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Bull C, Goh JY, Warren N, Kisely S. Experiences of individuals presenting to the emergency department for mental health reasons: A systematic mixed studies review. Aust N Z J Psychiatry 2024; 58:839-856. [PMID: 38880783 PMCID: PMC11420598 DOI: 10.1177/00048674241259918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
OBJECTIVE Emergency departments the world over have seen substantial increases in the number of individuals presenting for mental health reasons. However, we have a limited understanding of their experiences of care. The aim of this review was to systematically examine and synthesise literature relating to the experiences of individuals presenting to emergency department for mental health reasons. METHODS We followed Pluye and Hong's seven-step approach to conducting a systematic mixed studies review. Studies were included if they investigated adult mental health experiences in emergency department from the users' perspective. Studies describing proxy, carer/family or care provider experiences were excluded. RESULTS Sixteen studies were included. Thematic synthesis identified three themes and associated subthemes. Theme 1 - ED staff can make-or-break and ED experience - comprised: Feeling understood and heard; Engaging in judgement-free interactions; Receiving therapeutic support; Being actively and passively invalidated for presenting to the ED; and Once a psych patient, always a psych patient. Theme 2 - Being in the ED environment is counter-therapeutic - comprised: Waiting for an 'extremely' long time; and Lacking privacy. Theme 3 was Having nowhere else to go. CONCLUSIONS The experiences described by individuals presenting to emergency department for mental health reasons were mostly poor. The results illustrate a need for increased mental health education and training for all emergency department staff. Employment of specialist and lived experience workers should also be prioritised to support more therapeutic relationships and emergency department environments. In addition, greater investment in mental health systems is required to manage the current crisis and ensure future sustainability.
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Affiliation(s)
- Claudia Bull
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Queensland, Woolloongabba, QLD, Australia
- Queensland Centre for Mental Health Research, The University of Queensland, Woolloongabba, QLD, Australia
| | - Jia Yin Goh
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba, QLD, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
- Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
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Antonopoulou V, Meyer C, Chadwick P, Gibson B, Sniehotta FF, Vlaev I, Vassova A, Goffe L, Lorencatto F, McKinlay A, Chater AM. Understanding healthcare professionals' responses to patient complaints in secondary and tertiary care in the UK: A systematic review and behavioural analysis using the Theoretical Domains Framework. Health Res Policy Syst 2024; 22:137. [PMID: 39354470 PMCID: PMC11443808 DOI: 10.1186/s12961-024-01209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/01/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND The path of a complaint and patient satisfaction with complaint resolution is often dependent on the responses of healthcare professionals (HCPs). It is therefore important to understand the influences shaping HCP behaviour. This systematic review aimed to (1) identify the key actors, behaviours and factors influencing HCPs' responses to complaints, and (2) apply behavioural science frameworks to classify these influences and provide recommendations for more effective complaints handling behaviours. METHODS A systematic literature review of UK published and unpublished (so-called grey literature) studies was conducted (PROSPERO registration: CRD42022301980). Five electronic databases [Scopus, MEDLINE/Ovid, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Health Management Information Consortium (HMIC)] were searched up to September 2021. Eligibility criteria included studies reporting primary data, conducted in secondary and tertiary care, written in English and published between 2001 and 2021 (studies from primary care, mental health, forensic, paediatric or dental care services were excluded). Extracted data included study characteristics, participant quotations from qualitative studies, results from questionnaire and survey studies, case studies reported in commentaries and descriptions, and summaries of results from reports. Data were synthesized narratively using inductive thematic analysis, followed by deductive mapping to the Theoretical Domains Framework (TDF). RESULTS In all, 22 articles and three reports met the inclusion criteria. A total of 8 actors, 22 behaviours and 24 influences on behaviour were found. Key factors influencing effective handling of complaints included HCPs' knowledge of procedures, communication skills and training, available time and resources, inherent contradictions within the role, role authority, HCPs' beliefs about their ability to handle complaints, beliefs about the value of complaints, managerial and peer support and organizational culture and emotions. Themes mapped onto nine TDF domains: knowledge, skills, environmental context and resources, social/professional role and identity, social influences, beliefs about capability, intentions and beliefs about consequences and emotions. Recommendations were generated using the Behaviour Change Wheel approach. CONCLUSIONS Through the application of behavioural science, we identified a wide range of individual, social/organizational and environmental influences on complaints handling. Our behavioural analysis informed recommendations for future intervention strategies, with particular emphasis on reframing and building on the positive aspects of complaints as an underutilized source of feedback at an individual and organizational level.
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Affiliation(s)
- Vivi Antonopoulou
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
| | - Carly Meyer
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Paul Chadwick
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Beckie Gibson
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
- Department of Public Health, Preventive and Social Medicine, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
| | - Ivo Vlaev
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Warwick Business School, University of Warwick, Coventry, UK
| | - Anna Vassova
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Louis Goffe
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
- NIHR Health Determinants Research Collaboration, Gateshead Council, Gateshead, NE8 1HH, UK
| | - Fabiana Lorencatto
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Alison McKinlay
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Angel Marie Chater
- Centre for Behaviour Change (CBC), Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
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Lloyd R, Slade M, Byng R, Russell A, Ng F, Stirzaker A, Rennick-Egglestone S. Characteristics of positive feedback provided by UK health service users: content analysis of examples from two databases. BMJ Health Care Inform 2024; 31:e101113. [PMID: 39289005 PMCID: PMC11429259 DOI: 10.1136/bmjhci-2024-101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/26/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Most feedback received by health services is positive. Our systematic scoping review mapped all available empirical evidence for how positive patient feedback creates healthcare change. Most included papers did not provide specific details on positive feedback characteristics. OBJECTIVES Describe positive feedback characteristics by (1) developing heuristics for identifying positive feedback; (2) sharing annotated feedback examples; (3) describing their positive content. METHODS 200 items were selected from two contrasting databases: (1) https://careopinion.org.uk/; (2) National Health Service (NHS) Friends and Family Test data collected by an NHS trust. Preliminary heuristics and positive feedback categories were developed from a small convenience sample, and iteratively refined. RESULTS Categories were identified: positive-only; mixed; narrative; factual; grateful. We propose a typology describing tone (positive-only, mixed), form (factual, narrative) and intent (grateful). Separating positive and negative elements in mixed feedback was sometimes impossible due to ambiguity. Narrative feedback often described the cumulative impact of interactions with healthcare providers, healthcare professionals, influential individuals and community organisations. Grateful feedback was targeted at individual staff or entire units, but the target was sometimes ambiguous. CONCLUSION People commissioning feedback collection systems should consider mechanisms to maximise utility by limiting ambiguity. Since being enabled to provide narrative feedback can allow contributors to make contextualised statements about what worked for them and why, then there may be trade-offs to negotiate between limiting ambiguity, and encouraging rich narratives. Groups tasked with using feedback should plan the human resources needed for careful inspection, and consider providing narrative analysis training.
