Ramsey Lauren, Lawton Rebecca, Sheard Laura, O'Hara Jane
Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK.
School of Psychology, University of Leeds, Leeds, UK.
Digit Health. 2022 Oct 17;8:20552076221129085. doi: 10.1177/20552076221129085. eCollection 2022 Jan-Dec.
Patients are increasingly reporting about their healthcare experiences online and NHS Trusts are adopting different approaches to responding. However, the sociocultural contexts underpinning these organisational approaches remain unclear. Therefore, we aimed to explore the sociocultural contexts underpinning three organisations who adopted different approaches to responding to online patient feedback.
Recruitment of three NHS Trusts was theoretically guided, and determined based on their different approaches to responding to online patient feedback (a nonresponding organisation, a generic responding organisation and an organisation providing transparent, conversational responses). Ethnographic methods were used during a year of fieldwork involving staff interviews, observations of practice and documentary analysis. Three in-depth case studies are presented.
The first organisation did not respond to or use online patient feedback as staff were busy firefighting volumes of concerns received in other ways. The second organisation adopted a generic responding style due to resource constraints, fears of public engagement and focus on resolving known issues raised via more traditional feedback sources. The final organisation provided transparent, conversational responses to patients online and described a 10-year journey enabling their desired culture to be embedded.
We identified a range of barriers facing organisations who ignore or provide generic responses to patient feedback online. We also demonstrated the sociocultural context in which online interactions between staff and patients can be embraced to inform improvement. However, this represented a slow and difficult organisational journey. Further research is needed to better establish how organisations can recognise and overcome barriers to engaging with online patient feedback, and at pace.
患者越来越多地在网上分享他们的医疗体验，国民保健服务信托机构也在采取不同的方式进行回应。然而，支撑这些组织方式的社会文化背景仍不明确。因此，我们旨在探究支撑三个采取不同方式回应在线患者反馈的组织的社会文化背景。
对三个国民保健服务信托机构的招募以理论为指导，并根据它们回应在线患者反馈的不同方式来确定（一个不回应的机构、一个一般性回应的机构和一个提供透明、对话式回应的机构）。在为期一年的实地调查中采用了人种志方法，包括员工访谈、实践观察和文献分析。本文呈现了三个深入的案例研究。
第一个机构不回应或不利用在线患者反馈，因为员工忙于处理通过其他方式收到的大量问题。第二个机构由于资源限制、对公众参与的担忧以及专注于解决通过更传统反馈渠道提出的已知问题，采取了一般性回应方式。最后一个机构在线为患者提供透明、对话式的回应，并描述了一个长达十年的历程，借此使其期望的文化得以深入人心。
我们确定了忽视或对在线患者反馈提供一般性回应的组织所面临的一系列障碍。我们还展示了员工与患者之间的在线互动可被用于推动改进的社会文化背景。然而，这代表着一段缓慢且艰难的组织历程。需要进一步开展研究，以更好地确定组织如何能够识别并克服在参与在线患者反馈方面的障碍，而且要尽快做到这一点。
