Instruments to assess patient satisfaction after teleconsultation and triage: a systematic review

Iseli, Martina Allemann; Kunz, Regina; Blozik, Eva

doi:10.2147/ppa.s56160

Cited by 17 publications

(18 citation statements)

References 42 publications

(207 reference statements)

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“…8,282 Preliminary work highlighted the need to make minor modifications to three of the four GP Patient Survey items to improve comprehension by service users' and response options. The modified GP Patient Survey item set (entry access, timeliness of care, confidence and trust and overall experience) formed a single scale, which summarised the two-domain structure of the OPQ moderately well.…”

Section: Discussionmentioning

confidence: 99%

“…The Out-of-hours Patient Questionnaire (OPQ) is a complementary tool to the GP Patient Survey, which collects more detailed information on patient experience of out-of-hours care and has undergone more extensive testing and validation. 8,90,282 The second workstream tested the performance of GP Patient Survey out-of-hours questions against data derived from the OPQ to examine the validity of GP Patient Survey items.…”

Section: 83281mentioning

confidence: 99%

“…In the first stage, preliminary psychometric testing of the out-of-hours items was undertaken through cognitive interviews, combined with a pilot survey of out-of-hours users to test survey methods. The second stage tested the hypothesis that the GP Patient Survey items (modified after piloting) would demonstrate construct validity if together the GP Patient Survey items were correlated with the two known subscales of the OPQ (an established, valid and reliable measure of patient experience 8,282 ). Concurrent validity would be established if the thematically relevant OPQ items were found to be associated with each of the GP Patient Survey items in linear regression modelling.…”

Section: Study Aims and Objectivesmentioning

confidence: 99%

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Improving patient experience in primary care: a multimethod programme of research on the measurement and improvement of patient experience

Burt

Campbell

Abel

et al. 2017

Programme Grants Appl Res

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BackgroundThere has been an increased focus towards improving quality of care within the NHS in the last 15 years; as part of this, there has been an emphasis on the importance of patient feedback within policy, through National Service Frameworks and the Quality and Outcomes Framework. The development and administration of large-scale national patient surveys to gather representative data on patient experience, such as the national GP Patient Survey in primary care, has been one such initiative. However, it remains unclear how the survey is used by patients and what impact the data may have on practice.ObjectivesOur research aimed to gain insight into how different patients use surveys to record experiences of general practice; how primary care staff respond to feedback; and how to engage primary care staff in responding to feedback.MethodsWe used methods including quantitative survey analyses, focus groups, interviews, an exploratory trial and an experimental vignette study.Results(1)Understanding patient experience data. Patients readily criticised their care when reviewing consultations on video, although they were reluctant to be critical when completing questionnaires. When trained raters judged communication during a consultation to be poor, a substantial proportion of patients rated the doctor as ‘good’ or ‘very good’. Absolute scores on questionnaire surveys should be treated with caution; they may present an overoptimistic view of general practitioner (GP) care. However, relative rankings to identify GPs who are better or poorer at communicating may be acceptable, as long as statistically reliable figures are obtained. Most patients have a particular GP whom they prefer to see; however, up to 40% of people who have such a preference are unable regularly to see the doctor of their choice. Users of out-of-hours care reported worse experiences when the service was run by a commercial provider than when it was run by a not-for profit or NHS provider. (2)Understanding patient experience in minority ethnic groups. Asian respondents to the GP Patient Survey tend to be registered with practices with generally low scores, explaining about half of the difference in the poorer reported experiences of South Asian patients than white British patients. We found no evidence that South Asian patients used response scales differently. When viewing the same consultation in an experimental vignette study, South Asian respondents gave higher scores than white British respondents. This suggests that the low scores given by South Asian respondents in patient experience surveys reflect care that is genuinely worse than that experienced by their white British counterparts. We also found that service users of mixed or Asian ethnicity reported lower scores than white respondents when rating out-of-hours services. (3)Using patient experience data. We found that measuring GP–patient communication at practice level masks variation between how good individual doctors are within a practice. In general practices and in out-of-hours centres, staff were sceptical about the value of patient surveys and their ability to support service reconfiguration and quality improvement. In both settings, surveys were deemed necessary but not sufficient. Staff expressed a preference for free-text comments, as these provided more tangible, actionable data. An exploratory trial of real-time feedback (RTF) found that only 2.5% of consulting patients left feedback using touch screens in the waiting room, although more did so when reminded by staff. The representativeness of responding patients remains to be evaluated. Staff were broadly positive about using RTF, and practices valued the ability to include their own questions. Staff benefited from having a facilitated session and protected time to discuss patient feedback.ConclusionsOur findings demonstrate the importance of patient experience feedback as a means of informing NHS care, and confirm that surveys are a valuable resource for monitoring national trends in quality of care. However, surveys may be insufficient in themselves to fully capture patient feedback, and in practice GPs rarely used the results of surveys for quality improvement. The impact of patient surveys appears to be limited and effort should be invested in making the results of surveys more meaningful to practice staff. There were several limitations of this programme of research. Practice recruitment for our in-hours studies took place in two broad geographical areas, which may not be fully representative of practices nationally. Our focus was on patient experience in primary care; secondary care settings may face different challenges in implementing quality improvement initiatives driven by patient feedback. Recommendations for future research include consideration of alternative feedback methods to better support patients to identify poor care; investigation into the factors driving poorer experiences of communication in South Asian patient groups; further investigation of how best to deliver patient feedback to clinicians to engage them and to foster quality improvement; and further research to support the development and implementation of interventions aiming to improve care when deficiencies in patient experience of care are identified.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Discussionmentioning

confidence: 99%

Section: 83281mentioning

confidence: 99%

Section: Study Aims and Objectivesmentioning

confidence: 99%

See 1 more Smart Citation

Improving patient experience in primary care: a multimethod programme of research on the measurement and improvement of patient experience