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Affiliation(s)
- Rebecca Lloyd
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord Universitet, Namsos, Norway
| | - Richard Byng
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Alex Russell
- Harvard Medical School, Harvard University, Cambridge, Massachusetts, USA
- Recovery Research Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Alex Stirzaker
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Nottingham, UK
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McIntosh GL, Hibberd C, McGregor S. Capturing patient feedback to improve healthcare services. Nurs Stand 2024; 39:62-67. [PMID: 38881236 DOI: 10.7748/ns.2024.e12274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 06/18/2024]
Abstract
The primary purpose of gathering patient feedback is to listen to, reflect on and act on the feedback to improve patients' experiences, interactions and health outcomes. Nurses use patient feedback to guide person-centred care or to inform healthcare decisions. However, when healthcare services attempt to improve the quality of care, there can be a lack of process clarity, clear measurement and evidence of improvements. This article provides an overview of the strategies used to capture patient feedback and offers guidance on how nurses can make use of such information to promote healthcare improvement.
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Affiliation(s)
- Gwenne Louise McIntosh
- Faculty of Health Sciences and Sport, Health Sciences, University of Stirling, Stirling, Scotland
| | - Carina Hibberd
- Faculty of Health Sciences and Sport, Health Sciences, University of Stirling, Stirling, Scotland
| | - Suzanne McGregor
- lecturer in nursing, Faculty of Health Sciences and Sport, Health Sciences, University of Stirling, Stirling, Scotland
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5
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Han S, Liang Z. Using patient feedback to predict effects of quality improvement initiatives. Int J Health Plann Manage 2024. [PMID: 39039563 DOI: 10.1002/hpm.3827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/13/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Internationally, continuous efforts have been put into developing patient complaint channels to understand patients' experience and expectation of care, which can guide the improvement of health service quality. Despite agreement among the value of patient feedback, limited attention has been paid to using patient feedback to predict and promote the actual quality improvement initiatives. OBJECTIVE To determine whether patient feedback collected from a public feedback hotline can be used to predict the effect of hospital quality service improvement initiatives. METHODS A retrospective analysis of patient complaint data of a tertiary hospital from 2018 to 2021 was performed. Patient complaints were first coded by the standard classification method of the Australian Hospital Patient Experience Question Set. The characteristics of patients' complaints were then analysed by frequency and contingency table analysis. Finally, through Nonparametric Mann-Kendall test and Joinpoint regression model, the trends of each complaint characteristics were tested. RESULTS Amongst the 771 complaints received against clinicians, approximately 75% of them were concerning doctors. 'Harm and distress' was the key reason of complaints, followed by 'not cared for', 'lack of confidence', 'needs unmet' and 'not informed'. In 2021, the number of complaints received in relation to moderate 'harm and distress' caused by doctors increased by 667% from 2020. The categories of 'not informed', 'not cared for' and 'harm and distress' were also on the rise with statistical significance. In addition, complaints related to the lack of respect, bad attitude and unprofessional behaviour demonstrated by nurses (n = 83) and doctors (n = 121) were also recorded. CONCLUSION Patient feedbacks collected via a public feedback hotline provides a useful platform to gain insight into patient experience of care which are valuable to guide quality care improvement. To improve the care quality, clinicians need to participate in quality improvement strategies development at an early stage. Efforts in improving communication and interaction between doctors and patients are needed to improve patients' experience of care and developing patients' trust in both of the clinicians and the medical services. The study highlights the value of using public feedback hotline to generate evidence that can guide hospital service improvement.
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Affiliation(s)
- Sirou Han
- Hainan Province Center for Disease Control and Prevention, Haikou, China
| | - Zhanming Liang
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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Borrelli AM, Birch RJ, Spencer K. How does staff and patient feedback on hospital quality relate to mortality outcomes? A provider-level national study. Health Serv Manage Res 2024; 37:115-122. [PMID: 37368436 PMCID: PMC11041065 DOI: 10.1177/09514848231179182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
This study aimed to use national data to examine the relationship between staff and inpatient survey results (National Health Service (NHS) Friends and Family Test (FFT)) and assess how these align with more traditional measurements of hospital quality as captured by the summary hospital mortality indicator (SHMI). Provider level FFT responses were obtained for 128 English non-specialist acute providers for staff and inpatients between April 2016 and March 2019. Multilevel linear regression models assessed the relationship between staff and patient FFT recommendations, and separately how SHMI related to each of staff and patient FFT recommendations. A total of 1,536 observations were recorded across all providers and financial quarters. Patients were more likely to recommend their provider (95.5%) than staff (76.8%). In multivariable regression, a statistically significant association was observed between staff and patient FFT recommendations. A statistically significant negative relationship was also observed between staff FFT recommendations and SHMI. The association between SHMI and staff FFT recommendations suggests that staff feedback tools may provide a useful analogue for providers in potential need of intervention and improvement in care. For patients meanwhile, qualitative approaches and hospital organisations working in partnership with patients may provide better opportunities for patients to drive improvement.
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Affiliation(s)
- Antonio Michael Borrelli
- Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, South Yorkshire, Sheffield S5 7AT, UK
| | - Rebecca J Birch
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Katie Spencer
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
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Walker W, Jones J, Astley M. In-hospital end-of-life care: an appreciative analysis of bereaved family feedback. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:126-131. [PMID: 38335107 DOI: 10.12968/bjon.2024.33.3.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Experience feedback data is increasingly recognised as being helpful in improving healthcare services, and in meeting patient and family needs. This end-of-life care project, based on the principles of appreciative inquiry, sought to learn from the experiences of bereaved people whose relative had died in an acute hospital setting. Informal feedback, offered during a routine telephone call, was thematically analysed and interpreted in an appreciative manner. Confirmatory representations of caring practices and behaviours were identified, categorised and disseminated in a way that enabled staff to come to know and understand end-of-life care at its best, rather than as a set of problematised events. The findings served as a benchmark for individuals and teams to assess and progress their practice reflectively. The authors conclude that staff receptiveness to informal bereaved family feedback may be enhanced by focusing on the positive qualities of end-of-life care within existing practices.
