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Li H, Yang Z. The impact of digital literacy on personal health: Evidence from the China family panel study. Int J Health Plann Manage 2024; 39:1411-1433. [PMID: 38804897 DOI: 10.1002/hpm.3816] [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: 01/05/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND In the digital era, digital literacy is a fundamental indicator of a nation's quality and plays a crucial role in public health. Exploring the theoretical mechanisms and effects of digital literacy on individuals' health is of great practical importance, advancing the initiatives of 'Digital China' and 'Healthy China'. METHODS The study utilised three-period survey panel data from the China Family Panel Study spanning 2016, 2018, and 2020 to measure and evaluate levels of digital literacy, physical health, mental health, healthy lifestyle, and integrated health among the participants. Subsequently, a series of empirical analyses were conducted to examine the general impact, heterogeneous effects and transmission pathways of digital literacy on various types of health levels. RESULTS Digital literacy significantly enhances all aspects of respondents' health, and this conclusion remains valid even after conducting robustness tests and addressing endogeneity through variable substitution and selecting instrumental variables using the 2SLS method. Furthermore, examining heterogeneity by considering individual traits and the makeup of digital literacy reveals that the impact of digital literacy on individuals' health varies according to age, cultural background, personal income, and the components of digital literacy. Pathway analyses also demonstrate that medical accessibility, information access, social network, and planned behaviour are key routes through which digital literacy enhances the health of the population. CONCLUSIONS It is imperative for the government to actively promote the advancement of the digital healthcare industry, while individuals should strive to enhance their digital literacy. By collectively focussing on these efforts, national health can be significantly improved.
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Affiliation(s)
- Hao Li
- School of Business, Xinyang Normal University, Xinyang, China
- Dabie Mountain Economic and Social Development Center, Xinyang, China
| | - Zihan Yang
- School of Business, Xinyang Normal University, Xinyang, China
- Dabie Mountain Economic and Social Development Center, Xinyang, China
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Vats K. Navigating the Digital Landscape: Embracing Innovation, Addressing Challenges, and Prioritizing Patient-Centric Care. Cureus 2024; 16:e58352. [PMID: 38756283 PMCID: PMC11097284 DOI: 10.7759/cureus.58352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/18/2024] Open
Abstract
In the digital era, healthcare customer feedback plays a pivotal role in shaping the reputation of healthcare organizations. The study explores how digital advancements are integrated into modern healthcare, offering both transformative insights and addressing the challenges they present. It investigates how technologies such as artificial intelligence (AI), digital platforms, and patient feedback systems impact patient care, operational efficiency, and customer satisfaction in healthcare settings. The study emphasizes the importance of balancing both capitalizing on the opportunities presented by innovations and addressing the inherent difficulties associated with digitalization in healthcare, underlining the need for a comprehensive approach to navigating the opportunities and challenges in healthcare digitalization. AI is recognized for its role in reshaping value creation in healthcare, fostering collaboration among stakeholders, and improving patient care. Additionally, the study identifies key areas of research essential for effectively navigating the digital transformation in healthcare, including operational efficiency, patient-centric strategies, and organizational factors. However, along with the potential benefits come challenges, such as the need for regulatory frameworks to validate new technologies and address privacy concerns surrounding patient data. Managing reputation and customer relationships in the digital sphere also emerges as critical for healthcare organizations. In summary, the study underscores the importance of healthcare institutions prioritizing patient-centric care, adopting digital innovations, and adeptly navigating regulatory and ethical challenges. By doing so, they can enhance patient outcomes, and satisfaction, and drive innovation in today's dynamic healthcare landscape.
