The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders

Abstract

Background Engaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders’ experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use. Methods Semi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study. Results Twenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1) overcoming barriers to engagement, 2) consumer-initiated engagement; 3) breadth vs depth of engagement, 4) organisational transparency vs control and 5) users causing harm. Conclusions Social media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.

Refining a capability development framework for building successful consumer and staff partnerships in healthcare quality improvement: A coproduced eDelphi study

“…However, the results represent the lived experience of both healthcare staff and consumers who are experienced in QI partnerships and reflect literature that highlights the tokenistic nature of many CCI efforts in QI. 8,41,42 Despite the differences in importance ratings, overall the study indicated that the framework is applicable to both stakeholder groups, as only one capability description (regarding implementation of QI processes and practices), did not meet the threshold for inclusion for consumers. Additionally, statistical analyses indicated that staff and consumer participants rated items in the same way suggesting that both groups recognize that changes are needed to enhance CCI in QI, with staff needing to champion transformation.…”

Social Media as a Tool for Consumer Engagement in Hospital Quality Improvement and Service Design: Barriers and Enablers for Implementation

“…10,11,14,15 Because social media can reach audiences different to those reached by typical engagement methods, it may help grow the pool of people engaged in health service design and QI, and expand or re-imagine engagement strategies beyond the overreliance on 'career consumers. ' 16 Social media-based engagement can also allow consumer representatives, patients and families to connect more easily to organise and advocate for change, 15 which could help overcome potential disconnection between patient populations and their representatives. 17,18 The use of social media for consumer engagement is not without risks.…”

“…Engagement methods characterised by relationship building between consumers and service providers (such as co-design) might be more difficult via social media, 11,15 and the public nature of interactions on some social media platforms could expose both individuals and organisations to harms such as bullying, harassment and trolling. 11,15 Concerns about these risks, and a lack of understanding about ways to manage or mitigate them, may stymie efforts to further develop social media as a medium for engagement. 15 To better understand and inform the implementation of social media-based consumer engagement in public hospitals, we explored the following research question:…”

“…11,15 Concerns about these risks, and a lack of understanding about ways to manage or mitigate them, may stymie efforts to further develop social media as a medium for engagement. 15 To better understand and inform the implementation of social media-based consumer engagement in public hospitals, we explored the following research question:…”

“…Findings relating to risks and barriers of social media-based engagement have been presented in a previous article arising from this study. 15 Finally, we are using the term 'consumer engagement' in this article to describe involvement of users, or potential users, of health services in their design and improvement. 23 The term 'consumer representative' in this article refers to "a person who provides a consumer perspective, contributes consumer experiences, advocates for the interests of current and potential health service users, and takes part in decisionmaking processes"(p. 75) 23 and is currently engaged in a consumer representative role within a public hospital.…”