Bradford Institute for Health Research, Bradford Teaching Hospitals, Bradford, UK.
Bradford Institute for Health Research, Bradford Teaching Hospitals and School of Psychology, University of Leeds, Leeds, UK.
Health Expect. 2019 Feb;22(1):46-53. doi: 10.1111/hex.12829. Epub 2018 Sep 22.
Collecting feedback from patients about their experiences of health care is an important activity. However, improvement based on this feedback rarely materializes. In this study, we focus on answering the question-"what is impeding the use of patient experience feedback?"
We conducted a qualitative study in 2016 across three NHS hospital Trusts in the North of England. Focus groups were undertaken with ward-based staff, and hospital managers were interviewed in-depth (50 participants). We conducted a conceptual-level analysis.
On a macro level, we found that the intense focus on the collection of patient experience feedback has developed into its own self-perpetuating industry with a significant allocation of resource, effort and time being expended on this task. This is often at the expense of pan-organizational learning or improvements being made. On a micro level, ward staff struggled to interact with feedback due to its complexity with questions raised about the value, validity and timeliness of data sources.
Macro and micro prohibiting factors come together in a perfect storm which provides a substantial impediment to improvements being made. Recommendations for policy change are put forward alongside recognition that high-level organizational culture/systems are currently too sluggish to allow fruitful learning and action to occur from the feedback that patients give.
收集患者对其医疗体验的反馈是一项重要的活动。然而，基于这些反馈的改进很少实现。在这项研究中，我们专注于回答一个问题——“是什么阻碍了患者体验反馈的使用？”
我们在 2016 年在英格兰北部的三个 NHS 医院信托机构进行了一项定性研究。对病房工作人员进行了焦点小组讨论，并对医院管理人员进行了深入访谈（50 名参与者）。我们进行了概念层面的分析。
在宏观层面上，我们发现对患者体验反馈的强烈关注已经发展成为一个自我维持的行业，大量的资源、精力和时间都投入到了这项任务中。这往往是以牺牲组织整体学习或改进为代价的。在微观层面上，病房工作人员由于反馈的复杂性而难以与反馈互动，这些反馈引发了对数据源的价值、有效性和及时性的质疑。
宏观和微观上的阻碍因素共同作用，形成了一场完美风暴，这对改进造成了巨大的阻碍。我们提出了政策变革的建议，并认识到，目前高层组织文化/系统过于迟缓，无法从患者提供的反馈中进行有益的学习和采取行动。