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Affiliation(s)
- Kanika Vats
- Department of Management, School of Commerce and Management, Om Sterling Global University, Hisar, IND
- Department of Healthcare Regulatory Affairs, Emirates Classification Society (TASNEEF), Abu Dhabi, ARE
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Liu Y, Liu K, Zhang X, Guo Q. Does digital infrastructure improve public Health? A quasi-natural experiment based on China's Broadband policy. Soc Sci Med 2024; 344:116624. [PMID: 38290184 DOI: 10.1016/j.socscimed.2024.116624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/28/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
This study proposed a scheme for improving people's health from the perspective of digital infrastructure construction. We used the China Family Panel Studies conducted between 2010 and 2020 and the digital infrastructure construction marked by the Broadband China policy between 2014 and 2016 as a quasi-natural experiment. We adopted the multi-time difference-in-differences method to identify the causal relationship between digital infrastructure and people's health. We found that digital infrastructure construction significantly improved people's health, and the effect was more prominent among young and middle-aged residents and those with less than a university education. Moreover, digital infrastructure construction improved the utilization of medical services, helped residents develop healthy lifestyles, and increased people's health investments. Additionally, digital infrastructure reduced health inequality among people and promoted health equity. The findings could guide future policies to improve people's health and well-being.
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Affiliation(s)
- Yiwei Liu
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China
| | - Keshan Liu
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China
| | - XiangLin Zhang
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China
| | - Qiuyue Guo
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China.
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Han S, Xu M, Lao J, Liang Z. Collecting Patient Feedback as a Means of Monitoring Patient Experience and Hospital Service Quality - Learning from a Government-led Initiative. Patient Prefer Adherence 2023; 17:385-400. [PMID: 36819644 PMCID: PMC9936816 DOI: 10.2147/ppa.s397444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE Patient feedback plays a significant role in hospital service improvement. However, how to encourage patient feedback that can guide hospital service improvement is still being explored. By examining patient feedback data related to a tertiary hospital in China that was collected from the "12345" Government Service Convenience Hotline (GSCH), the paper discusses the learnings from GSCH in encouraging patient feedback and how quality improvement initiatives have effected the number and types of complaints made by patients and their families via GSCH. METHODS The study retrospectively collected and analyzed complaints on a Tertiary General University-affiliated hospital made via GSCH between 2016 and 2020. Patient care process-related complaints were coded using the health care complaint analysis tool (HCAT) and other complaint data were categorized based on the nature of the complaints. The autoregressive integrated moving average (ARIMA) models and mosaic plots were used to observe complaints trends and different complaint variables, respectively. The relationship between various quality improvement initiatives introduced since 2018 and patient complaints was also tested. RESULTS Close to 67% (n=2688) of calls made to the GSCH hotlines about the hospital were classified as a complaint including 60.6% vs 39.4% related to patient care process and nonpatient care process, respectively. For patient care process-related complaints, specifically against departments and personnel, 57.72% (n=961) were on clinical departments and 55.87% (n=471) were on doctors. Comparing the proportion of the complaint data in different categories in the two-year period of 2017-2018 and 2019-2020, an increase in management problems (47.73% vs 58.50%, P<0.001) and decrease in relationship problems (33.65% vs 25.69%, P=0.002) were recorded. CONCLUSION A unified, transparent, and impartial GSCH platform greatly encourages feedback from patients and families. Feedbacks provide evidence to guide health care organizations in improving the overall experience of patients and the quality of services that they provide.
