How do staff use and respond to patient feedback to inform improvements to the quality and safety of care in a hospital setting?


Research team: Dr Lauren Ramsey, Professor Jane O’Hara, Dr Laura Sheard, Professor Rebecca Lawton, and Dr James Munro (CEO of Care Opinion)


Care Opinion

CLAHRC South London and Kings College London as part of a 2019 NIHR SPARC award titled ‘Exploring how online patient feedback is situated within the wider patient experience landscape using novel qualitative methodological approaches’

Why is this project important?

In recent years, NHS policy has highlighted the need for health services to adopt a more patient-centred approach to care. Aligning with this vision, patients are increasingly recognised as the biggest resource that healthcare has for improving services. Both the collection of patient feedback, and the ways that they are able to provide their feedback, has increased rapidly. This includes an increase in the development and uptake of online feedback tools, generating an enormous resource.

Whilst increasing amounts of feedback are being collected, there is a growing consensus that there is not enough being done with feedback to highlight what is working well, and where meaningful improvements could be made. Research suggests that using patient feedback to inform improvement remains challenging in practice for a variety of reasons. This includes staff working within a ‘blame culture’ prompting defensive responses, a lack of staff autonomy or authority to implement change and changes rarely fitting in smoothly with current systems or ways of working.

Adding further complexity, patients are increasingly providing their feedback publically online, on social media (e.g. Facebook and Twitter) and on online platforms (e.g. NHS Choices and Care Opinion). However, this research area is relatively unexplored.

What are we doing?

Lauren Ramsey (PhD student) began this project in October 2018. Lauren’s PhD will explore how online patient feedback is responded to and used to inform quality improvement in different NHS Trusts.

Lauren has completed a systematic literature review exploring how healthcare staff use patient feedback to inform improvements to the quality and safety of care. The research team are collaborating with one of the leading online patient feedback platform providers, Care Opinion. The team plan to explore how healthcare staff respond to patient feedback online, and how this compares with how online patient feedback is used in practice to inform improvement.

Based on stories posted on Care Opinion, Lauren has developed a framework within the project that identifies organisations in terms of a typology of responses to stories posted. The image below gives an overview of the framework (click on image to enlarge).


Patient and Public Involvement and Engagement

Lauren has met with our Lay Leader to discuss how to meaningfully involve patients and NHS staff in this research. Talking to patients and NHS staff about their views on the typology of responses via our  Citizen participation group and the Yorkshire Quality and Safety Research (YQSR) Group patient panel was suggested as a useful way forward.

Outputs and Impact                                                                                              

Contact for more information: Dr Lauren Ramsey