Investigating the Potential Contribution of Patient Rating Sites to Hospital Supervision: Exploratory Results From an Interview Study in the Netherlands

Abstract

BackgroundOver the last decades, the patient perspective on health care quality has been unconditionally integrated into quality management. For several years now, patient rating sites have been rapidly gaining attention. These offer a new approach toward hearing the patient’s perspective on the quality of health care.ObjectiveThe aim of our study was to explore whether and how patient reviews of hospitals, as reported on rating sites, have the potential to contribute to health care inspector’s daily supervision of hospital care.MethodsGiven the unexplored nature of the topic, an interview study among hospital inspectors was designed in the Netherlands. We performed 2 rounds of interviews with 10 senior inspectors, addressing their use and their judgment on the relevance of review data from a rating site.ResultsAll 10 Dutch senior hospital inspectors participated in this research. The inspectors initially showed some reluctance to use the major patient rating site in their daily supervision. This was mainly because of objections such as worries about how representative they are, subjectivity, and doubts about the relevance of patient reviews for supervision. However, confrontation with, and assessment of, negative reviews by the inspectors resulted in 23% of the reviews being deemed relevant for risk identification. Most inspectors were cautiously positive about the contribution of the reviews to their risk identification.ConclusionsPatient rating sites may be of value to the risk-based supervision of hospital care carried out by the Health Care Inspectorate. Health care inspectors do have several objections against the use of patient rating sites for daily supervision. However, when they are presented with texts of negative reviews from a hospital under their supervision, it appears that most inspectors consider it as an additional source of information to detect poor quality of care. Still, it should always be accompanied and verified by other quality and safety indicators. More research on the value and usability of patient rating sites in daily hospital supervision and other health settings is needed.

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

“…The CQC additionally took advantage of a data sharing partnership with other websites collecting intelligence from users that is then used by the regulator. First, the primary espoused reason for involvement is improving regulatory work, and by consequence improving the quality and safety of care (5,16,17,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38). In this view, patients and families are seen as an additional information source.…”

“…42 43, 44, 45). Also, by analyzing reviews written on an independent patient rating website and social media posts, the regulator may identify risks from the patient's perspective (26,27,28,46,47,48,49).…”

“…It is regularly argued that patients lack the necessary knowledge to contribute, and less weight is given to their input than, for instance, the input of professionals (e.g. in case of incident investigations, theme based inspections or experts-by-experience) (6,12,13,14,16,23,26,42,39). As described earlier, the main argument for involvement is that patients and families provide additional information.…”

“…There are also ways to include users, patient, and family perspectives based on existing information which can be capitalized on (5). For example, using social media as a way to trace problems in health care, or by aggregating information from patient complaints and text mining to search for new types of risks and topics for future inspections (26,27,28,29,48,49,61,62,63). While uniquely representing quality of care from a patient's point of view, however, this requires further reflection on methodological issues such as the reliability and validity of these (public) resources.…”

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

“…The CQC additionally took advantage of a data sharing partnership with other websites collecting intelligence from users that is then used by the regulator. First, the primary espoused reason for involvement is improving regulatory work, and by consequence improving the quality and safety of care (5,16,17,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38). In this view, patients and families are seen as an additional information source.…”