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Affiliation(s)
- Wendy Walker
- Reader in Nursing (End-of-life Care and Bereavement), The Royal Wolverhampton NHS Trust
| | - Jennifer Jones
- Specialist Nurse-Bereavement/Lead Medical Examiner Officer, The Royal Wolverhampton NHS Trust
| | - Melanie Astley
- Clinical Nurse Specialist-Palliative Care, The Royal Wolverhampton NHS Trust
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Baker J, White K, Redley B. Consumer compliments about nursing and midwifery care: A 12-month retrospective analysis. J Adv Nurs 2023; 79:4804-4814. [PMID: 37376718 DOI: 10.1111/jan.15763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/20/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
AIMS To analyse the compliments received from patients' and companions and to describe the characteristics of high-quality nursing and midwifery care from the perspective of healthcare consumers. DESIGN Retrospective analysis of health service compliments data. METHODS All compliments specific to nursing and midwifery care received between July 2020 and June 2021 were extracted from the reporting database for six hospital sites of a large public health service in Victoria, Australia. Inductive coding captured the characteristics and qualities of nurses and midwives elicited from the compliments. Deductive coding used two frameworks: an adapted health complaints assessment tool, and 10 dimensions of nursing and midwifery care used in the health service. Descriptive statistics were used for analysis of coded data. RESULTS Of the 2833 records identified, 433 nursing and midwifery-specific compliments were identified; of these 225 consumer or care partner compliments were identified for analysis. Most compliments (80.4%, n = 181) were from the smaller hospital sites compared to 19.6% (n = 44) received at the largest hospital site; and from care programmes that typically care for older patients (42.7%, n = 113). Only 39% (n = 89) of compliments related to quality and safety of clinical care, 9% (n = 21) related to management and 17% (n = 38) to relationships. Forty-nine percent (n = 113) related to dimensions of fundamental nursing and midwifery care, with psychological care best represented (39.8%, n = 89). Most often, compliments related to characteristics or attributes of nurses. CONCLUSION Analysis of compliments reveals characteristics of nursing and midwifery care valued by healthcare consumers. Surprisingly, few compliments related to clinical dimensions of nursing and midwifery practice. Comments related to psychological aspects of nursing and midwifery care were most common. Understanding consumer perceptions of high-quality care provided by nurses and midwives provide guidance about care delivery that meets or exceed consumer expectations. The findings suggest low consumer awareness about professional and clinical aspects of nursing and midwifery work. IMPACT Compliments provide a unique insight into consumer perspectives of high-quality nursing and midwifery care. When making compliments, consumers most often commented about the attributes and characteristics of nurses and midwives, rather than clinical aspects of care. Compliments specific to nursing and midwifery care provide guidance to enhance care delivery to meet or exceed consumer expectations. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jessica Baker
- Nursing and Midwifery Education and Strategy, Monash Health, Clayton, Victoria, Australia
| | - Karin White
- Nursing and Midwifery Education and Strategy, Monash Health, Clayton, Victoria, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety Research- Monash Health Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
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Lloyd R, Munro J, Evans K, Gaskin-Williams A, Hui A, Pearson M, Slade M, Kotera Y, Day G, Loughlin-Ridley J, Enston C, Rennick-Egglestone S. Health service improvement using positive patient feedback: Systematic scoping review. PLoS One 2023; 18:e0275045. [PMID: 37796785 PMCID: PMC10553339 DOI: 10.1371/journal.pone.0275045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 05/14/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Healthcare services regularly receive patient feedback, most of which is positive. Empirical studies suggest that health services can use positive feedback to create patient benefit. Our aim was to map all available empirical evidence for how positive patient feedback creates change in healthcare settings. METHODS Empirical studies in English were systematically identified through database searches (ACM Digital Library, AMED, ASSIA, CINAHL, MEDLINE and PsycINFO), forwards and backwards citation, and expert consultation. We summarise the characteristics of included studies and the feedback they consider, present a thematic synthesis of qualitative findings, and provide narrative summaries of quantitative findings. RESULTS 68 papers were included, describing research conducted across six continents, with qualitative (n = 51), quantitative (n = 10), and mixed (n = 7) methods. Only two studies were interventional. The most common settings were hospitals (n = 27) and community healthcare (n = 19). The most common recipients were nurses (n = 29). Most outcomes described were desirable. These were categorised as (a) short-term emotional change for healthcare workers (including feeling motivated and improved psychological wellbeing); (b) work-home interactional change for healthcare workers (such as improved home-life relationships); (c) work-related change for healthcare workers (such as improved performance and staff retention). Some undesirable outcomes were described, including envy when not receiving positive feedback. The impact of feedback may be moderated by characteristics of particular healthcare roles, such as night shift workers having less interaction time with patients. Some factors moderating the change created by feedback are modifiable. CONCLUSION Further interventional research is required to assess the effectiveness and cost-effectiveness of receiving positive feedback in creating specific forms of change such as increases in staff retention. Healthcare managers may wish to use positive feedback more regularly, and to address barriers to staff receiving feedback.
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Affiliation(s)
- Rebecca Lloyd
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | | | - Kerry Evans
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | | | - Ada Hui
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Mark Pearson
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Health and Community Participation Division, Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
| | - Yasuhiro Kotera
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Giskin Day
- Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Joanne Loughlin-Ridley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Clare Enston
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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Wilson C, Janes G, Lawton R, Benn J. Types and effects of feedback for emergency ambulance staff: a systematic mixed studies review and meta-analysis. BMJ Qual Saf 2023; 32:573-588. [PMID: 37028937 PMCID: PMC10512001 DOI: 10.1136/bmjqs-2022-015634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/13/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Extensive research has been conducted into the effects of feedback interventions within many areas of healthcare, but prehospital emergency care has been relatively neglected. Exploratory work suggests that enhancing feedback and follow-up to emergency medical service (EMS) staff might provide staff with closure and improve clinical performance. Our aim was to summarise the literature on the types of feedback received by EMS professionals and its effects on the quality and safety of patient care, staff well-being and professional development. METHODS A systematic review and meta-analysis, including primary research studies of any method published in peer-reviewed journals. Studies were included if they contained information on systematic feedback to emergency ambulance staff regarding their performance. Databases searched from inception were MEDLINE, Embase, AMED, PsycINFO, HMIC, CINAHL and Web of Science, with searches last updated on 2 August 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Data analysis followed a convergent integrated design involving simultaneous narrative synthesis and random effects multilevel meta-analyses. RESULTS The search strategy yielded 3183 articles, with 48 studies meeting inclusion criteria after title/abstract screening and full-text review. Interventions were categorised as audit and feedback (n=31), peer-to-peer feedback (n=3), postevent debriefing (n=2), incident-prompted feedback (n=1), patient outcome feedback (n=1) or a combination thereof (n=4). Feedback was found to have a moderate positive effect on quality of care and professional development with a pooled effect of d=0.50 (95% CI 0.34, 0.67). Feedback to EMS professionals had large effects in improving documentation (d=0.73 (0.00, 1.45)) and protocol adherence (d=0.68 (0.12, 1.24)), as well as small effects in enhancing cardiac arrest performance (d=0.46 (0.06, 0.86)), clinical decision-making (d=0.47 (0.23, 0.72)), ambulance times (d=0.43 (0.12, 0.74)) and survival rates (d=0.22 (0.11, 0.33)). The between-study heterogeneity variance was estimated at σ2=0.32 (95% CI 0.22, 0.50), with an I2 value of 99% (95% CI 98%, 99%), indicating substantial statistical heterogeneity. CONCLUSION This review demonstrated that the evidence base currently does not support a clear single point estimate of the pooled effect of feedback to EMS staff as a single intervention type due to study heterogeneity. Further research is needed to provide guidance and frameworks supporting better design and evaluation of feedback interventions within EMS. PROSPERO REGISTRATION NUMBER CRD42020162600.
