How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation

Louise Locock, Catherine M. Montgomery* (Corresponding Author), Stephen Parkin, Alison Chisholm, Jennifer Bostock, Sue Dopson, Melanie Gager, Elizabeth Gibbons, Chris Graham, Jenny King, Angela Martin, John Powell, Sue Ziebland

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objectives: Improving patient experience is widely regarded as a key component of healthcare quality. However, while a considerable amount of data is 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 used patient experience data for improvement. Teams were given initial training and received ongoing support through a ‘learning community’.

Results: In every site, staff undertook quality improvement projects using a range of data sources. Teams engaged collectively in a process of sense-making using formal and informal sources of intelligence. While survey data were popular, ‘soft’ intelligence, such as patients’ stories, informal comments, and observations also informed staff’s improvement plans, without always being recognised as ‘data’. Teams with staff from different professional backgrounds and grades tended to make more progress, being able to draw on a wider net of practical, organisational and social resources, support and skills, which we describe as team-based capital.

Conclusions: Organisational recognition, or rejection, of specific forms of patient experience intelligence as ‘data’ affects whether staff feel they are actionable. Teams combining a diverse range of staff generated higher levels of ‘team-based capital’ for quality improvement than those adopting a uni-disciplinary approach. This may be a key mechanism for achieving person-centred improvement in healthcare.
Original languageEnglish
JournalJournal of Health Services Research & Policy
Publication statusAccepted/In press - 23 Oct 2019

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Intelligence
Quality Improvement
Economics
Quality of Health Care
Information Storage and Retrieval
Learning
Interviews
Delivery of Health Care

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How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation. / Locock, Louise; Montgomery, Catherine M. (Corresponding Author); Parkin, Stephen; Chisholm, Alison; Bostock, Jennifer; Dopson, Sue; Gager, Melanie; Gibbons, Elizabeth; Graham, Chris; King, Jenny; Martin, Angela; Powell, John; Ziebland, Sue.

In: Journal of Health Services Research & Policy, 23.10.2019.

Research output: Contribution to journalArticle

Locock, L, Montgomery, CM, Parkin, S, Chisholm, A, Bostock, J, Dopson, S, Gager, M, Gibbons, E, Graham, C, King, J, Martin, A, Powell, J & Ziebland, S 2019, 'How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation', Journal of Health Services Research & Policy.
Locock, Louise ; Montgomery, Catherine M. ; Parkin, Stephen ; Chisholm, Alison ; Bostock, Jennifer ; Dopson, Sue ; Gager, Melanie ; Gibbons, Elizabeth ; Graham, Chris ; King, Jenny ; Martin, Angela ; Powell, John ; Ziebland, Sue. / How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation. In: Journal of Health Services Research & Policy. 2019.
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abstract = "Objectives: Improving patient experience is widely regarded as a key component of healthcare quality. However, while a considerable amount of data is 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 used patient experience data for improvement. Teams were given initial training and received ongoing support through a ‘learning community’.Results: In every site, staff undertook quality improvement projects using a range of data sources. Teams engaged collectively in a process of sense-making using formal and informal sources of intelligence. While survey data were popular, ‘soft’ intelligence, such as patients’ stories, informal comments, and observations also informed staff’s improvement plans, without always being recognised as ‘data’. Teams with staff from different professional backgrounds and grades tended to make more progress, being able to draw on a wider net of practical, organisational and social resources, support and skills, which we describe as team-based capital.Conclusions: Organisational recognition, or rejection, of specific forms of patient experience intelligence as ‘data’ affects whether staff feel they are actionable. Teams combining a diverse range of staff generated higher levels of ‘team-based capital’ for quality improvement than those adopting a uni-disciplinary approach. This may be a key mechanism for achieving person-centred improvement in healthcare.",
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