Understanding and Using Health Experiences

Ziébland, Sue; Coulter, Angela; Calabrese, Joseph D.; Locock, Louise

doi:10.1093/acprof:oso/9780199665372.001.0001

Cited by 61 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously published studies have examined the types of patient experience data currently in use in the NHS, the systems (or lack thereof) through which these data inform QI specifically, and the initiatives that are implemented as a result. [3][4][5][6][7] In 2012, a survey highlighted the main methods used to collect patient experience data, the frequency with which these data were collected, and the mechanisms through which they were reported and made available to the public. 8 Furthermore, an evidence scan in 2013 reviewed existing approaches to measuring patient experience and their relevance to person-centred care, 9 and essential aspects of care experiences indicative of good care can be found in national clinical guidelines.…”

Section: Fundingmentioning

confidence: 99%

Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

Donetto

Desai

Zoccatelli

et al. 2019

Health Serv Deliv Res

View full text Add to dashboard Cite

Background Although NHS organisations have access to a wealth of patient experience data in various formats (e.g. surveys, complaints and compliments, patient stories and online feedback), not enough attention has been paid to understanding how patient experience data translate into improvements in the quality of care. Objectives The main aim was to explore and enhance the organisational strategies and practices through which patient experience data are collected, interpreted and translated into quality improvements in acute NHS hospital trusts in England. The secondary aim was to understand and optimise the involvement and responsibilities of nurses in senior managerial and front-line roles with respect to such data. Design The study comprised two phases. Phase 1 consisted of an actor–network theory-informed ethnographic study of the ‘journeys’ of patient experience data in five acute NHS hospital trusts, particularly in cancer and dementia services. Phase 2 comprised a series of Joint Interpretive Forums (one cross-site and one at each trust) bringing together different stakeholders (e.g. members of staff, national policy-makers, patient/carer representatives) to distil generalisable principles to optimise the use of patient experience data. Setting Five purposively sampled acute NHS hospital trusts in England. Results The analysis points to five key themes: (1) each type of data takes multiple forms and can generate improvements in care at different stages in its complex ‘journey’ through an organisation; (2) where patient experience data participate in interactions (with human and/or non-human actors) characterised by the qualities of autonomy (to act/trigger action), authority (to ensure that action is seen as legitimate) and contextualisation (to act meaningfully in a given situation), quality improvements can take place in response to the data; (3) nurses largely have ultimate responsibility for the way in which data are collected, interpreted and used to improve care, but other professionals also have important roles that could be explored further; (4) formalised quality improvement can confer authority to patient experience data work, but the data also lead to action for improvement in ways that are not formally identified as quality improvement; (5) sense-making exercises with study participants can support organisational learning. Limitations Patient experience data practices at trusts performing ‘worse than others’ on the Care Quality Commission scores were not examined. Although attention was paid to the views of patients and carers, the study focused largely on organisational processes and practices. Finally, the processes and practices around other types of data were not examined, such as patient safety and clinical outcomes data, or how these interact with patient experience data. Conclusions NHS organisations may find it useful to identify the local roles and processes that bring about autonomy, authority and contextualisation in patient experience data work. The composition and expertise of patient experience teams could better complement the largely invisible nursing work that currently accounts for a large part of the translation of data into care improvements. Future work To date, future work has not been planned. Study registration NIHR 188882. Funding The National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Section: Fundingmentioning

confidence: 99%

Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

Donetto

Desai

Zoccatelli

et al. 2019

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…Response Frameworkunderstanding why UK hospital staff find it difficult to make improvements based on patient feedback: a qualitative study. Soc Sci Med 2017;178: [19][20][21][22][23][24][25][26][27] have proposed a conceptual 'patient feedback response framework' to understand why front-line staff may find it difficult to respond to feedback. This framework has three components: l normative legitimacy (i.e.…”

Section: Scientific Summary Backgroundmentioning

confidence: 99%

“…There is already good evidence of what matters most to many patients and how they experience services; 19 the gap is in how trusts can respond to the available local and national data and use them to improve care. 3,17,20,21 It should, of course, be noted that the process of gathering and analysing data on patient experiences at local level can itself be part of building momentum for the use of these data in improvement. In narrative-based approaches such as experience-based co-design (EBCD), collecting experiences (narratives) and using them for improvement are closely linked as part of the same process of cultural change.…”

Section: Existing Evidence On Using Patient Feedback and Patient Expementioning

confidence: 99%

Understanding how front-line staff use patient experience data for service improvement: an exploratory case study evaluation

