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患者体验调查在质量保证与改进中的作用:一项针对英国全科医疗的焦点小组研究

The role of patient experience surveys in quality assurance and improvement: a focus group study in English general practice.

作者信息

Boiko Olga, Campbell John L, Elmore Natasha, Davey Antoinette F, Roland Martin, Burt Jenni

机构信息

Primary Care, University of Exeter Medical School, Exeter, UK.

Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK.

出版信息

Health Expect. 2015 Dec;18(6):1982-94. doi: 10.1111/hex.12298. Epub 2014 Nov 4.

Abstract

BACKGROUND

Despite widespread adoption of patient feedback surveys in international health-care systems, including the English NHS, evidence of a demonstrable impact of surveys on service improvement is sparse.

OBJECTIVE

To explore the views of primary care practice staff regarding the utility of patient experience surveys.

DESIGN

Qualitative focus groups.

SETTING AND PARTICIPANTS

Staff from 14 English general practices.

RESULTS

Whilst participants engaged with feedback from patient experience surveys, they routinely questioned its validity and reliability. Participants identified surveys as having a number of useful functions: for patients, as a potentially therapeutic way of getting their voice heard; for practice staff, as a way of identifying areas of improvement; and for GPs, as a source of evidence for professional development and appraisal. Areas of potential change stimulated by survey feedback included redesigning front-line services, managing patient expectations and managing the performance of GPs. Despite this, practice staff struggled to identify and action changes based on survey feedback alone.

DISCUSSION

Whilst surveys may be used to endorse existing high-quality service delivery, their use in informing changes in service delivery is more challenging for practice staff. Drawing on the Utility Index framework, we identified concerns relating to reliability and validity, cost and feasibility acceptability and educational impact, which combine to limit the utility of patient survey feedback.

CONCLUSIONS

Feedback from patient experience surveys has great potential. However, without a specific and renewed focus on how to translate feedback into action, this potential will remain incompletely realized.

摘要

背景

尽管患者反馈调查在包括英国国民健康服务体系(NHS)在内的国际医疗保健系统中得到广泛应用,但关于调查对服务改进产生明显影响的证据却很少。

目的

探讨基层医疗实践工作人员对患者体验调查效用的看法。

设计

定性焦点小组。

地点和参与者

来自14家英国普通诊所的工作人员。

结果

虽然参与者认可患者体验调查的反馈,但他们经常质疑其有效性和可靠性。参与者认为调查有一些有用的功能:对患者来说,是一种让他们的声音被听到的潜在治疗方式;对实践工作人员来说,是一种识别改进领域的方式;对全科医生来说,是专业发展和评估的证据来源。调查反馈激发的潜在变革领域包括重新设计一线服务、管理患者期望和管理全科医生的绩效。尽管如此,实践工作人员仅根据调查反馈难以识别并采取变革行动。

讨论

虽然调查可用于认可现有的高质量服务提供,但对实践工作人员来说,利用调查来指导服务提供的变革更具挑战性。借鉴效用指数框架,我们确定了与可靠性和有效性、成本和可行性、可接受性以及教育影响相关的问题,这些问题共同限制了患者调查反馈的效用。

结论

患者体验调查的反馈具有巨大潜力。然而,如果不特别重新关注如何将反馈转化为行动,这一潜力将仍无法完全实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af0f/5810660/4dd6a41485cc/HEX-18-1982-g001.jpg

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