Using patient comments from a standardised experience survey to investigate their perceptions and prioritise improvement actions: a thematic and syntactic analysis

BACKGROUND

Although patient experience surveys flourish in many countries with the aim to improve quality of care, questions remain concerning their ability to become effective drivers of change within institutions. The patient comments from the French national patient experience hospital survey were analysed using an innovative structured approach to characterise patient experience and identify field actions for the institutions.

METHODS

The comments were taken from the two open-ended questions comprised in the patient experience survey of the Hospices Civils de Lyon between 2018 and 2019. The comments analysis methodology consisted in three steps: thematic analysis; syntactic analysis; generation of statistics for the creation of a patient journey and prioritisation of sub-themes. The STROBE statement checklist was followed.

RESULTS

Over a year, 79.7% of the 7 362 respondents left at least one comment at the end of the survey and were included in the study, for a total of 5 868 surveys and 10 061 comments. These led to the identification of 28 general themes and 184 specific sub-themes. From the patient journey created, 23 sub-themes were prioritised and gathered into four key categories: relationship between patient and staff; environment; surgery and pain management; information and care coordination. For each of them, the actions and expectations formulated by the respondents were described.

CONCLUSIONS

The analysis of patient comments obtained from a standardised survey allowed to characterise the patient journey using data that describes patient experience, enabling a prioritisation of actions aiming to improve practice and quality of care at the institution, department, and staff level.

[E-Satis : A new method for analysis of Patient-Reported Outcome Measures (PROMs)]

OBJECTIVE

Almost 80% of the patients responding to the nationwide French patient experience and satisfaction survey (e-Satis) provided free text comments. The objective of this article is to describe an innovative methodology for analysis of this qualitative data.

METHODOLOGY

This methodological approach is based on analysis of qualitative data from the comments (verbatims) of respondents to the e-Satis survey. Analysis of the verbatims consists in three main steps: (i) analysis of the meaning of the words, with constitution of a thematic dictionary through exploratory research without preconceived notions; (ii) analysis of the syntax, i.e., the way in which the ideas are articulated, which will enable calculation of a linguistic indicator of speakers' involvement in their speech; (iii) production of statistics and characterisation of the themes, which will include three indicators: occurrence of the themes, the average satisfaction shown in the respondents' discourse, and the positive and negative involvement with which they express themselves. Given these results, a priority matrix of four categories of action is established: strong points, priority areas, good practices, and weak signals.

RESULTS

This methodological approach was applied to 5868 e-Satis questionnaires out of a total of 10,061 verbatims by respondents hospitalised at the Hospices Civils de Lyon between 2018 and 2019. The analysis identified 28 major themes with 184 sub-themes. An extract is presented in this article for illustration purposes.

DISCUSSION

A methodological approach based on analysis of qualitative data will enable transformation of unstructured data (verbatims) into measurable and comparable data. This methodology is structured to overcome the limitations of closed questions; open questions allow respondents to describe their experiences and perceptions in their own words. Moreover, it is a first step toward comparability of results over time with those of other establishments. This approach is unique in France on account of (a) its exploratory thematic research without preconceived notions and (b) its syntactic analysis of verbatims.

CONCLUSIONS

This verbatim analysis methodology should enable precise and operational characterization of Patient Experience and induce prioritized improvement actions in healthcare institutions.

Studying both patient and staff experience to investigate their perceptions and to target key interactions to improve: a scoping review

OBJECTIVE

The improvement of patient experience (PE) is related to the experience of staff caring for them. Yet there is little evidence as to which interactions matter the most for both patients and staff, or how they are perceived by them. We aimed to summarise the interactions and the perceptions between patients and staff from studies by using both patient and staff experience data in healthcare institutions.

DESIGN

Scoping review.

METHODS

We conducted a scoping review, including studies dealing with PE and staff experience. Two authors independently reviewed each title/abstract and the selected full-text articles. A list of variables (objective, study design, data sources, tools used, results, interactions, perceptions and actions) was charted and summarised using a narrative approach including both qualitative and quantitative data. Studies were grouped according to their objective and the key interactions summarised according to this stratification. The perceptions of patients and staff were identified in the results of selected studies and were classified into four categories: commonalities and disagreements of perceptions, patients' perceptions not perceived by professionals and professional's perceptions not perceived by patients.

RESULTS

A total of 42 studies were included. The stratification of studies by type of objective resulted in six groups that allowed to classify the key interactions (n=154) identified in the results of the selected studies. A total of 128 perceptions related to interaction between patient and staff were reported with the following distribution: commonalities (n=35), disagreements (n=18), patients' perceptions not perceived by professionals (n=47) and professional's perceptions not perceived by patients (n=28). We separated positive and negative perceptions, which resulted in seven scenarios, each with actions that can be carried out for one or both populations to overcome barriers.

CONCLUSION

The study of both patient and staff experience allowed the identification of actions that can be taken to change the perceptions of patients and staff.