Giles Sally J, Reynolds Caroline, Heyhoe Jane, Armitage Gerry
NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health, University of Manchester, Manchester, UK.
Bradford Institute for Health Research, Bradford, UK.
J Ren Care. 2017 Mar;43(1):37-49. doi: 10.1111/jorc.12186. Epub 2016 Dec 19.
It is increasingly acknowledged that patients can provide direct feedback about the quality and safety of their care through patient reporting systems. The aim of this study was to explore the feasibility of patients, healthcare professionals and researchers working in partnership to develop a patient-led quality and safety feedback system within an existing electronic health record (EHR), known as Renal PatientView (RPV).
Phase 1 (inception) involved focus groups (n = 9) and phase 2 (requirements) involved cognitive walkthroughs (n = 34) and 1:1 qualitative interviews (n = 34) with patients and healthcare professionals. A Joint Services Expert Panel (JSP) was convened to review the findings from phase 1 and agree the core principles and components of the system prototype. Phase 1 data were analysed using a thematic approach. Data from phase 1 were used to inform the design of the initial system prototype. Phase 2 data were analysed using the components of heuristic evaluation, resulting in a list of core principles and components for the final system prototype.
Phase 1 identified four main barriers and facilitators to patients feeding back on quality and safety concerns. In phase 2, the JSP agreed that the system should be based on seven core principles and components.
Stakeholders were able to work together to identify core principles and components for an electronic patient quality and safety feedback system in renal services. Tensions arose due to competing priorities, particularly around anonymity and feedback. Careful consideration should be given to the feasibility of integrating a novel element with differing priorities into an established system with existing functions and objectives.
人们越来越认识到,患者可以通过患者报告系统对其医疗服务的质量和安全性提供直接反馈。本研究的目的是探讨患者、医疗保健专业人员和研究人员合作开发一个以患者为主导的质量和安全反馈系统的可行性,该系统将在现有的电子健康记录(EHR)中运行,即肾科患者视图(RPV)。
第1阶段(初始阶段)包括焦点小组(n = 9),第2阶段(需求阶段)包括认知走查(n = 34)以及与患者和医疗保健专业人员进行的一对一质性访谈(n = 34)。召集了一个联合服务专家小组(JSP)来审查第1阶段的研究结果,并确定系统原型的核心原则和组成部分。第1阶段的数据采用主题分析法进行分析。第1阶段的数据用于为初始系统原型的设计提供信息。第2阶段的数据采用启发式评估的组成部分进行分析,得出最终系统原型的核心原则和组成部分列表。
第1阶段确定了患者反馈质量和安全问题的四个主要障碍和促进因素。在第2阶段,联合服务专家小组同意该系统应基于七个核心原则和组成部分。
利益相关者能够共同努力,确定肾科服务中电子患者质量和安全反馈系统的核心原则和组成部分。由于相互竞争的优先事项,特别是在匿名性和反馈方面,出现了紧张关系。应仔细考虑将具有不同优先事项的新元素集成到具有现有功能和目标的既定系统中的可行性。