Management and Healthcare Laboratory (MeS), Institute of Management and EMbeDS, Scuola Superiore Sant'Anna, piazza Martiri della Libertà 33, Pisa, Italy.
BMC Health Serv Res. 2020 Apr 16;20(1):315. doi: 10.1186/s12913-020-05099-4.
The use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use. This paper presents an empirical case of PREMs innovation in Italy, to foster patient data use up to the ward level, by keeping strengths and addressing weaknesses of previous PREMs survey experiences. The paper reports key lessons learned in this ongoing experience of action research, directly involving practitioners.
The aim of this paper is to present the results of an ongoing action research, encompassing the innovation of PREMs collection, reporting and use, currently adopted by 21 hospitals of two Italian regions. The continuous and systematic PREMs collection has been implemented between 2017 and 2019 and includes: a continuous web-based administration, using web-services; an augmented and positive questionnaire matching standard closed-ended questions with narrative sections; the inclusion and benchmarking of patient data within a shared performance evaluation system; public disclosure of aggregated anonymized data; a multi-level and real-time web-platform for reporting PREMs to professionals. The action research was carried out with practitioners in a real-life and complex context. The authors used multiple data sources and methods: observations, feedback of practitioners, collected during several workshops and meetings, and analysis of preliminary data on the survey implementation.
A continuous and systematic PREMs observatory was developed and adopted in two Italian regions. PREMs participation and response rates tend to increase over time, reaching stable percentages after the first months. Narrative feedback provide a 'positive narration' of episodes and behaviours that made the difference to patients and can inform quality improvement actions. Real-time reporting of quantitative and qualitative data is enabling a gratifying process of service improvement and people management at all the hospitals' levels.
The PREMs presented in this paper has been recognized by healthcare professionals and managers as a strategic and positive tool for improving an actual use of PREMs at system and ward levels, by measuring and highlighting positive deviances, such as compassionate behaviours.
患者报告体验测量（PREMs）在改善医疗服务方面具有巨大潜力，但应用有限。本文介绍了意大利 PREMs 创新的实证案例，通过保持先前 PREMs 调查经验的优势并解决其弱点，促进患者数据在病房层面的使用。本文报告了这一正在进行的行动研究中直接涉及从业者的关键经验教训。
本文旨在介绍一项正在进行的行动研究的结果，该研究涵盖了 PREMs 收集、报告和使用的创新，目前已被两个意大利地区的 21 家医院采用。从 2017 年到 2019 年，持续和系统地进行了 PREMs 收集，包括：使用网络服务的持续在线管理；增强和积极的问卷，将标准封闭式问题与叙述部分匹配；将患者数据纳入共享绩效评估系统并进行基准测试；公开披露匿名汇总数据；一个用于向专业人员报告 PREMs 的多级别实时网络平台。该行动研究是在现实复杂的环境中与从业者一起进行的。作者使用了多种数据来源和方法：观察、从业者的反馈，这些反馈是在多次研讨会和会议中收集的，以及对调查实施的初步数据进行分析。
在两个意大利地区开发并采用了一个持续和系统的 PREMs 观察站。PREMs 的参与率和回应率随着时间的推移呈上升趋势，在前几个月后达到稳定的百分比。叙述性反馈提供了关于对患者产生影响的事件和行为的“积极叙述”，可以为质量改进行动提供信息。实时报告定量和定性数据正在使所有医院层面的服务改进和人员管理过程变得令人满意。
本文介绍的 PREMs 已被医疗保健专业人员和管理人员视为在系统和病房层面上改进 PREMs 实际使用的战略和积极工具，通过测量和突出有同情心的行为等积极偏差。
