Wild Data: How Frontline Hospital Staff Make Sense of Patients’ Experiences

Catherine Montgomery* (Corresponding Author), Alison Chisholm, Stephen Parkin, Louise Locock

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Patient‐centred care has become the touchstone of healthcare policy in developed healthcare systems. The ensuing commodification of patients’ experiences has resulted in a mass of data but little sense of whether and how such data are used. We sought to understand how front‐line staff use patient experience data for quality improvement in the National Health Service (NHS). We conducted a 12‐month ethnographic case study evaluation of improvement projects in six NHS hospitals in England in 2016–2017. Drawing on the sociology of everyday life, we show how front‐line staff worked with a notion of data as interpersonal and embodied. In addition to consulting organisationally sanctioned forms of data, staff used their own embodied interactions with patients, carers, other staff and the ward environment to shape improvements. The data staff found useful involved face‐to‐face interaction and dialogue; were visual, emotive, and allowed for immediate action. We draw on de Certeau to re‐conceptualise this as ‘wild data’. We conclude that patient experience data are relational, and have material, social and affective dimensions, which have been elided in the literature to date. Practice‐based theories of the everyday help to envision ‘patient experience’ not as a disembodied tool of managerialism but as an embedded part of healthcare staff professionalism.
Original languageEnglish
Pages (from-to)1424-1440
Number of pages17
JournalSociology of Health & Illness
Volume42
Issue number6
Early online date31 May 2020
DOIs
Publication statusPublished - 11 Jul 2020

Bibliographical note

Acknowledgements
The authors would like to thank the ward teams and senior management teams at the six participating case study sites, as well as the US‐PEx team of investigators and lay panel members. All authors were employed by the Nuffield Department of Primary Care Health Sciences at the University of Oxford at the time of undertaking the research. The views expressed are those of the authors and do not necessarily reflect the views and opinions of the authors' institutions. This research was funded by the NIHR Health Services and Delivery Research Programme 14/156/06, with scholarship by CM supported in part by the Wellcome Trust through (grant number 209519/Z/17/Z). LL was supported by Oxford NIHR Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Keywords

  • patient experience
  • quality improvement
  • data practices
  • ethnography
  • England
  • QUALITY
  • SAFETY
  • COMMODIFICATION
  • CARE
  • CHALLENGES
  • WORK
  • FEEDBACK
  • SOFT INTELLIGENCE

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