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Affiliation(s)
- Sirou Han
- Hospital Administration Department, The Second Affiliated Hospital of Shandong First Medical University, Taian, People’s Republic of China
- School of Public Health, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, People’s Republic of China
| | - Min Xu
- Hospital Administration Department, The Second Affiliated Hospital of Shandong First Medical University, Taian, People’s Republic of China
- Correspondence: Min Xu, Hospital Administration Department, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, Shandong Province, 271000, People’s Republic of China, Tel +86-137-9112-0603, Email
| | - Jiahui Lao
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, People’s Republic of China
| | - Zhanming Liang
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- Zhanming Liang, College of Public Health, Medical and Veterinary Sciences, James Cook University, JCU Townsville Campus, Douglas, Building 41, Room 217, Townsville, QLD, 4870, Australia, Tel +61-7-4781-5040, Email
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Hanna E, Robert G. Understanding amputation care in England and Scotland: a qualitative exploration of patient stories posted on an online patient feedback site. Disabil Rehabil 2022; 44:7217-7225. [PMID: 34663151 DOI: 10.1080/09638288.2021.1988154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Undergoing an amputation is a life-altering experience that can involve a protracted and intensive period of care from a range of healthcare professionals. Amputation care within the NHS has historically been criticised. Here we seek to understand how patients are experiencing care by exploring their stories and identifying features of both high- and low-quality care. MATERIALS AND METHODS We analysed patient stories posted on the patient feedback site Care Opinion during the period 2018-2020 to examine how amputee patients (and their families) experience NHS care. Using thematic analysis, we identified four key themes. RESULTS We found that patients' stories of undergoing an amputation as posted on Care Opinion give overwhelmingly positive feedback on their experiences. Patients report feeling well-supported by empathetic staff, and that the outcomes, in terms of quality of life and restoration of mobility, are beneficial. Time was a common feature within the posts we examined and negative experiences of care often related to untimeliness in a variety of ways. CONCLUSIONS Care Opinion provides a useful and accessible resource for understanding how patients experience amputation care; analysis of stories posted there provides preliminary ideas of the features of "good care" from a patient-centred perspective.IMPLICATIONS FOR REHABILITATIONPatients undergoing amputations view professionalism of staff as important for good care.Timeliness is important to patients in seeing care in positive terms, ensuring patients are supported in their care during and after amputation in a timely manner is therefore important for achieving good rehabilitation care.Rehabilitation and related services supporting patients who have undergone amputations could usefully patient feedback sites as a means for further understanding the experiences of their patients and for improving services where necessary.
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Affiliation(s)
- Esmée Hanna
- Institute of Allied Health Sciences Research, De Montfort University, Leicester, UK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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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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Khonsari S, O Neill C, Mayland CR, Gilmour F, Aitken M, Mckeown A, Russell S, Mcalees A, Gardner M, Johnston B. Views of Care at End of Life: A Secondary Analysis of Online Feedback Using Care Opinion. J Patient Exp 2022; 9:23743735221103029. [PMID: 35664932 PMCID: PMC9158404 DOI: 10.1177/23743735221103029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Although there are studies on the use of social media and palliative and end-of-life care (PEOLC), there are no studies specifically investigating the content of online public feedback about PEOLC services. This study sought to understand experiences of end-of-life care provided in hospitals in the West of Scotland by exploring the main themes within the content of stories posted on a nationally endorsed nonprofit feedback online platform, Care Opinion, within a 2-year period. We used “Appreciative Inquiry” as a theoretical framework for this study to determine what works well in end-of-life care, while also identifying areas for further improvement. Of the 1428 stories published on “Care Opinion” from March 2019 to 2021 regarding hospitals in the West of Scotland, 48 (3.36%) were related to end-of-life care, of which all were included in data analysis. Using the software package NVivo and thematic analysis, we identified 4 key themes. We found that people overwhelmingly posted positive feedback about their experiences with end-of-life care. People reported positively about staff professionalism in providing compassionate and person-centered care to meet their loved ones needs at end of life. Other experiences of care related to challenges facing healthcare services, particularly during the COVID-19 pandemic. Quality appraisal of staff responses highlighted areas for improving feedback. This study can add to the aim of improving staff response to people’s concerns about end-of-life care. This study has provided a novel perspective of patients’ experiences of end-of-life care in hospitals in the West of Scotland. Novel insights were the appreciation of quality of care, staff professionalism, effective communication, and meeting patient’s needs at end-of-life particularly by nursing staff.
