Is There a Mismatch Between the Perspectives of Patients and Regulators on Healthcare Quality? A Survey Study

Bouwman, Renée; Bomhoff, Manja; Robben, Paul; Friele, R.D.

doi:10.1097/pts.0000000000000413

Cited by 15 publications

(35 citation statements)

References 23 publications

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“…Previous research suggests that patients and families who make a formal complaint primarily desire two outcomes: a patient-centric response (eg, an explanation of how the incident could have happened) and system-level quality improvement (eg, to prevent errors from happening to others) 18–26. The existing literature suggests, however, that healthcare complaints practice has not yet been successful at achieving the complex dual role of case-by-case handling and system-wide improvement 16 17 27.…”

Section: Introductionmentioning

confidence: 99%

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

et al. 2020

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IntroductionA global rise in patient complaints has been accompanied by growing research to effectively analyse complaints for safer, more patient-centric care. Most patients and families complain to improve the quality of healthcare, yet progress has been complicated by a system primarily designed for case-by-case complaint handling.AimTo understand how to effectively integrate patient-centric complaint handling with quality monitoring and improvement.MethodLiterature screening and patient codesign shaped the review’s aim in the first stage of this three-stage review. Ten sources were searched including academic databases and policy archives. In the second stage, 13 front-line experts were interviewed to develop initial practice-based programme theory. In the third stage, evidence identified in the first stage was appraised based on rigour and relevance, and selected to refine programme theory focusing on what works, why and under what circumstances.ResultsA total of 74 academic and 10 policy sources were included. The review identified 12 mechanisms to achieve: patient-centric complaint handling and system-wide quality improvement. The complaint handling pathway includes (1) access of information; (2) collaboration with support and advocacy services; (3) staff attitude and signposting; (4) bespoke responding; and (5) public accountability. The improvement pathway includes (6) a reliable coding taxonomy; (7) standardised training and guidelines; (8) a centralised informatics system; (9) appropriate data sampling; (10) mixed-methods spotlight analysis; (11) board priorities and leadership; and (12) just culture.DiscussionIf healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this.

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Section: Introductionmentioning

confidence: 99%

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

et al. 2020

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“…This claim is supported by the evaluations of experiments included in our study. The fact that the information provided by users introduces an additional, and different, perspective, also means that it can clash with the perspective of, for instance, professionals or regulators (6,16,39,54). Our findings suggest that the input of users has sometimes been put aside by questioning its legitimacy.…”

Section: Unpacking the Landscape Of User Involvement In Regulationmentioning

confidence: 83%

“…This might warrant changes in procedures and regulatory frameworks as patients and regulators can have different values and perspectives (e.g. what counts as an incident, how quality of care should be judged) (6,16,45,54). In this regard, it should be emphasized that participation on its own does not necessarily lead to increased patient-centeredness or learning (2,23).…”

Section: Unpacking the Landscape Of User Involvement In Regulationmentioning

confidence: 99%

What methods are used to promote patient and family involvement in healthcare regulation? A case study across four countries

Wiig

Rutz

Boyd

et al. 2020

Preprint

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Background In healthcare regulation, the subject of patient and family involvement figures increasingly prominently on the agenda. However, the literature on involving patient and families in regulation is still in its infancy. A systematic analysis of how patient and family involvement in regulation is accomplished across different health systems is lacking. We provide such an overview by mapping and classifying methods of patient and family involvement in regulatory practice in four countries; Norway, England, the Netherlands, and Australia. We thus provide a knowledge base that enables discussions about possible types of involvement, and advantages and difficulties of involvement encountered in practice.Methods The research design was a multiple case study of patient and family involvement in regulation in four countries. The authors collected 1) academic literature if available and 2) documents of regulators that describe user involvement. Based on the data collected, the authors from each country completed a pre-agreed template to describe the involvement methods. The following information was extracted and included if available: 1) Method of involvement, 2) Type of regulatory activity, 3) Purpose of involvement, 4) Who is involved and 5) Lessons learnt.Results Our mapping of involvement methods showed a range of methods being used in regulation, which we classified into four categories: individual proactive, individual reactive, collective proactive, and collective reactive methods. Reported advantages include: increased quality of regulation, increased legitimacy, perceived justice for those affected, and empowerment. Difficulties were also reported concerning: how to incorporate the input of users in decisions, the fact that not all users want to be involved, time and costs required, organizational procedures standing in the way of involvement, and dealing with emotions.Conclusions Our mapping of user involvement methods found a broad variety of involvement methods. These can serve as inspiration to regulators in healthcare. The paper shows that making involvement in regulation successful is a challenging and complex task. The fact that regulators are experimenting with different methods can be valued positively in this regard.

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“…Also, it is not clear how to use information from experts-by-experience. This is especially important if involvement is conducted to comply with political expectations and not as a way of improving the quality of regulatory activities (31,53). In many cases, information provided by users introduces an additional, and different, perspective, but this also means that it can clash with the perspective of, for instance, professionals or regulators (6,16,39,54).…”

Section: Regulators Used Methods In All Four Categories Identi Ed In mentioning

confidence: 99%

“…An important question to re ect on is how to conduct training of users, patients, family members, and inspectors to succeed with involvement in regulation (12). The danger is that such training may lead to the professionalization of patient input, which can distance the participants from their experiences as patients (53). This is problematic because tapping into these experiences is often considered the most important reason for involvement (2,64).…”

Section: Regulators Used Methods In All Four Categories Identi Ed In mentioning

confidence: 99%

What methods are used to promote patient and family involvement in healthcare regulation? A case study across four countries

Wiig

Rutz

Boyd

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In the regulation of healthcare, the subject of patient and family involvement figures increasingly prominently on the agenda. However, the literature on involving patients and families in regulation is still in its infancy. A systematic analysis of how patient and family involvement in regulation is accomplished across different health systems is lacking. We provide such an overview by mapping and classifying methods of patient and family involvement in regulatory practice in four countries; Norway, England, the Netherlands, and Australia. We thus provide a knowledge base that enables discussions about possible types of involvement, and advantages and difficulties of involvement encountered in practice. Methods: The research design was a multiple case study of patient and family involvement in regulation in four countries. The authors collected 1) academic literature if available and 2) documents of regulators that describe user involvement. Based on the data collected, the authors from each country completed a pre-agreed template to describe the involvement methods. The following information was extracted and included where available: 1) Method of involvement, 2) Type of regulatory activity, 3) Purpose of involvement, 4) Who is involved and 5) Lessons learnt.Results: Our mapping of involvement strategies showed a range of methods being used in regulation, which we classified into four categories: individual proactive, individual reactive, collective proactive, and collective reactive methods. Reported advantages included: increased quality of regulation, increased legitimacy, perceived justice for those affected, and empowerment. Difficulties were also reported concerning: how to incorporate the input of users in decisions, the fact that not all users want to be involved, time and costs required, organizational procedures standing in the way of involvement, and dealing with emotions. Conclusions: Our mapping of user involvement strategies establishes a broad variety of ways to involve patients and families. The four categories can serve as inspiration to regulators in healthcare. The paper shows that stimulating involvement in regulation is a challenging and complex task. The fact that regulators are experimenting with different methods can be viewed positively in this regard.

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Is There a Mismatch Between the Perspectives of Patients and Regulators on Healthcare Quality? A Survey Study

Cited by 15 publications

References 23 publications

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

What methods are used to promote patient and family involvement in healthcare regulation? A case study across four countries

What methods are used to promote patient and family involvement in healthcare regulation? A case study across four countries

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