Burt

Campbell

Abel

et al. 2017

Programme Grants Appl Res

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“…Therefore we developed the questionnaire based on the review of the literature, utilised in a previous study. There is a need for development of a standard questionnaire for evaluating satisfaction of various stakeholders with video consultation [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital

Martin‐Khan

Fatehi

Kezilas

et al. 2015

BMC Health Serv Res

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BackgroundThe Princess Alexandra Hospital Telehealth Centre (PAH-TC) is a project jointly funded by the Australian national government and Queensland Health. It seeks to provide a whole-of-hospital telehealth service using videoconferencing and store-and-forward capabilities for a range of specialities. The aim of this study was to investigate whether the introduction of a new telehealth coordination service provided by a tertiary hospital centre increased telehealth activities of a tertiary hospital. Evaluation included service delivery records and stakeholder satisfaction.MethodsTelehealth service delivery model before and after the establishment of the centre is described as well as the project implementation. The study retrieved data related to the number and scope of previous, and current, telehealth service episodes, to ascertain any change in activity levels following the introduction of the new telehealth coordination service. In addition, using a cross-sectional research design, the satisfaction of patients, clinicians and administrators was surveyed. The survey focused on technical utility and perceived clinical validity.ResultsIntroduction of a new centralised telehealth coordination service was associated with an increase in the scope of telehealth from five medical disciplines, in the year before the establishment, to 34 disciplines two years after the establishment. The telehealth consultations also increases from 412 (the year before), to 735 (one year after) and 1642 (two years after) the establishment of the centre. Respondents to the surveys included patients (27), clinicians who provided the consultations (10) and clinical or administrative staff who hosted the telehealth consultations in the remote site (8). There were high levels of agreement in relation to the telehealth option saving time and money, and an important health service delivery model. There was evidence from the remote site that modifying roles to incorporate this new service was challenging.ConclusionThe introduction of a centralised coordination for telehealth service of a tertiary hospital was associated with the increase in the scope and level of telehealth activity of the hospital. The project and model of health care delivery described in this paper can be adopted by tertiary hospitals to grow their telehealth activities, and potentially reduce costs associated with the delivery of services at a distance.

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“…9 The OPQ was highlighted as having had rigorous development and good psychometric properties by a recent systematic review of instruments assessing patient satisfaction following teleconsultation and triage. 10 In addition, the OPQ covers the entirety of service users' experience of out-of-hours care; from the decision to make contact through to the completion of their care management, allowing assessment of how comprehensive the GPPS items are. The OPQ has been used previously for capturing service users' experiences of out-of-hours care.…”

Section: Introductionmentioning

confidence: 99%

Establishing the validity of English GP Patient Survey items evaluating out-of-hours care

et al. 2015

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BackgroundA 2014 national audit used the English General Practice Patient Survey (GPPS) to compare service users’ experience of out-of-hours general practitioner (GP) services, yet there is no published evidence on the validity of these GPPS items.ObjectivesEstablish the construct and concurrent validity of GPPS items evaluating service users’ experience of GP out-of-hours care.MethodsCross-sectional postal survey of service users (n=1396) of six English out-of-hours providers. Participants reported on four GPPS items evaluating out-of-hours care (three items modified following cognitive interviews with service users), and 14 evaluative items from the Out-of-hours Patient Questionnaire (OPQ). Construct validity was assessed through correlations between any reliable (Cochran's α>0.7) scales, as suggested by a principal component analysis of the modified GPPS items, with the ‘entry access’ (four items) and ‘consultation satisfaction’ (10 items) OPQ subscales. Concurrent validity was determined by investigating whether each modified GPPS item was associated with thematically related items from the OPQ using linear regressions.ResultsThe modified GPPS item-set formed a single scale (α=0.77), which summarised the two-component structure of the OPQ moderately well; explaining 39.7% of variation in the ‘entry access’ scores (r=0.63) and 44.0% of variation in the ‘consultation satisfaction’ scores (r=0.66), demonstrating acceptable construct validity. Concurrent validity was verified as each modified GPPS item was highly associated with a distinct set of related items from the OPQ.ConclusionsMinor modifications are required for the English GPPS items evaluating out-of-hours care to improve comprehension by service users. A modified question set was demonstrated to comprise a valid measure of service users’ overall satisfaction with out-of-hours care received. This demonstrates the potential for the use of as few as four items in benchmarking providers and assisting services in identifying, implementing and assessing quality improvement initiatives.

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Instruments to assess patient satisfaction after teleconsultation and triage: a systematic review

Cited by 17 publications

References 42 publications

Improving patient experience in primary care: a multimethod programme of research on the measurement and improvement of patient experience

Improving patient experience in primary care: a multimethod programme of research on the measurement and improvement of patient experience

Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital

Establishing the validity of English GP Patient Survey items evaluating out-of-hours care

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