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Affiliation(s)
- Caitlin Wilson
- School of Psychology, University of Leeds, Leeds, UK
- Research and Development Department, Yorkshire Ambulance Service NHS Trust, Wakefield, UK
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK
| | - Gillian Janes
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Rebecca Lawton
- School of Psychology, University of Leeds, Leeds, UK
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK
| | - Jonathan Benn
- School of Psychology, University of Leeds, Leeds, UK
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK
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Gillespie A, Reader TW. Online patient feedback as a safety valve: An automated language analysis of unnoticed and unresolved safety incidents. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:1463-1477. [PMID: 35945156 DOI: 10.1111/risa.14002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Safety reporting systems are widely used in healthcare to identify risks to patient safety. But, their effectiveness is undermined if staff do not notice or report incidents. Patients, however, might observe and report these overlooked incidents because they experience the consequences, are highly motivated, and independent of the organization. Online patient feedback may be especially valuable because it is a channel of reporting that allows patients to report without fear of consequence (e.g., anonymously). Harnessing this potential is challenging because online feedback is unstructured and lacks demonstrable validity and added value. Accordingly, we developed an automated language analysis method for measuring the likelihood of patient-reported safety incidents in online patient feedback. Feedback from patients and families (n = 146,685, words = 22,191,427, years = 2013-2019) about acute NHS trusts (hospital conglomerates; n = 134) in England were analyzed. The automated measure had good precision (0.69) and excellent recall (0.98) in identifying incidents; was independent of staff-reported incidents (r = -0.04 to 0.19); and was associated with hospital-level mortality rates (z = 3.87; p < 0.001). The identified safety incidents were often reported as unnoticed (89%) or unresolved (21%), suggesting that patients use online platforms to give visibility to safety concerns they believe have been missed or ignored. Online stakeholder feedback is akin to a safety valve; being independent and unconstrained it provides an outlet for reporting safety issues that may have been unnoticed or unresolved within formal channels.
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Affiliation(s)
- Alex Gillespie
- Department of Psychological & Behavioural Science, London School of Economics, London, UK
- Department of Psychology, Oslo New University College, Oslo, Norway
| | - Tom W Reader
- Department of Psychological & Behavioural Science, London School of Economics, London, UK
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12
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Liu M, Hu L, Xu Y, Wang Y, Liu Y. Patient healthcare experiences of cancer hospitals in China: A multilevel modeling analysis based on a national survey. Front Public Health 2023; 11:1059878. [PMID: 36908411 PMCID: PMC9992183 DOI: 10.3389/fpubh.2023.1059878] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/02/2023] [Indexed: 02/24/2023] Open
Abstract
Importance Patient satisfaction is a crucial indicator for assessing quality of care in healthcare settings. However, patient satisfaction benchmark for cancer hospitals in China is not established. Objective To examine patient satisfaction levels in tertiary cancer hospitals in China, and inter-hospital variations after case-mix adjustment. Design A nationwide cross-sectional hospital performance survey conducted from January to March 2021. Settings At 30 tertiary cancer hospitals in China. Participants A total of 4,847 adult inpatients consecutively recruited at 30 tertiary cancer hospitals were included. Exposures Patient characteristics included demographic characteristics (sex, age, education, and annual family income), clinical characteristics (cancer type, cancer stage, self-reported health status, and length of stay), and actual respondents of questionnaire. Main outcomes and measures Patient satisfaction was measured using 23 items covering five aspects, administrative process, hospital environment, medical care, symptom management, and overall satisfaction. Responses to each item were recorded using a 5-point Likert scale. Patient satisfaction level for each aspect was described at individual and hospital levels. Using multilevel logistic regression, patient characteristics associated with patient satisfaction were examined as case-mix adjusters and inter-hospital variation were determined. Results The satisfaction rates for symptom management, administrative process, hospital environment, overall satisfaction, and medical care aspects were 74.56, 81.70, 84.18, 84.26, and 90.86% with a cut-off value of 4, respectively. Significant predictors of patient satisfaction included sex, age, cancer type, cancer stage, self-reported health status, and actual respondent (representative or patient) (all P < 0.05). The ranking of the hospitals' performance in satisfaction was altered after the case-mix adjustment was made. But even after the adjustment, significant variation in satisfaction among hospitals remained. Conclusions and relevance This study pointed to symptom management as a special area, to which a keen attention should be paid by policymakers and hospital administrators. Significant variation in satisfaction among hospitals remained, implying that future studies should examine major factors affecting the variation. In review, target interventions are needed in low-performing hospitals.
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Affiliation(s)
| | - Linlin Hu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Ramsey L, Lawton R, Sheard L, O’Hara J. Exploring the sociocultural contexts in which healthcare staff respond to and use online patient feedback in practice: In-depth case studies of three NHS Trusts. Digit Health 2022; 8:20552076221129085. [PMID: 36276183 PMCID: PMC9580083 DOI: 10.1177/20552076221129085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 09/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives Patients are increasingly reporting about their healthcare experiences online and NHS Trusts are adopting different approaches to responding. However, the sociocultural contexts underpinning these organisational approaches remain unclear. Therefore, we aimed to explore the sociocultural contexts underpinning three organisations who adopted different approaches to responding to online patient feedback. Methods Recruitment of three NHS Trusts was theoretically guided, and determined based on their different approaches to responding to online patient feedback (a nonresponding organisation, a generic responding organisation and an organisation providing transparent, conversational responses). Ethnographic methods were used during a year of fieldwork involving staff interviews, observations of practice and documentary analysis. Three in-depth case studies are presented. Findings The first organisation did not respond to or use online patient feedback as staff were busy firefighting volumes of concerns received in other ways. The second organisation adopted a generic responding style due to resource constraints, fears of public engagement and focus on resolving known issues raised via more traditional feedback sources. The final organisation provided transparent, conversational responses to patients online and described a 10-year journey enabling their desired culture to be embedded. Conclusions We identified a range of barriers facing organisations who ignore or provide generic responses to patient feedback online. We also demonstrated the sociocultural context in which online interactions between staff and patients can be embraced to inform improvement. However, this represented a slow and difficult organisational journey. Further research is needed to better establish how organisations can recognise and overcome barriers to engaging with online patient feedback, and at pace.
