Louise Locock1, Catherine Montgomery2, Stephen Parkin3, Alison Chisholm4, Jennifer Bostock5, Sue Dopson6, Melanie Gager7, Elizabeth Gibbons8, Chris Graham9, Jenny King10, Angela Martin11, John Powell12, Sue Ziebland13. 1. Professor of Health Services Research, Health Services Research Unit, University of Aberdeen, UK. 2. Senior Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK. 3. Research Fellow, National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK. 4. Qualitative Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK. 5. Lay Research Advisor, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK. 6. Rhodes Trust Professor of Organisational Behaviour, Saïd Business School, University of Oxford, UK. 7. Follow-up Sister in Critical Care, Royal Berkshire NHS Foundation Trust, UK. 8. Senior Research Scientist, Nuffield Department of Population Health, University of Oxford, UK. 9. Chief Executive, Picker Institute Europe, UK. 10. Chief Research Officer, Picker Institute Europe, UK. 11. Programme Coordinator, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK. 12. Associate Professor, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK. 13. Professor of Medical Sociology, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
Abstract
OBJECTIVES: Improving patient experience is widely regarded as a key component of health care quality. However, while a considerable amount of data are collected about patient experience, there are concerns this information is not always used to improve care. This study explored whether and how frontline staff use patient experience data for service improvement. METHODS: We conducted a year-long ethnographic case study evaluation, including 299 hours of observations and 95 interviews, of how frontline staff in six medical wards at different hospital sites in the United Kingdom used patient experience data for improvement. RESULTS: In every site, staff undertook quality improvement projects using a range of data sources. Teams of health care practitioners and ancillary staff engaged collectively in a process of sense-making using formal and informal sources of patient experience data. While survey data were popular, 'soft' intelligence - such as patients' stories, informal comments and observations - also informed staff's improvement plans, without always being recognized as data. Teams with staff from different professional backgrounds and grades tended to make more progress than less diverse teams, being able to draw on a wider net of practical, organizational and social resources, support and skills, which we describe as team-based capital. CONCLUSIONS: Organizational recognition, or rejection, of specific forms of patient experience intelligence as 'data' affects whether staff feel the data are actionable. Teams combining a diverse range of staff generated higher levels of 'team-based capital' for quality improvement than those adopting a single disciplinary approach. This may be a key mechanism for achieving person-centred improvement in health care.
OBJECTIVES: Improving patient experience is widely regarded as a key component of health care quality. However, while a considerable amount of data are collected about patient experience, there are concerns this information is not always used to improve care. This study explored whether and how frontline staff use patient experience data for service improvement. METHODS: We conducted a year-long ethnographic case study evaluation, including 299 hours of observations and 95 interviews, of how frontline staff in six medical wards at different hospital sites in the United Kingdom used patient experience data for improvement. RESULTS: In every site, staff undertook quality improvement projects using a range of data sources. Teams of health care practitioners and ancillary staff engaged collectively in a process of sense-making using formal and informal sources of patient experience data. While survey data were popular, 'soft' intelligence - such as patients' stories, informal comments and observations - also informed staff's improvement plans, without always being recognized as data. Teams with staff from different professional backgrounds and grades tended to make more progress than less diverse teams, being able to draw on a wider net of practical, organizational and social resources, support and skills, which we describe as team-based capital. CONCLUSIONS: Organizational recognition, or rejection, of specific forms of patient experience intelligence as 'data' affects whether staff feel the data are actionable. Teams combining a diverse range of staff generated higher levels of 'team-based capital' for quality improvement than those adopting a single disciplinary approach. This may be a key mechanism for achieving person-centred improvement in health care.
Entities:
Keywords:
learning community; patient experience data; team-based capital
Authors: Louise Locock; Glenn Robert; Annette Boaz; Sonia Vougioukalou; Caroline Shuldham; Jonathan Fielden; Sue Ziebland; Melanie Gager; Ruth Tollyfield; John Pearcey Journal: J Health Serv Res Policy Date: 2014-05-19
Authors: Louise Locock; Catherine Montgomery; Stephen Parkin; Alison Chisholm; Jennifer Bostock; Sue Dopson; Melanie Gager; Elizabeth Gibbons; Chris Graham; Jenny King; Angela Martin; John Powell; Sue Ziebland Journal: J Health Serv Res Policy Date: 2020-02-14
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