Using a national archive of patient experience narratives to promote local patient-centered quality improvement:

an ethnographic process evaluation of 'accelerated' experience-based co-design

Louise Locock, Glenn Robert, Annette Boaz, Sonia Vougioukalou, Caroline Shuldham, Jonathan Fielden, Sue Ziebland, Melanie Gager, Ruth Tollyfield, John Pearcey

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objectives
To evaluate an accelerated form of experience-based co-design (EBCD), a type of participatory action research in which patients and staff work together to improve quality; to observe how acceleration affected the process and outcomes of the intervention.

Methods
An ethnographic process evaluation of an adapted form of EBCD was conducted, including observations, interviews, questionnaires and documentary analysis. Whilst retaining all components of EBCD, the adapted approach replaced local patient interviews with secondary analysis of a national archive of patient experience narratives to create national trigger films; shortened the timeframe; and employed local improvement facilitators. It was tested in intensive care and lung cancer in two English National Health Service (NHS) hospitals. A total of 96 clinical staff (primarily nursing and medical), and 63 patients and family members participated in co-design activities.

Results
The accelerated approach proved acceptable to staff and patients; using films of national rather than local narratives did not adversely affect local NHS staff engagement, and may have made the process less threatening or challenging. Local patients felt the national films generally reflected important themes although a minority felt they were more negative than their own experience. However, they served their purpose of ‘triggering’ discussion between patients and staff, and the resulting 48 co-design (improvement) activities across the four pathways were similar to those in EBCD, but achieved more quickly and at lower cost.

Conclusions
Accelerated EBCD offers a rigorous and relatively cost-effective patient-centered quality improvement approach.
Original languageEnglish
Pages (from-to)200-207
Number of pages8
JournalJournal of Health Services Research & Policy
Volume19
Issue number4
Early online date19 May 2014
DOIs
Publication statusPublished - 1 Oct 2014

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Quality Improvement
National Health Programs
Interviews
Costs and Cost Analysis
Health Services Research
Nursing Staff
Medical Staff
Critical Care
Lung Neoplasms

Cite this

Using a national archive of patient experience narratives to promote local patient-centered quality improvement: an ethnographic process evaluation of 'accelerated' experience-based co-design. / Locock, Louise; Robert, Glenn; Boaz, Annette; Vougioukalou, Sonia; Shuldham, Caroline; Fielden, Jonathan; Ziebland, Sue; Gager, Melanie; Tollyfield, Ruth; Pearcey, John.

In: Journal of Health Services Research & Policy, Vol. 19, No. 4, 01.10.2014, p. 200-207.

Research output: Contribution to journalArticle

Locock, Louise ; Robert, Glenn ; Boaz, Annette ; Vougioukalou, Sonia ; Shuldham, Caroline ; Fielden, Jonathan ; Ziebland, Sue ; Gager, Melanie ; Tollyfield, Ruth ; Pearcey, John. / Using a national archive of patient experience narratives to promote local patient-centered quality improvement: an ethnographic process evaluation of 'accelerated' experience-based co-design. In: Journal of Health Services Research & Policy. 2014 ; Vol. 19, No. 4. pp. 200-207.
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