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Affiliation(s)
- Lauren Ramsey
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK,Lauren Ramsey, Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House Bradford Royal Infirmary, Duckworth Ln, Bradford BD9 6RJ UK.
| | - Rebecca Lawton
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK,School of Psychology, University of Leeds, Leeds, UK
| | | | - Jane O’Hara
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK,School of Healthcare, University of Leeds, Leeds, UK
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Adams C, Walpola R, Schembri AM, Harrison R. The ultimate question? Evaluating the use of Net Promoter Score in healthcare: A systematic review. Health Expect 2022; 25:2328-2339. [PMID: 35985676 PMCID: PMC9615049 DOI: 10.1111/hex.13577] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/29/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient experience is a complex phenomenon that presents challenges for appropriate and effective measurement. With the lack of a standardized measurement approach, efforts have been made to simplify the evaluation and reporting of patient experience by using single-item measures, such as the Net Promoter Score (NPS). Although NPS is widely used in many countries, there has been little research to validate its effectiveness and value in the healthcare setting. The aim of this study was to systematically evaluate the evidence that is available about the application of NPS in healthcare settings. METHODS Studies were identified using words and synonyms that relate to NPS, which was applied to five electronic databases: Medline, CINAHL, Proquest, Business Journal Premium, and Scopus. Titles and abstracts between January 2005 and September 2020 were screened for relevance, with the inclusion of quantitative and qualitative studies in the healthcare setting that evaluated the use of NPS to measure patient experience. RESULTS Twelve studies met the inclusion criteria. Four studies identified benefits associated with using NPS, such as ease of use, high completion rates and being well-understood by a range of patients. Three studies questioned the usefulness of the NPS recommendation question in healthcare settings, particularly when respondents are unable to select their service provider. The free-text comments section, which provides additional detail and contextual cues, was viewed positively by patients and staff in 4 of 12 studies. According to these studies, NPS can be influenced by a wide range of variables, such as age, condition/disease, intervention and cultural variation; therefore, caution should be taken when using NPS for comparisons. Four studies concluded that NPS adds minimal value to healthcare improvement. CONCLUSION The literature suggests that many of the proposed benefits of using NPS are not supported by research. NPS may not be sufficient as a stand-alone metric and may be better used in conjunction with a larger survey. NPS may be more suited for use in certain healthcare settings, for example, where patients have a choice of provider. Staff attitudes towards the use of NPS for patient surveying are mixed. More research is needed to validate the use of NPS as a primary metric of patient experience. PATIENT OR PUBLIC CONTRIBUTION Consumer representatives were provided with the research findings and their feedback was sought about the study. Consumers commented that they found the results to be useful and felt that this study highlighted important considerations when NPS data is used to evaluate patient experience.
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Affiliation(s)
- Corey Adams
- St Vincent's Health Network SydneySydneyNew South WalesAustralia
| | - Ramesh Walpola
- School of Population HealthUniversity of New South Wales (UNSW)SydneyNew South WalesAustralia
| | - Anthony M. Schembri
- St Vincent's Health Network SydneySydneyNew South WalesAustralia
- School of Population HealthUniversity of New South Wales (UNSW)SydneyNew South WalesAustralia
| | - Reema Harrison
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
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15
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Jesus TS, Stern BZ, Struhar J, Deutsch A, Heinemann AW. The use of patient experience feedback in rehabilitation quality improvement and codesign activities: Scoping review of the literature. Clin Rehabil 2022; 37:261-276. [DOI: 10.1177/02692155221126690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To characterize the literature, reported enablers, and gaps on the use of patient experience feedback for person-centered rehabilitation quality improvement and codesign activities. Design Scoping Review. Data sources Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web of Science, ProQuest), website searches (e.g. Beryl Institute), snowballing, and key-informant recommendations. Methods Two independent reviewers performed title and abstract screenings and full-text reviews. Eligibility focused on English-language, peer-reviewed (all time) and gray literature (last five years) that used patient experience feedback in rehabilitation improvement activities. The aims, settings, methods, findings, implications, and reported limitations were extracted, followed by content analyses identifying reported enablers and gaps. Results Among the 901 unique references and 52 full texts reviewed, ten were included: four used patient experience surveys for improving patient experiences; six used codesign methodologies to engage patient feedback in service improvement activities. Implementation enablers included securing managerial support, having a structured methodology and facilitator, using efficient processes, engaging staff experiences, and using appreciative inquiry. Reported study gaps included limited follow-up, low sample sizes, analytical limitations, lack of reported limitations, or narrow range of perspectives (e.g. not from people with severe impairments). Conclusion Few examples of the use of patient experience feedback in quality improvement or codesign activities were found in the rehabilitation literature. Patient experience improvement activities relied exclusively on retrospective survey data, which were not combined with often more actionable forms (e.g. qualitative, real time) of patient experience feedback. Further research might consider design of activities that collect and use patient experience feedback for rehabilitation service improvements.
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Affiliation(s)
- TS Jesus
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - BZ Stern
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Struhar
- Nerve, Muscle + Bone Innovation Center & Oncology Innovation Center, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - A Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- RTI International, Chicago, IL, USA
| | - AW Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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16
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Kynoch K, Ameen M, Ramis MA, Khalil H. Use of Patient-Reported Data within the Acute Healthcare Context: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11160. [PMID: 36141433 PMCID: PMC9517657 DOI: 10.3390/ijerph191811160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/24/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs) and patient satisfaction surveys provide important information on how care can be improved. However, data collection does not always translate to changes in practice or service delivery. This scoping review aimed to collect, map and report on the use of collected patient-reported data used within acute healthcare contexts for improvement to care or processes. Using JBI methods, an extensive search was undertaken of multiple health databases and trial registries for published and unpublished studies. The concepts of interest included the types and characteristics of published patient experience and PROMs research, with a specific focus on the ways in which data have been applied to clinical practice. Barriers and facilitators to the use of collected data were also explored. From 4057 records, 86 papers were included. Most research was undertaken in North America, Canada or the UK. The Hospital Consumer Assessment of Healthcare Providers and Systems tool (HCAHPS) was used most frequently for measuring patient satisfaction. Where reported, data were applied to improve patient-centred care and utilization of health resources. Gaps in the use of patient data within hospital services are noticeable. Engaging management and improving staff capability are needed to overcome barriers to implementation.
