy six-step process to using the Not Quite Right video. It summarises each scene and suggests topics, questions, and discussion points to explore with your group.

We hope the video and the facilitator’s guide help you to lead discussions around healthcare improvement research. Please do send us your feedback. We’ll use your insights to improve future versions.


Westbrook J, Li L, Hooper T, Raban M, Middleton S, Lehnbom E. 2017. "Effectiveness of a 'Do not interrupt' bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility study." BMJ Quality & Safety 734-742.