Abstract
BackgroundResponding to online patient feedback is considered integral to patient safety and quality improvement. However, guidance on how to respond effectively is limited, with limited attention paid to patient perceptions and reactions.ObjectivesTo identify factors considered potentially helpful in enhancing response quality; coproduce a best‐practice response framework; and quality‐appraise existing responses.DesignA four‐stage mixed methodology: (i) systematic search of stories published on Care Opinion about adult mental health services in the South West of England; (ii) collaborative thematic analysis of responses to identify factors potentially helpful in enhancing response quality; (iii) validation of identified factors by a patient‐carer group (n = 12) leading to the coproduction of a best‐practice response framework; and (iv) quality appraisal of existing responses.ResultsA total of 245 stories were identified, with 183 (74.7%) receiving a response. Twenty‐four (9.8%) had been heard but not yet responded to. 1.6% (n = 4/245) may lead to a change. Nineteen factors were considered influential in response quality. These centred around seven subject areas: (i) introductions; (ii) explanations; (iii) speed of response; (iv) thanks and apologies; (v) response content; (vi) signposting; and (vii) response sign‐off that were developed into a conceptual framework (the Plymouth, Listen, Learn and Respond framework). Quality appraisal of existing responses highlighted areas for further improvement demonstrating the framework's utility.ConclusionThis study advances existing understanding by providing previously unavailable guidance. It has clear practical and theoretical implications for those looking to improve health‐care services, patient safety and quality of care. Further validation of the conceptual framework is encouraged.
Highlights
Patient feedback is considered integral to quality improvement and patient safety.[1,2,3,4]
The advent of Web 2.0 and subsequent electronic word-of-mouth platforms such as Patient Opinion ( Care Opinion) and iWantGreatCare has transformed the ways in which patients access and evaluate health-care services, and the way in which they publically share their health-care experiences.[5,6,7]. In spite of their acknowledged importance and increasing use,[8] limited attention has explored how health-care organizations respond to patient feedback online, how patients perceive and react to these responses, and how organizational responses might be improved.[5]
Our research strongly suggests responses need to provide appropriate explanations, be made accessible to patients and be presented in a polite, empathic manner facilitated by assurance, honesty and respect
Summary
Patient feedback is considered integral to quality improvement and patient safety.[1,2,3,4] The advent of Web 2.0 and subsequent electronic word-of-mouth (eWOM) platforms such as Patient Opinion ( Care Opinion) (www.careopinion.org.uk) and iWantGreatCare (www.iwantgreatcare.org) has transformed the ways in which patients access and evaluate health-care services, and the way in which they publically share their health-care experiences.[5,6,7] in spite of their acknowledged importance and increasing use,[8] limited attention has explored how health-care organizations respond to patient feedback online, how patients perceive and react to these responses, and how organizational responses might be improved.[5]Being able to effectively respond to patient feedback is considered important if health-care providers are to better monitor patient safety and quality of care,[1] improve systemic issues and encourage patient-centred care.[4,5,9,10] As described by Doig and others, it is possible to complete a feedback process with a higher opinion of the organization if the feedback process has been satisfactory.[5,9] In contrast, the provision of an unsatisfactory response can lead to negative emotions including frustration and dissatisfaction.[9,11] While some patients may accept that service provision can go wrong due to human error, as suggested by Rio-Lanza, an organization’s response, or lack of response, to the service failure can be the most likely cause of service dissatisfaction.[10]. Objectives: To identify factors considered potentially helpful in enhancing response quality; coproduce a best-practice response framework; and quality-appraise existing responses. Design: A four-stage mixed methodology: (i) systematic search of stories published on Care Opinion about adult mental health services in the South West of England; (ii) collaborative thematic analysis of responses to identify factors potentially helpful in enhancing response quality; (iii) validation of identified factors by a patient-carer group (n = 12) leading to the coproduction of a best-practice response framework; and (iv) quality appraisal of existing responses. Conclusion: This study advances existing understanding by providing previously unavailable guidance It has clear practical and theoretical implications for those looking to improve health-care services, patient safety and quality of care.
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