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Affiliation(s)
- Kathryn Kynoch
- Mater Health and Queensland Centre for Evidence Based Nursing and Midwifery, A JBI Centre of Excellence, Brisbane 4006, Australia
| | - Mary Ameen
- Faculty of Medicine, Nursing and Health Sciences, Monash Rural Health Churchill, Monash University, Churchill 3842, Australia
| | - Mary-Anne Ramis
- Mater Health and Queensland Centre for Evidence Based Nursing and Midwifery, A JBI Centre of Excellence, Brisbane 4006, Australia
| | - Hanan Khalil
- School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
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17
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Fracso D, Bourrel G, Jorgensen C, Fanton H, Raat H, Pilotto A, Baker G, Pisano MM, Ferreira R, Valsecchi V, Pers YM, Engberink AO. The chronic disease Self-Management Programme: A phenomenological study for empowering vulnerable patients with chronic diseases included in the EFFICHRONIC project. Health Expect 2022; 25:947-958. [PMID: 35014112 PMCID: PMC9122418 DOI: 10.1111/hex.13430] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/14/2021] [Accepted: 12/24/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction The Chronic Disease Self‐Management Programme (CDSMP) has resulted in improved health outcomes for patients. However, research has focused mainly on those with chronic conditions and has not extensively explored prevention programmes targeting individuals with specific vulnerability profiles. Aim This study aimed to understand the effects of the CDSMP on the lived experience of vulnerable patients included in the EFFICHRONIC project in France, based on their needs and expectations before and after participation. Methods We conducted a qualitative phenomenological semio‐pragmatic study based on 37 in‐depth interviews with 20 patients (20 before/17 after CDSMP). Results By transforming existential dimensions (identity, relationship with others and bodily experience), chronic illness generates new needs in the vulnerable person. By resonating with the expectations and needs of participants, the CDSMP induces motivation and a sense of belonging to a community of peers. It has enabled the participants to become actors of their own health until empowerment. Although some limitations are reported, the programme has awakened a desire in the participants to take better care of their health and to develop personal skills with, for some, a desire to become involved in health education. Conclusion Our phenomenological approach highlighted the resonance between the programme (its design and implementation) and the lived experience of patients, as an effective element of empowerment. This necessitates training the facilitators to elicit the lived experience of patients. Furthermore, as a patient‐centred approach is required, the facilitators need to learn how to adapt the design of the programme to the singularity of the patient. Patient or Public Contribution Patients provided the data that were collected through in‐depth interviews, and their experiences before and after the programme were analysed.
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Affiliation(s)
- Dallal Fracso
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France.,Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France
| | - Gérard Bourrel
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France.,Institut Desbrest d'Epidémiologie et de Santé Public, UMR UA11 INSERM, Université de Montpellier, Montpellier, France
| | - Christian Jorgensen
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Hélène Fanton
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Graham Baker
- Quality Institute for Self Management Education and Training, Portsmouth, UK
| | - Marta M Pisano
- General Direction of Care, Humanization and Social and Health Care, Ministry of Health, Biosanitary Research Institute of the Principality of Asturias, Asturias, Spain
| | - Rosanna Ferreira
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Verushka Valsecchi
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Yves-Marie Pers
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Agnes Oude Engberink
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France.,Institut Desbrest d'Epidémiologie et de Santé Public, UMR UA11 INSERM, Université de Montpellier, Montpellier, France
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18
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Chen X, Zhao W, Yuan J, Qin W, Zhang Y, Zhang Y. The Relationships Between Patient Experience with Nursing Care, Patient Satisfaction and Patient Loyalty: A Structural Equation Modeling. Patient Prefer Adherence 2022; 16:3173-3183. [PMID: 36510572 PMCID: PMC9738976 DOI: 10.2147/ppa.s386294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE When creating and managing patient loyalty, medical institutes always focus on medical technicians, overall healthcare quality, and hospital brands, and the role of nursing seems to be underappreciated. Empirical evidence about the relationship between patient experience with nursing care and patient loyalty is limited, especially in the Chinese healthcare system. This study aimed to explore to what extent patient experience with nursing care influences patient loyalty to the hospital and the impact routes. PATIENTS AND METHODS This study is a multicenter cross-sectional survey. The STROBE was selected as the checklist in this study. Patient experience with nursing care, patient satisfaction and patient loyalty were collected from 1469 inpatients in three hospitals in China through a paper-based survey. Data were analyzed using SPSS and AMOS software; a structural equation model was established to explore the effect of patient experience with nursing care and satisfaction on patient loyalty using the PROCESS macro. RESULTS There were significant direct and indirect effects between patient experience with nursing care and patient loyalty, explaining 32.0% of patient loyalty variance. Patient experience with nursing care had a direct and positive impact on patient loyalty (β=0.298, P<0.01), and better patient experience with nursing care was directly associated with better patient loyalty. In addition, the results also revealed the effect of patient experience with nursing care on patient loyalty was partially mediated by patient satisfaction with nursing care and overall hospital services (β=0.162, P<0.01). CONCLUSION This study confirmed the importance of nursing care in creating patient loyalty; improving the patient experience with nursing care would be beneficial to patient loyalty. When creating patient loyalty, hospital administrators and nursing managers should make efforts to develop positive patient experience of nursing care in daily clinical practice through organizational changes, culture shaping and staff education.
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Affiliation(s)
- Xiao Chen
- Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, 200032, People’s Republic of China
| | - Wenjuan Zhao
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, 200032, People’s Republic of China
| | - Jie Yuan
- Department of Nursing, Shanghai Fengxian District Hospital of Traditional Chinese Medicine, Shanghai, 201499, People’s Republic of China
| | - Wei Qin
- Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yuhong Zhang
- Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yuxia Zhang
- Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, 200032, People’s Republic of China
- Correspondence: Yuxia Zhang; Yuhong Zhang, Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, People’s Republic of China, Tel +86 13816881925, Fax +86 64041990, Email ;
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Pearce M, Wilkins V, Chaulk D. Using patient complaints to drive healthcare improvement: a narrative overview. Hosp Pract (1995) 2021; 49:393-398. [PMID: 34433356 DOI: 10.1080/21548331.2021.1973279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Patient complaints are directly related to patient experience and safety. While complaints have the potential to be a major driving force in quality improvement, there is little evidence-based structure to use as a guide. The existing literature draws attention to the significant variability in complaint reporting and analysis systems as major barriers. Furthermore, weak change strategies are frequently implemented in response to complaints. This often prevents further investigation into larger systems issues that could be addressed with quality improvement initiatives. Several recent studies describe success with the use of a standardized tool to classify patient complaints, which highlights attempts at overcoming these barriers. There are opportunities to more effectively use patient complaints to drive improvement including a cultural shift with supportive leadership, transparency with the complaint process, and the use of a standardized tool to better organize and process complaints.
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Affiliation(s)
- Matthew Pearce
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Victoria Wilkins
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - David Chaulk
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
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20
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Walsh L, Hyett N, Howley J, Juniper N, Li C, MacLeod-Smith B, Rodier S, Hill SJ. The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders. BMC Health Serv Res 2021; 21:876. [PMID: 34445972 PMCID: PMC8393819 DOI: 10.1186/s12913-021-06927-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/12/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Engaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders' experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use. METHODS Semi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study. RESULTS Twenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1) overcoming barriers to engagement, 2) consumer-initiated engagement; 3) breadth vs depth of engagement, 4) organisational transparency vs control and 5) users causing harm. CONCLUSIONS Social media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.