Locock

Graham

King

et al. 2020

Health Serv Deliv Res

View full text Add to dashboard Cite

Background and aim The NHS collects a large number of data on patient experience, but there are concerns that it does not use this information to improve care. This study explored whether or not and how front-line staff use patient experience data for service improvement. Methods Phase 1 – secondary analysis of existing national survey data, and a new survey of NHS trust patient experience leads. Phase 2 – case studies in six medical wards using ethnographic observations and interviews. A baseline and a follow-up patient experience survey were conducted on each ward, supplemented by in-depth interviews. Following an initial learning community to discuss approaches to learning from and improving patient experience, teams developed and implemented their own interventions. Emerging findings from the ethnographic research were shared formatively. Phase 3 – dissemination, including an online guide for NHS staff. Key findings Phase 1 – an analysis of staff and inpatient survey results for all 153 acute trusts in England was undertaken, and 57 completed surveys were obtained from patient experience leads. The most commonly cited barrier to using patient experience data was a lack of staff time to examine the data (75%), followed by cost (35%), lack of staff interest/support (21%) and too many data (21%). Trusts were grouped in a matrix of high, medium and low performance across several indices to inform case study selection. Phase 2 – in every site, staff undertook quality improvement projects using a range of data sources. The number and scale of these varied, as did the extent to which they drew directly on patient experience data, and the extent of involvement of patients. Before-and-after surveys of patient experience showed little statistically significant change. Making sense of patient experience ‘data’ Staff were engaged in a process of sense-making from a range of formal and informal sources of intelligence. Survey data remain the most commonly recognised and used form of data. ‘Soft’ intelligence, such as patient stories, informal comments and daily ward experiences of staff, patients and family, also fed into staff’s improvement plans, but they and the wider organisation may not recognise these as ‘data’. Staff may lack confidence in using them for improvement. Staff could not always point to a specific source of patient experience ‘data’ that led to a particular project, and sometimes reported acting on what they felt they already knew needed changing. Staff experience as a route to improving patient experience Some sites focused on staff motivation and experience on the assumption that this would improve patient experience through indirect cultural and attitudinal change, and by making staff feel empowered and supported. Staff participants identified several potential interlinked mechanisms: (1) motivated staff provide better care, (2) staff who feel taken seriously are more likely to be motivated, (3) involvement in quality improvement is itself motivating and (4) improving patient experience can directly improve staff experience. ‘Team-based capital’ in NHS settings We propose ‘team-based capital’ in NHS settings as a key mechanism between the contexts in our case studies and observed outcomes. ‘Capital’ is the extent to which staff command varied practical, organisational and social resources that enable them to set agendas, drive process and implement change. These include not just material or economic resources, but also status, time, space, relational networks and influence. Teams involving a range of clinical and non-clinical staff from multiple disciplines and levels of seniority could assemble a greater range of capital; progress was generally greater when the team included individuals from the patient experience office. Phase 3 – an online guide for NHS staff was produced in collaboration with The Point of Care Foundation. Limitations This was an ethnographic study of how and why NHS front-line staff do or do not use patient experience data for quality improvement. It was not designed to demonstrate whether particular types of patient experience data or quality improvement approaches are more effective than others. Future research Developing and testing interventions focused specifically on staff but with patient experience as the outcome, with a health economics component. Studies focusing on the effect of team composition and diversity on the impact and scope of patient-centred quality improvement. Research into using unstructured feedback and soft intelligence. Funding The National Institute for Health Research Health Services and Delivery Research programme.

show abstract

“…In keeping with the increasing popularity of the Internet for sharing personal experiences, research about online communication has also become more common (Mazanderani & Powell, 2013;Morison et al, 2015). Qualitative researchers, among others, commonly explore human behavior and experiences through analysis of Internet content.…”

Section: The Potential Of Internet Content For Qualitative Researchmentioning

confidence: 99%

“…to personal narratives shared on the Internet (Mazanderani & Powell, 2013;Morison, Gibson, Wigginton, & Crabb, 2015). Specifically, the Internet is the site of much communication about illness, caregiving, and health-care interactions among other topics.…”

mentioning

confidence: 99%

Ethical, Practical, and Methodological Considerations for Unobtrusive Qualitative Research About Personal Narratives Shared on the Internet

Burles

Bally

2018

International Journal of Qualitative Methods

View full text Add to dashboard Cite

As Internet research grows in popularity, attention to the ethics of studying online content is crucial to ensuring ethical diligence and appropriateness. Over recent years, ethical guidelines and recommendations have emerged to advise researchers and institutional review boards on best practices. However, these guidelines are sometimes irrelevant, overly rigid, or lack recognition of the contingent nature of ethical decision-making in qualitative research. Furthermore, varied ethical stances and practices are evident in existing literature. This article explores key ethical issues for qualitative research involving online content, with a focus on the unobtrusive study of personal narratives shared via the Internet. Principles of informed consent and confidentiality are examined in depth alongside practical and methodological considerations for unobtrusive qualitative research. This critical exploration contributes to ongoing discussion of ethical conduct of Internet research and promotes ethically aware yet flexible approaches to online qualitative research and creative methodological efforts to overcoming ethical challenges.

show abstract

Understanding and Using Health Experiences

Cited by 61 publications

References 0 publications

Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

Understanding how front-line staff use patient experience data for service improvement: an exploratory case study evaluation

Ethical, Practical, and Methodological Considerations for Unobtrusive Qualitative Research About Personal Narratives Shared on the Internet

Contact Info

Product

Resources

About