Abstract
BackgroundThe use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use. This paper presents an empirical case of PREMs innovation in Italy, to foster patient data use up to the ward level, by keeping strengths and addressing weaknesses of previous PREMs survey experiences. The paper reports key lessons learned in this ongoing experience of action research, directly involving practitioners.MethodsThe aim of this paper is to present the results of an ongoing action research, encompassing the innovation of PREMs collection, reporting and use, currently adopted by 21 hospitals of two Italian regions. The continuous and systematic PREMs collection has been implemented between 2017 and 2019 and includes: a continuous web-based administration, using web-services; an augmented and positive questionnaire matching standard closed-ended questions with narrative sections; the inclusion and benchmarking of patient data within a shared performance evaluation system; public disclosure of aggregated anonymized data; a multi-level and real-time web-platform for reporting PREMs to professionals. The action research was carried out with practitioners in a real-life and complex context. The authors used multiple data sources and methods: observations, feedback of practitioners, collected during several workshops and meetings, and analysis of preliminary data on the survey implementation.ResultsA continuous and systematic PREMs observatory was developed and adopted in two Italian regions. PREMs participation and response rates tend to increase over time, reaching stable percentages after the first months. Narrative feedback provide a ‘positive narration’ of episodes and behaviours that made the difference to patients and can inform quality improvement actions. Real-time reporting of quantitative and qualitative data is enabling a gratifying process of service improvement and people management at all the hospitals’ levels.ConclusionsThe PREMs presented in this paper has been recognized by healthcare professionals and managers as a strategic and positive tool for improving an actual use of PREMs at system and ward levels, by measuring and highlighting positive deviances, such as compassionate behaviours.
Highlights
The use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use
This paper presents the results of an ongoing action research, and suggests methods for improving the use of patient-data by solving several of the most important issues related to the collection and reporting of PREMs data
Study design The aim of this paper is to present the results of an ongoing action research [52], which is appropriate when a new approach is built or implanted on an existing system [53], such as the traditional way of PREMs’ collection, reporting and use
Summary
The use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use. Public disclosure and proper dissemination of patient data within healthcare organizations' performance evaluation systems can foster patient-driven changes in healthcare [3, 4]. This can positively impact organizations’ performance [5], and health professionals’ culture and behaviours [4, 6], on the basis of various mechanisms, such as the reputational lever [7]. Patient surveys can be used to introduce and evaluate new services and innovations [18,19,20]
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