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Affiliation(s)
| | | | | | | | - Chi Li
- Albury Wodonga Health, Albury, Australia
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21
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Caring for care: Online feedback in the context of public healthcare services. Soc Sci Med 2021; 285:114280. [PMID: 34358947 DOI: 10.1016/j.socscimed.2021.114280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 01/30/2023]
Abstract
People increasingly provide feedback about healthcare services online. These practices have been lauded for enhancing patient power, choice and control, encouraging greater transparency and accountability, and contributing to healthcare service improvement. Online feedback has also been critiqued for being unrepresentative, spreading inaccurate information, undermining care relations, and jeopardising professional autonomy. Through a thematic analysis of 37 qualitative interviews, this paper explores the relationship between online feedback and care improvement as articulated by healthcare service users (patients and family members) who provided feedback across different online platforms and social media in the UK. Online feedback was framed by interviewees as, ideally, a public and, in many cases, anonymous 'conversation' between service users and healthcare providers. These 'conversations' were thought of not merely as having the potential to bring about tangible improvements to healthcare, but as in themselves constituting an improvement in care. Vital to this was the premise that providing feedback was an enactment of care - care for other patients, certainly, but also care for healthcare as such and even for healthcare professionals. Ultimately, feedback was understood as an enactment of care for the National Health Service (NHS), as symbolically encompassing all of the above. Putting these findings in dialogue with STS scholarship on care, we argue that, in this context, the provision of online feedback can be understood as a form of care that is, simultaneously, both directed at healthcare (in the round, including patients, professionals, services, organisations, and, of course, health itself) and part of healthcare. We conceptualise this as 'caring for care'. This conceptualization moves beyond dominant framings of online feedback in terms of 'choice' and 'voice'. It embeds online feedback within pre-existing healthcare systems, relations and moral commitments, foregrounds the mutuality of care relations, and draws attention to the affective labour of feedback practices.
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22
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Jones B, Heslop D, Harrison R. Seldom heard voices: a meta-narrative systematic review of Aboriginal and Torres Strait Islander peoples healthcare experiences. Int J Equity Health 2020; 19:222. [PMID: 33317556 PMCID: PMC7734845 DOI: 10.1186/s12939-020-01334-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 11/26/2020] [Indexed: 11/11/2022] Open
Abstract
Background It is well established that Aboriginal and Torres Strait Islander populations face considerable health inequities, exacerbated by poorer healthcare quality. Patient experience is recognised as a major contributing factor to healthcare quality and outcomes, therefore, enriched knowledge of the patient experiences of Aboriginal and Torres Strait Islander populations is critical to redress health inequities. This review synthesises evidence of the healthcare experiences amongst Aboriginal and Torres Strait Islander patients through a metanarrative synthesis of qualitative literature. Methods A systematic search strategy was developed and applied to six electronic databases between January 2000 and July 2019. Titles and abstracts were screened before applying the inclusion criteria to full text articles. A meta-narrative synthesis was undertaken. Results Fifty-four publications were identified from four research traditions; each with a unique conceptualisation of patient experience. Three themes emerged that demonstrate Aboriginal and Torres Strait Islander patient experiences are informed by 1) beliefs about wellbeing and healthcare provision, 2) their level of trust in the healthcare system, and 3) individual and community health system interactions. The findings highlight a range of aspects of patient experience that were important to participating Aboriginal and Torres Strait Islanders in the included studies but not captured currently in health system surveys. Conclusion This review highlights the influence of beliefs about health and wellbeing on the patient experience amongst Aboriginal and Torres Strait Islander populations in the Australian health system. Patient experiences were informed by past experience and their trust in the health system. The different factors influencing patient experience and the gravity of their influence must be considered in current approaches to capturing patient experience data collection methods. Trial registration PROSPERO (ID: CRD42019134765).
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Affiliation(s)
- Benjamin Jones
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
| | - David Heslop
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
| | - Reema Harrison
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia.
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23
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Gillespie A, Reader TW. Identifying and encouraging high-quality healthcare: an analysis of the content and aims of patient letters of compliment. BMJ Qual Saf 2020; 30:484-492. [PMID: 32641354 PMCID: PMC8142452 DOI: 10.1136/bmjqs-2019-010077] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/17/2020] [Accepted: 06/13/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although healthcare institutions receive many unsolicited compliment letters, these are not systematically conceptualised or analysed. We conceptualise compliment letters as simultaneously identifying and encouraging high-quality healthcare. We sought to identify the practices being complimented and the aims of writing these letters, and we test whether the aims vary when addressing front-line staff compared with senior management. METHODS A national sample of 1267 compliment letters was obtained from 54 English hospitals. Manual classification examined the practices reported as praiseworthy, the aims being pursued and who the letter was addressed to. RESULTS The practices being complimented were in the relationship (77% of letters), clinical (50%) and management (30%) domains. Across these domains, 39% of compliments focused on voluntary non-routine extra-role behaviours (eg, extra-emotional support, staying late to run an extra test). The aims of expressing gratitude were to acknowledge (80%), reward (44%) and promote (59%) the desired behaviour. Front-line staff tended to receive compliments acknowledging behaviour, while senior management received compliments asking them to reward individual staff and promoting the importance of relationship behaviours. CONCLUSIONS Compliment letters reveal that patients value extra-role behaviour in clinical, management and especially relationship domains. However, compliment letters do more than merely identify desirable healthcare practices. By acknowledging, rewarding and promoting these practices, compliment letters can potentially contribute to healthcare services through promoting desirable behaviours and giving staff social recognition.
