“I am convinced that a Mangomoment brings Joy in Life for patients & family and Joy in Work for healthcare professionals.”
Recently we have published lots of tweets about “Mangomoments“. I receive lots of positive feedback on the new campaign but also some questions from international colleagues as most of the Mangomoment-stuff is in Dutch. That is why I publish this new blog with information for my international social network. I hope you find it interesting and look forward to your feedback.
How did I get inspired by Mango’s?
Two months after waking up from coma in intensive care, Viviane described how hard it was lying in bed all the time, what the sound of the bedside alarms did to her, what the gray ceiling looked like, how she heard the voices of deceased family members and saw them standing next to her bed, and why she thought about euthanasia,… Her reflections were captured on a documentary by a journalist, Annemie Struyf, who stayed for two weeks as an observer at an intensive care unit in a major teaching hospital (UZ Leuven), and who was clearly emotional as she was touched by Viviane’s story. Following a tense silence, the journalist asked: “Is there something I can do now for you, that would make you happy?”. Viviane’s answer was surprising … “a mango, I would really like to taste a mango again, that is what I really like”. At the last day of her observation, the journalist brought Viviane a mango. Viviane was touched and became emotional, expressing that she “will never ever forget this moment” (Via Annemie, 2015).
Why was I confused about this emo-moment at Leuven ICU?
The documentary confused me. How was it possible that none of the healthcare workers had asked her this basic question: “What can I do now for you, to make you happy?” And how can a “mango” give a patient such an unforgettable moment? I got in touch with the journalist, informed her about my work on quality, patient safety and second victims and asked her if the scene was set up or that it just spontaneously happened. “Of course it was spontaneous, it just happened, there was positive chemistry between us” the journalist replied.
A year later, we have finished the pilot phase of the “in search of Mangomoments, from never to always events” campaign within oncology. With the support of Kom Op Tegen Kanker (Stand up to Cancer), the effort has yielded over 200 Mangomoments-stories, provided by cancer patients, family members and healthcare professionals. They bring happiness and joy.
How is “Mangomoment” defined and can these examples help you to understand our concept?
Mangomoments are small, unexpected, surprising, nearly unnoticeable acts or gestures during daily care activities, which are of great value in the care experience of patients, residents, families and/or healthcare professionals. They happen during normal care activities and are different from events like “make a wish” or “VIPs visiting the children’s hospital”.
The following three examples serve to illustrate: 1) the story of the lady who was just diagnosed with breast cancer and her physician came to her room at the end of his working day, without his white coat, just to be with her for five minutes and listen to her or 2) the story that was told by the director of a nursing home who was asked to take a picture in the snow of two residents in love – a photograph that became their Christmas card or 3) the story of a lady who told us that her Mangomoment of the day was the arrival of the housekeeping lady, because she was the only one not asking questions about fatigue, pain and nausea but chose to share the daily news from the tabloids in a normal, everyday kind of conversation.
Are Mangomoments linked with “micromoments of positive resonance”?
Dr. Barbara Fredrickson, professor of psychology at the University of North Carolina, argues that people need to get essential daily nutrients, not only from food, but also from a laugh, a hug or even a smaller moment of positive emotion, especially with someone with whom they click, as they open themselves up to one another and connect. The kinds of nutrients found in the “positive chemistry” as described by the journalist. These micro-moments of positive resonance build bonds, weave the social fabric that creates our communities and promote health (Fredrickson, 2013). Peter Pronovost states that we should actively search for micromoments of positive resonance and they should expand to how clinicians treat one another as well (Pronovost, 2016). In our recent work on second victims with clinicians involved in adverse events, we found that an open, non-blame, culture and personal positivism play an important role in the aftermath of such an event (Van Gerven et al., 2016). Second victim symptoms like hypervigilance, fear, stress, shame, doubt and flashbacks, do not help clinicians in openly disclosing the events and restore trust. This lack of openness and communication makes clinicians feel uncomfortable towards patients, family members and their own team members. Having positive care experiences can make clinicians more resilient and enhance their work engagement.
