Partnering with consumers to co-design a person-centred coding framework for qualitative patient experience data

Abstract

BackgroundPatient Reported Experience Measures (PREMs) provide health organisations insight into how ‘person-centric’ care is. Qualitative data in PREMs surveys provide essential context about experience but are challenging to analyse at an organisational level. ObjectiveTo co-design a person-centred coding framework to assist in the analysis of qualitative PREMs data. Patient involvementConsumer representatives were involved in problem identification, co-design, coding of raw data (testing), evaluation and manuscript authorship. MethodologyCo-design principles guided production of a deductive coding framework with Picker Principles of Person-Centred Care as a conceptual framework. The framework was co-designed over 4 stages, with cross-professional stakeholders (including two consumer representatives): 1) assessment of current state and understanding priorities; 2) adapting Picker Principles of Person-Centred Care as a coding framework; 3) testing and evaluation of a coding template over two quality improvement (QI) cycles against measures of inter-coder reliability and perceived usefulness; 4) endorsement and planning for implementation. ResultsThe Picker Principles were a suitable coding framework for inpatient PREMs data, and a coding template in an electronic spreadsheet met end-user needs. Results of the first QI cycle indicated a need for ‘less academic’ domain names and definitions, which were reviewed and updated to a first-person perspective in partnership with a consumer representative. Inter-coder reliability measures and qualitative feedback improved after cycle two testing and evaluation. DiscussionThis single site study produced a feasible solution to apply person-centred principles to analyse PREMs data and requires testing in different settings. Cross-disciplinary partnerships enabled the development of a reliable and acceptable deductive coding framework that was usable for people without prior experience in qualitative data analysis. Practical valueOur solution offers an example for health services to harness the value of qualitative PREMs data and partner with consumers to take person-centric action to improve the safety, equity, and experience of healthcare.