School of Dentistry, The University of Queensland, Brisbane, Australia; Centre for Allied Health Research, Royal Brisbane and Women's Hospital, Herston, Australia.
Safety and Implementation Service, Royal Brisbane and Women's Hospital, Herston, Australia; Champion Health Agency, Brisbane, Australia.
Patient Educ Couns. 2023 Nov;116:107938. doi: 10.1016/j.pec.2023.107938. Epub 2023 Aug 12.
Patient Reported Experience Measures (PREMs) provide health organisations insight into how 'person-centric' care is. Qualitative data in PREMs surveys provide essential context about experience but are challenging to analyse at an organisational level.
To co-design a person-centred coding framework to assist in the analysis of qualitative PREMs data.
Consumer representatives were involved in problem identification, co-design, coding of raw data (testing), evaluation and manuscript authorship.
Co-design principles guided production of a deductive coding framework with Picker Principles of Person-Centred Care as a conceptual framework. The framework was co-designed over 4 stages, with cross-professional stakeholders (including two consumer representatives): 1) assessment of current state and understanding priorities; 2) adapting Picker Principles of Person-Centred Care as a coding framework; 3) testing and evaluation of a coding template over two quality improvement (QI) cycles against measures of inter-coder reliability and perceived usefulness; 4) endorsement and planning for implementation.
The Picker Principles were a suitable coding framework for inpatient PREMs data, and a coding template in an electronic spreadsheet met end-user needs. Results of the first QI cycle indicated a need for 'less academic' domain names and definitions, which were reviewed and updated to a first-person perspective in partnership with a consumer representative. Inter-coder reliability measures and qualitative feedback improved after cycle two testing and evaluation.
This single site study produced a feasible solution to apply person-centred principles to analyse PREMs data and requires testing in different settings. Cross-disciplinary partnerships enabled the development of a reliable and acceptable deductive coding framework that was usable for people without prior experience in qualitative data analysis.
Our solution offers an example for health services to harness the value of qualitative PREMs data and partner with consumers to take person-centric action to improve the safety, equity, and experience of healthcare.
患者报告的体验衡量指标（PREMs）为医疗机构提供了有关“以患者为中心”的护理的深入了解。PREMs 调查中的定性数据提供了有关体验的重要背景信息，但在组织层面上进行分析具有挑战性。
共同设计一个以患者为中心的编码框架，以协助分析定性 PREMs 数据。
消费者代表参与了问题识别、共同设计、原始数据（测试）编码、评估和手稿撰写。
共同设计原则指导了一个演绎编码框架的制作，该框架以关怀照护的皮克原则（Picker Principles of Person-Centred Care）为概念框架。该框架经过四个阶段共同设计，涉及跨专业利益相关者（包括两名消费者代表）：1）评估当前状况和理解优先事项；2）将关怀照护的皮克原则改编为编码框架；3）在两个质量改进（QI）周期中，使用编码模板对两个质量改进（QI）周期进行测试和评估，以衡量编码者之间的可靠性和感知有用性；4）认可和实施计划。
关怀照护的皮克原则是住院 PREMs 数据的合适编码框架，电子表格中的编码模板满足了最终用户的需求。第一个 QI 周期的结果表明需要“不那么学术”的领域名称和定义，这些名称和定义在与消费者代表合作的基础上进行了审查和更新，以第一人称视角呈现。经过第二周期的测试和评估，编码者之间的可靠性衡量标准和定性反馈得到了改善。
这项单站点研究提出了一种可行的解决方案，可将以人为本的原则应用于分析 PREMs 数据，并需要在不同环境中进行测试。跨学科合作使我们能够开发出一种可靠且可接受的演绎编码框架，即使对于没有定性数据分析经验的人来说也具有可操作性。
我们的解决方案为卫生服务机构提供了一个范例，使其能够利用定性 PREMs 数据的价值，并与消费者合作，采取以人为本的行动，提高医疗保健的安全性、公平性和体验。
