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英国医院的患者体验反馈:有哪些类型可用,它们在质量改进 (QI) 中的潜在作用是什么?

Patient experience feedback in UK hospitals: What types are available and what are their potential roles in quality improvement (QI)?

机构信息

Bradford Institute for Health Research, Bradford, UK.

University of Leeds, Leeds, UK.

出版信息

Health Expect. 2019 Jun;22(3):317-326. doi: 10.1111/hex.12885. Epub 2019 Apr 23.

Abstract

BACKGROUND & OBJECTIVES: The comparative uses of different types of patient experience (PE) feedback as data within quality improvement (QI) are poorly understood. This paper reviews what types are currently available and categorizes them by their characteristics in order to better understand their roles in QI.

METHODS

A scoping review of types of feedback currently available to hospital staff in the UK was undertaken. This comprised academic database searches for "measures of PE outcomes" (2000-2016), and grey literature and websites for all types of "PE feedback" potentially available (2005-2016). Through an iterative consensus process, we developed a list of characteristics and used this to present categories of similar types.

MAIN RESULTS

The scoping review returned 37 feedback types. A list of 12 characteristics was developed and applied, enabling identification of 4 categories that help understand potential use within QI-(1) Hospital-initiated (validated) quantitative surveys: for example the NHS Adult Inpatient Survey; (2) Patient-initiated qualitative feedback: for example complaints or twitter comments; (3) Hospital-initiated qualitative feedback: for example Experience Based Co-Design; (4) Other: for example Friends & Family Test. Of those routinely collected, few elicit "ready-to-use" data and those that do elicit data most suitable for measuring accountability, not for informing ward-based improvement. Guidance does exist for linking collection of feedback to QI for some feedback types in Category 3 but these types  are not routinely used.

CONCLUSION

If feedback is to be used more frequently within QI, more attention must be paid to obtaining and making available the most appropriate types.

摘要

背景与目的

不同类型的患者体验(PE)反馈作为质量改进(QI)数据的比较使用尚未被充分理解。本文回顾了目前可用的反馈类型,并根据其特征对其进行分类,以便更好地理解它们在 QI 中的作用。

方法

对英国医院工作人员目前可获得的反馈类型进行了范围综述。这包括对 2000 年至 2016 年“PE 结果测量”的学术数据库搜索,以及对 2005 年至 2016 年所有潜在可用的“PE 反馈”的灰色文献和网站的搜索。通过迭代共识过程,我们制定了一份特征清单,并使用该清单提出了相似类型的分类。

主要结果

范围综述返回了 37 种反馈类型。制定并应用了 12 个特征清单,从而确定了 4 个有助于理解在 QI 中潜在用途的类别:(1)医院发起(已验证)的定量调查:例如 NHS 成人住院调查;(2)患者发起的定性反馈:例如投诉或推特评论;(3)医院发起的定性反馈:例如基于经验的共同设计;(4)其他:例如朋友和家人测试。在常规收集的反馈中,很少有反馈能够提供“现成可用”的数据,而那些能够提供数据的反馈最适合用于衡量问责制,而不是为病房改进提供信息。对于类别 3 中的某些反馈类型,确实存在将反馈与 QI 联系起来的指导,但这些类型并未得到常规使用。

结论

如果要在 QI 中更频繁地使用反馈,就必须更加关注获取和提供最合适的反馈类型。

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