Barry Heather E, Campbell John L, Asprey Anthea, Richards Suzanne H
University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
BMJ Qual Saf. 2016 Nov;25(11):851-859. doi: 10.1136/bmjqs-2015-003963. Epub 2015 Oct 21.
English National Quality Requirements mandate out-of-hours primary care services to routinely audit patient experience, but do not state how it should be done.
We explored how providers collect patient feedback data and use it to inform service provision. We also explored staff views on the utility of out-of-hours questions from the English General Practice Patient Survey (GPPS).
A qualitative study was conducted with 31 staff (comprising service managers, general practitioners and administrators) from 11 out-of-hours primary care providers in England, UK. Staff responsible for patient experience audits within their service were sampled and data collected via face-to-face semistructured interviews.
Although most providers regularly audited their patients' experiences by using patient surveys, many participants expressed a strong preference for additional qualitative feedback. Staff provided examples of small changes to service delivery resulting from patient feedback, but service-wide changes were not instigated. Perceptions that patients lacked sufficient understanding of the urgent care system in which out-of-hours primary care services operate were common and a barrier to using feedback to enable change. Participants recognised the value of using patient experience feedback to benchmark services, but perceived weaknesses in the out-of-hours items from the GPPS led them to question the validity of using these data for benchmarking in its current form.
The lack of clarity around how out-of-hours providers should audit patient experience hinders the utility of the National Quality Requirements. Although surveys were common, patient feedback data had only a limited role in service change. Data derived from the GPPS may be used to benchmark service providers, but refinement of the out-of-hours items is needed.
英国国家质量要求规定非工作时间的初级医疗服务要定期对患者体验进行审核,但未说明应如何进行。
我们探讨了服务提供者如何收集患者反馈数据并将其用于指导服务提供。我们还探讨了工作人员对英国全科医疗患者调查(GPPS)中有关非工作时间问题实用性的看法。
对来自英国英格兰11家非工作时间初级医疗服务提供者的31名工作人员(包括服务经理、全科医生和行政人员)进行了定性研究。对负责其服务内患者体验审核的工作人员进行抽样,并通过面对面的半结构化访谈收集数据。
尽管大多数服务提供者通过患者调查定期审核患者体验,但许多参与者强烈倾向于额外的定性反馈。工作人员提供了因患者反馈而对服务提供进行小改进的例子,但未引发全服务范围的变革。普遍认为患者对非工作时间初级医疗服务所运作的紧急护理系统缺乏足够了解,这是利用反馈实现变革的一个障碍。参与者认识到利用患者体验反馈来对服务进行基准评估的价值,但认为GPPS中有关非工作时间的项目存在缺陷,这使他们质疑以当前形式使用这些数据进行基准评估的有效性。
非工作时间服务提供者应如何审核患者体验缺乏明确规定,这阻碍了国家质量要求的效用。尽管调查很常见,但患者反馈数据在服务变革中作用有限。GPPS得出的数据可用于对服务提供者进行基准评估,但需要对非工作时间的项目进行完善。