What has Dame Judy Dench got to do with Mangomoments?
I still wondered if it was a coincidence that Viviane asked for a “mango” during her ICU stay. In October 2017, Dame Judy Dench, the actress and Academy Award winner, better known as “M” in the James Bond movies, appeared in Victoria & Abdul, a movie on the friendship between the empress and her Indian clerk. As their friendship deepens, the queen begins to see a changing world through new eyes, joyfully reclaiming her humanity. When Victoria and Abdul are walking through the park and Victoria asks “A mango, what is it?”, Abdul answers “The queen of fruit! In India, gifting a basket of mangoes is considered a gesture of friendship. The sacred mango tree is a symbol of love.” The movie trailer concludes “A queen for a queen. Abdul Karim, introduced Victoria to the mango, and made the world a little sweeter”.
So please join our Mangomoment-movement and make healthcare a little …
Maybe it is time for healthcare to make Mangomoments more objective and discuss them during interprofessional briefings. It will bring happiness to patients and families and perhaps they can decrease burnout by enhancing engagement and Joy in Work (Perlo et al, 2017). Maybe even high impact scientific journals should launch next to editorials & viewpoints, a section on “Mangomoments” and help us to make healthcare a little sweeter.
This blog is based on my recent perspective in Lancet Oncology and the Blog at KULeuven BLOGT:
Vanhaecht, K. (2018). In search of Mangomoments. The Lancet Oncology, 19 (2), art.nr. https://doi.org/10.1016/S1470-2045(18)30034-2, 165.
I acknowledge all members of the Mangomoment team (Elly, Ellen, Deborah, Ellen and Luk) at the Leuven Institute for Healthcare Policy, KU Leuven and Kom Op Tegen Kanker (Flemish Cancer Foundation) for the unrestricted grant. Thank you to Annemie Struyf, the journalist, for the inspiration. A special thank you to Pedro Delgado and Maureen Bisognano of the Institute for Healthcare Improvement (IHI) for their help in writing the Lancet Oncology perspective. Thanks to Sarah Somers of KU Leuven News Agency for the help with the KULeuven BLOG and the Press-team of KU Leuven (Tine, Sigrid, Bregt, Sarah), Press team of Leuven University Hospitals (Suzy & Sara) and the incredible team of KOTK (Inge, Isabel, Karen, Anja, Lieve, Chris, Marina, Daniel, Hedwig, Marc and colleagues).
Ethical Committee: The campaign is approved by the Ethical Committee of Leuven University Hospitals, Leuven, Belgium with reference number B322201731927
Funding Agency: The campaign is funded by the Stand Up To Cancer, Kom Op Tegen Kanker, with an unrestricted grant
Via Annemie (2015). Eén.be. https://communicatie.een.be/via-annemie–annemie-struyf-op-intensieve-zorg (last accessed 01/03/2018)
Fredrickson, B. L. (2013). Love 2.0. New York: Hudson Street Press/Penguin.
Pronovost, P. (2016). Patient Care: What’s Love Got to Do with It? Armstrong Institute Blog. Available at https://armstronginstitute.blogs.hopkinsmedicine.org (last accessed 01/03/2018)
Van Gerven, E., Bruyneel, L., Panella, M., Euwema, M., Sermeus, W., Vanhaecht, K. (2016). Psychological impact and recovery after involvement in a patient safety incident: a repeated measures analysis. BMJ Open, 6 (8), art.nr. 27580830
Victoria & Abdul (2017). A humble servant and a mighty queen. Universal Pictures. https://www.facebook.com/UniversalPicturesBelgium/videos/10212913638329628/
Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. (2017). IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement.
And if you ask us if we are supported ?
Yes we are! Even our Flemish Minister for Health, Jo Vandeurzen, published a video message on Mangomoments (in Dutch):
And to end this blog … just some “Mangomoment” fun I received from my colleague Barbara … as everybody is linking me now with Mango’s …
MANGOMOMENT is a registered Trademark by KU Leuven.