Monday, 16 March 8-9pm #nihrptexp
Patients are at the heart of healthcare and so their feedback on the care they receive are an essential element of understanding and improving services. But collecting and acting on patient feedback is not always straightforward. A recent review of the evidence by the NIHR Dissemination Centre, Improving Care by Using Patient Feedback, found that there is a lack of clarity amongst staff and patients around the purpose of collecting feedback and how it is used to improve care.
The NHS excels in collecting certain kinds of patient experience data, with the national in-patient survey in England being one of the first of its kind in the world when introduced in 2001. Scotland introduced a national survey in 2010, Wales in 2013 and Northern Ireland in 2014. It is less clear how the national survey has triggered improvement. Feedback is also collected through complaint systems but Liu et al (2019) found that an emphasis on ‘putting out fires’ may detract from using them to improve care for future patients.
Concerns about the ‘reliability’ of feedback means that staff are often unsure how to deal with unsolicited feedback (such as that left online) and feedback from vulnerable people, including those with acute mental health problems, is seldom heard.
The review also found that staff who deliver care don’t always see the feedback. When they do, it is not presented in a way they can not make sense of it. And when they do see good summaries, they may not have the skills and resources to make improvements. As yet unpublished work by Gillespie (2019) suggests that there is an association between defensiveness in staff responses to online feedback and the summary hospital mortality indicator, possibly revealing a broader hospital culture which blocks critical, but potentially important, information moving from patients to staff.
Patient experience is deeply personal and cannot be translated into an average experience. Using survey averages can give a misleading impression and looking at outlying experiences is more useful for service improvement than triangulating data into a single truth.
How can we take these research finding and use them to ensure patient experience feedback is central to assessing and improving care, and assuring that all healthcare organisations are doing this well? A tweet jointly hosted by Elaine Maxwell of NIHR DC and Lesley Goodburn of NHS England and NHS Improvement on Monday, 16 March at 8pm hopes to provide some answers.
@NIHRevidence @lgoodbu #nihrptexp
- Why do some organisations embrace online patient feedback and others do not?
- Why is some feedback described as ‘anecdote’ and other feedback as ‘data’? Who decides which is which?
- How do we integrate unsolicited patient feedback into quality improvement and safety practices?
- What support do staff working directly with staff need to help them make change based on patient feedback