Systematic review of approaches to using patient experience data for quality improvement in healthcare settings

Abstract

ObjectivesExplore how patient-reported experience measures (PREMs) are collected, communicated and used to inform quality improvement (QI) across healthcare settings.DesignSystematic review.SettingVarious primary and secondary care settings, including general practice, and acute and chronic care hospitals.ParticipantsA full range of patient populations from (children through to the elderly) and staff (from healthcare practitioners to senior managers).MethodsScientific databases were searched (CINAHL, PsycINFO, MEDLINE and Cochrane Libraries) as was grey literature. Qualitative and quantitative studies describing collection of PREM data and subsequent QI actions in any healthcare setting were included. Risk of bias was assessed using established criteria. Of 5312 initial hits, 32 full texts were screened, and 11 were included.ResultsPatient experience data were most commonly collected through surveys and used to identify small areas of incremental change to services that do not require a change to clinician behaviour (eg, changes to admission processes and producing educational materials). While staff in most studies reported having made effective improvements, authors struggled to identify what those changes were or the impact they had.ConclusionsFindings suggest there is no single best way to collect or use PREM data for QI, but they do suggest some key points to consider when planning such an approach. For instance, formal training is recommended, as a lack of expertise in QI and confidence in interpreting patient experience data effectively may continue to be a barrier to a successful shift towards a more patient-centred healthcare service. In the context of QI, more attention is required on how patient experience data will be used to inform changes to practice and, in turn, measure any impact these changes may have on patient experience.

Consumer preference to utilise a mobile health app: A stated preference experiment

“…Overall, these negative associations conveyed a withdrawal of participants' willingness to use the app when their personal information reaches the public domain, or when the intention to use of their data is unclear. The results from this study suggest that individuals are more willing to share sensitive information, if the use of their data was to support research activity and or could have the potential to reduce medical errors [22,26,42].…”

“…Existing literature identified three overarching themes into which barriers and enablers of digital technology uptake were categorised. These three themes were broadly: service delivery to consumers [2, [16][17][18][19][20][21]; technology facilitation by staff members [2, 13,[22][23][24][25][26][27]; and strategic organisational factors [1-3, 18, 22, 24, 28-30]. The barriers and enablers identified were dependent on the purpose and objectives of each study.…”

Patient experiences with care across various types of mental health care: Questionnaire development, measurement invariance, and patients' reports

“…This is not surprising, since designing specific interventions to improve patient experience in daily practice is a yet to be accomplished mission. Two systematic reviews recently concluded that actual interventions to improve patient experiences are rare (Davidson et al, ; Gleeson et al, ). Also in Belgium, patient experiences, although frequently measured, have not been part of any formal quality improvement method.…”

Reflection in practice: How can patient experience feedback trigger staff reflection in hospital acute care settings?

“…Around one‐third of patient complaints relate to staff‐patient relationships such as communication, empathy, courtesy, consideration and compassion demonstrated by front‐line staff; these aspects of care are critical for positive patient experiences . Evidence suggests, however, that patient experience data currently available in the NHS tend to be used to stimulate changes in care processes which are technical in nature, rather than tackling the more difficult task of changing clinician behaviour …”

“…[5][6][7] Evidence suggests, however, that patient experience data currently available in the NHS tend to be used to stimulate changes in care processes which are technical in nature, rather than tackling the more difficult task of changing clinician behaviour. 8 Although staff are unlikely to intentionally behave in ways that are detrimental to the patient experience, they may lack insight into how their behaviours affect patients or how to modify those behaviours. One approach for promoting insight and change is reflective learning.…”