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Affiliation(s)
- Alex Gillespie
- Department of Psychological & Behavioural Science, London School of Economics, London, UK
| | - Tom W Reader
- Department of Psychological & Behavioural Science, London School of Economics, London, UK
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24
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Sehlbach C, Govaerts MJB, Mitchell S, Teunissen TGJ, Smeenk FWJM, Driessen EW, Rohde GGU. Perceptions of people with respiratory problems on physician performance evaluation-A qualitative study. Health Expect 2019; 23:247-255. [PMID: 31747110 PMCID: PMC6978864 DOI: 10.1111/hex.12999] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Despite increasing calls for patient and public involvement in health-care quality improvement, the question of how patient evaluations can contribute to physician learning and performance assessment has received scant attention. OBJECTIVE The objective of this study was to explore, amid calls for patient involvement in quality assurance, patients' perspectives on their role in the evaluation of physician performance and to support physicians' learning and decision making on professional competence. DESIGN A qualitative study based on semi-structured interviews. SETTING AND PARTICIPANTS The study took place in a secondary care setting in the Netherlands. The authors selected 25 patients from two Dutch hospitals and through the Dutch Lung Foundation, using purposive sampling. METHODS Data were analysed according to the principles of template analysis, based on an a priori coding framework developed from the literature about patient empowerment, feedback and performance assessment. RESULTS The analysis unearthed three predominant patient perspectives: the proactive perspective, the restrained perspective and the outsider perspective. These perspectives differed in terms of perceived power dynamics within the doctor-patient relationship, patients' perceived ability, and willingness to provide feedback and evaluate their physician's performance. Patients' perspectives thus affected the role patients envisaged for themselves in evaluating physician performance. DISCUSSION AND CONCLUSION Although not all patients are equally suitable or willing to be involved, patients can play a role in evaluating physician performance and continuing training through formative approaches. To involve patients successfully, it is imperative to distinguish between different patient perspectives and empower patients by ensuring a safe environment for feedback.
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Affiliation(s)
- Carolin Sehlbach
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Marjan J B Govaerts
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Truus G J Teunissen
- Patient Contributor, and Researcher at the Department of Medical Humanities, Amsterdam Public Health research institute (APH), Amsterdam UMC Free University Medical Centre, Amsterdam, The Netherlands
| | - Frank W J M Smeenk
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.,Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Erik W Driessen
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Gernot G U Rohde
- Department of Respiratory Medicine, University Hospital, Goethe University, Frankfurt, Germany
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Sheard L, Marsh C, Mills T, Peacock R, Langley J, Partridge R, Gwilt I, Lawton R. Using patient experience data to develop a patient experience toolkit to improve hospital care: a mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07360] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Patients are increasingly being asked to provide feedback about their experience of health-care services. Within the NHS, a significant level of resource is now allocated to the collection of this feedback. However, it is not well understood whether or not, or how, health-care staff are able to use these data to make improvements to future care delivery.
Objective
To understand and enhance how hospital staff learn from and act on patient experience (PE) feedback in order to co-design, test, refine and evaluate a Patient Experience Toolkit (PET).
Design
A predominantly qualitative study with four interlinking work packages.
Setting
Three NHS trusts in the north of England, focusing on six ward-based clinical teams (two at each trust).
Methods
A scoping review and qualitative exploratory study were conducted between November 2015 and August 2016. The findings of this work fed into a participatory co-design process with ward staff and patient representatives, which led to the production of the PET. This was primarily based on activities undertaken in three workshops (over the winter of 2016/17). Then, the facilitated use of the PET took place across the six wards over a 12-month period (February 2017 to February 2018). This involved testing and refinement through an action research (AR) methodology. A large, mixed-methods, independent process evaluation was conducted over the same 12-month period.
Findings
The testing and refinement of the PET during the AR phase, with the mixed-methods evaluation running alongside it, produced noteworthy findings. The idea that current PE data can be effectively triangulated for the purpose of improvement is largely a fallacy. Rather, additional but more relational feedback had to be collected by patient representatives, an unanticipated element of the study, to provide health-care staff with data that they could work with more easily. Multidisciplinary involvement in PE initiatives is difficult to establish unless teams already work in this way. Regardless, there is merit in involving different levels of the nursing hierarchy. Consideration of patient feedback by health-care staff can be an emotive process that may be difficult initially and that needs dedicated time and sensitive management. The six ward teams engaged variably with the AR process over a 12-month period. Some teams implemented far-reaching plans, whereas other teams focused on time-minimising ‘quick wins’. The evaluation found that facilitation of the toolkit was central to its implementation. The most important factors here were the development of relationships between people and the facilitator’s ability to navigate organisational complexity.
Limitations
The settings in which the PET was tested were extremely diverse, so the influence of variable context limits hard conclusions about its success.
Conclusions
The current manner in which PE feedback is collected and used is generally not fit for the purpose of enabling health-care staff to make meaningful local improvements. The PET was co-designed with health-care staff and patient representatives but it requires skilled facilitation to achieve successful outcomes.
Funding
The National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Laura Sheard
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Claire Marsh
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Thomas Mills
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rosemary Peacock
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | | | - Ian Gwilt
- Lab4Living, Sheffield Hallam University, Sheffield, UK
| | - Rebecca Lawton
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
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26
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Abebe E, Zillich AJ. Please like, follow, subscribe, and share. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ephrem Abebe
- Department of Pharmacy Practice, College of Pharmacy Purdue University West Lafayette Indiana
| | - Alan J. Zillich
- Department of Pharmacy Practice, College of Pharmacy Purdue University West Lafayette Indiana
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27
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Marsh C, Peacock R, Sheard L, Hughes L, Lawton R. Patient experience feedback in UK hospitals: What types are available and what are their potential roles in quality improvement (QI)? Health Expect 2019; 22:317-326. [PMID: 31016863 PMCID: PMC6543142 DOI: 10.1111/hex.12885] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/22/2019] [Accepted: 03/13/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND & OBJECTIVES The comparative uses of different types of patient experience (PE) feedback as data within quality improvement (QI) are poorly understood. This paper reviews what types are currently available and categorizes them by their characteristics in order to better understand their roles in QI. METHODS A scoping review of types of feedback currently available to hospital staff in the UK was undertaken. This comprised academic database searches for "measures of PE outcomes" (2000-2016), and grey literature and websites for all types of "PE feedback" potentially available (2005-2016). Through an iterative consensus process, we developed a list of characteristics and used this to present categories of similar types. MAIN RESULTS The scoping review returned 37 feedback types. A list of 12 characteristics was developed and applied, enabling identification of 4 categories that help understand potential use within QI-(1) Hospital-initiated (validated) quantitative surveys: for example the NHS Adult Inpatient Survey; (2) Patient-initiated qualitative feedback: for example complaints or twitter comments; (3) Hospital-initiated qualitative feedback: for example Experience Based Co-Design; (4) Other: for example Friends & Family Test. Of those routinely collected, few elicit "ready-to-use" data and those that do elicit data most suitable for measuring accountability, not for informing ward-based improvement. Guidance does exist for linking collection of feedback to QI for some feedback types in Category 3 but these types are not routinely used. CONCLUSION If feedback is to be used more frequently within QI, more attention must be paid to obtaining and making available the most appropriate types.
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Affiliation(s)
- Claire Marsh
- Bradford Institute for Health Research, Bradford, UK
| | | | - Laura Sheard
- Bradford Institute for Health Research, Bradford, UK
| | - Lesley Hughes
- Bradford Institute for Health Research, Bradford, UK
| | - Rebecca Lawton
- Bradford Institute for Health Research, Bradford, UK.,University of Leeds, Leeds, UK
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