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Affiliation(s)
- Sahar Khonsari
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Catriona R Mayland
- University of Sheffield; Honorary Clinical Fellow, University of Liverpool, Sheffield, UK
| | - Fraser Gilmour
- Executive Director and Head of Care Opinion, Stirling, Scotland, UK
| | - Marc Aitken
- Clinical Professor of Nursing and Palliative Care, School of Medicine, Dentistry & Nursing, University of Glasgow and NHS Greater and Clyde, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | - Bridget Johnston
- Clinical Professor of Nursing and Palliative Care, School of Medicine, Dentistry & Nursing, University of Glasgow and NHS Greater and Clyde, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
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Berry E, Skea ZC, Campbell MK, Locock L. ‘Using humanity to change systems’ – understanding the work of online feedback moderation: A case study of Care Opinion Scotland. Digit Health 2022; 8:20552076211074489. [PMID: 35223075 PMCID: PMC8874190 DOI: 10.1177/20552076211074489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To gain a deeper understanding of online patient feedback moderation through the organisation of Care Opinion in Scotland. Methods An ethnographic study, initially using in-person participant observations, switching to remote methods due to the pandemic. This involved the use of remote observations and interviews. Interviews were carried out with the whole Scottish team (n = 8). Results Our results identify three major themes of work found in online patient feedback moderation. The first is process work, where moderators make decisions on how to edit and publish stories. The second is emotional labour from working with healthcare experiences and with NHS staff. The third is the brokering/mediation role of Care Opinion, where they must manage the relationships between authors, subscribing healthcare providers and Scottish Government. Our results also capture that these different themes are not independent and can at times influence the others. Conclusion Our results build on previous literature on Care Opinion and provide novel insights into the emotional and brokering/mediation work they undertake. Care Opinion holds a unique position, where they must balance the interests of the key stakeholders. Care Opinion holds the power to amplify authors’ voices but the power to make changes to services lies with NHS staff and services. Online moderation work is complex, and moderators require support to carry out their work especially given the emotional impact. Further research is planned to understand how patient stories are used by NHS Scotland, and the emotional labour involved with stories, from both the author and NHS staff perspective.
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Affiliation(s)
- Emma Berry
- Health Services Research Unit, University of Aberdeer, Aberdeen, UK
| | - Zoë C Skea
- Health Services Research Unit, University of Aberdeer, Aberdeen, UK
| | | | - Louise Locock
- Health Services Research Unit, University of Aberdeer, Aberdeen, UK
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9
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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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Baines R, Underwood F, O'Keeffe K, Saunders J, Jones RB. Implementing online patient feedback in a 'special measures' acute hospital: A case study using Normalisation Process Theory. Digit Health 2021; 7:20552076211005962. [PMID: 33868704 PMCID: PMC8020246 DOI: 10.1177/20552076211005962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/06/2021] [Indexed: 11/30/2022] Open
Abstract
Objective Online patient feedback is becoming increasingly prevalent on an
international scale. However, limited research has explored how healthcare
organisations implement such feedback. This research sought to explore how
an acute hospital, recently placed into ‘special measures’ by a regulatory
body implemented online feedback to support its improvement journey. Methods Semi-structured interviews were conducted with eleven key stakeholders
involved in the implementation and/or use of online patient feedback. Data
was analysed using deductive thematic analysis with Normalisation Process
Theory used as the analytical framework. Research findings are translated
into the Engage, Support and Promote (ESP) model, a model of rapid feedback
adoption. Results Participants viewed the implementation of online feedback as an opportunity
to learn, change and improve. Factors found to facilitate implementation
were often linked to engagement, support and promotion. Although less
frequently described, barriers to implementation included staff anxieties
about time pressures, moderation processes and responding responsibilities.
Such anxieties were often addressed by activities including the provision of
evidence based responder training. Overall, staff were overwhelmingly
positive about the value of online feedback with 24 impacts identified at an
individual and organisational level, including the ability to boost staff
morale, resilience and pride. Conclusions The rapid implementation of online patient feedback can be achieved in a
‘special measures’ organisation. However, the difficulties of implementing
such feedback should not be underestimated. In order to embed online
feedback, staff members need to be engaged and feel supported, with
opportunities to provide, respond and invite patient feedback frequently
promoted to both patients and staff members.
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Affiliation(s)
- Rebecca Baines
- Centre for Health Technology, University of Plymouth, Plymouth, UK
| | - Frazer Underwood
- South West Clinical School in Cornwall, University of Plymouth and Royal Cornwall Hospital NHS Trust.,Royal Cornwall Hospital NHS Trust, Truro, UK.,Centre for Innovations in Health and Social Care: A JBI Centre of Excellence, University of Plymouth, UK
| | - Kim O'Keeffe
- South West Clinical School in Cornwall, University of Plymouth and Royal Cornwall Hospital NHS Trust.,Royal Cornwall Hospital NHS Trust, Truro, UK
| | | | - Ray B Jones
- Centre for Health Technology, University of Plymouth, Plymouth, UK
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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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