Nurses' perceptions of feedback from cardiac rehabilitation registries: a qualitative study across the UK and Denmark

Abstract

Background/Aims Feedback on performance is a widely used strategy aiming to improve quality of care; however, limited research exists regarding nurses' perceptions of feedback. This article explores cardiac rehabilitation nurse leads' perceptions of the feedback provided through two national registries. Method This was a qualitative study which used semi-structured interviews. Cardiac rehabilitation nurses (n=12) were strategically recruited across the UK and Denmark. The transcribed interviews were analysed using content analysis, and differences and similarities were identified. Results Overall, five themes emerged; accessibility, reliability, usefulness, relevance and attitudes towards public reporting. In the UK, the nurses perceived that data regarding feedback were accessible, trustworthy, useful and reflected the important elements in cardiac rehabilitation. However, in Denmark, the nurses perceived that feedback data were unavailable, had reliability issues and only partly reflected the important aspects of cardiac rehabilitation. Nurses in both countries were ambivalent towards public reporting. Conclusions In order to facilitate high quality service delivery and improvement, registries should consider cardiac rehabilitation nurse leads' perceptions when delivering feedback.

Qualitative study measuring the usability of the International Cardiac Rehabilitation Registry

“…Results of this study are concordant with the two other studies on the usability of CR registries, and many other studies on the usability of health registries or other health technologies more broadly 46–50. For instance, a qualitative study in Denmark and the UK established the perceived utility of CR registry feedback mechanisms 31. Another qualitative study in the same countries highlighted CR registry adoption and implementation issues around data entry processes, resources and management support, and quality improvement 32…”

“…[46][47][48][49][50] For instance, a qualitative study in Denmark and the UK established the perceived utility of CR registry feedback mechanisms. 31 Another qualitative study in the same countries highlighted CR registry adoption and implementation issues around data entry processes, resources and management support, and quality improvement. 32 The implications of this study in terms of revisions to optimise the utility of the ICRR have been outlined above.…”

“…The subsequent interview guide was developed by the senior author, and input was integrated from ICRR Executive (see online supplemental appendix S1). Based on previous knowledge31 32 and informed by theory,21 the interview questions aimed to invite variation on the following parameters: registry adoption (eg, effort expectancy for approvals, patient consent), perceived ease of use/operability, system characteristics such as variables and patient report, as well as perceived usefulness of ICRR output to support quality improvement and other programme needs. We strived to keep the interviews open to incite participants to tell us as freely as possible about important aspects of adopting and using the registry seen from their point of view.…”

Pilot testing of the International Council of Cardiovascular Prevention and Rehabilitation Registry

“…While the value of registries has been established [ 13 ], previous research highlights the need for quality to ensure that the registry can fulfill its’ intended purpose [ 14 , 15 ]. Other research has highlighted the challenges of implementing registries, including in the CR setting specifically [ 16 ], and the importance of ensuring their utility to end-users to support participation [ 17 ]. Therefore, it is important to field test implementation in these settings to identify issues.…”

Development of the International Cardiac Rehabilitation Registry Including Variable Selection and Definition Process

“…Moreover, we know there are biases in patient access to CR [ 52 ], and hence also patients in the registry may not be representative of the average cardiac patient in these settings. Second, target CR programs may have difficulty participating due the fact that they have few resources, and due to known barriers to CR registry uptake [ 53 54 ]. ICRR will be available to sites at no cost, and interested sites will be thoroughly informed about the resources needed to participate and supported in participating prior to on-boarding.…”