Patient Experience Feedback Research Articles

Implementing a real-time patient experience feedback in inpatient rehabilitation: Process evaluation informed by the normalisation process theory.

Near real-time patient experience feedback (NRTPEF) can enable a patient-centric, immediate service recovery but has not been widely used in inpatient rehabilitation. We 1) assess the utility, feasibility, and acceptability of implementing a new NRTPEF, perceived by patients and providers; and 2) understand how the NRTPEF became embedded into routine provider practices. Mixed methods process evaluation of the 8-month implementation of an innovative NRTPEF in an inpatient rehabilitation unit, using interviews and focus groups with all the service-unit leaders and interviews with a randomised sample of patients. Beyond descriptive statistics and content analysis, the Normalisation Process Theory (NPT) informed a framework analysis. Patients and service-unit leaders perceived high utility in the NRTPEF (median: 9 for both; 0-10 scale) and qualitative comments emphasised the value of providing/obtaining timely feedback. The system was found feasible and acceptable for patients (median: 9.5), but with an improvement margin for providers (median: 7.3). Suggestions include strengthening the data-relay format. Even in the pilot form, providers found the NRTPEF became embedded into practice (median 10; average: 8.6). The analysis based on the NPT shows how providers saw differential value, engaged with, and used the patient feedback into reconfigured practices. An innovative NRTPEF was found useful, feasible and acceptable, but with refinement opportunities before scale-up.

Near real-time patient experience feedback with data relay to providers: a systematic review of its effectiveness.

Near Real-Time Feedback (NRTF) on the patient's experience with care, coupled with data relay to providers, can inform quality-of-care improvements, including at the point of care. The objective is to systematically review contemporary literature on the impact of the use of NRTF and data relay to providers on standardized patient experience measures. Six scientific databases and five specialty journals were searched supplemented by snowballing search strategies, according to the registered study protocol. Eligibility included studies in English (2015-2023) assessing the impact of NRTF and data relay on standardized patient-reported experience measures as a primary outcome. Eligibility and quality appraisals were performed by two independent reviewers. An expert former patient (Patient and Family Advisory Council and communication sciences background) helped interpret the results. Eight papers met review eligibility criteria, including three randomized controlled trials (RCTs) and one non-randomized study. Three of these studies involved in-person NRTF prior to data relay (patient-level data for immediate corrective action or aggregated and peer-compared) and led to significantly better results in all or some of the experience measures. In turn, a kiosk-based NRTF achieved no better experience results. The remaining studies were pre-post designs with mixed or neutral results and greater risks of bias. In-person NRTF on the patient experience followed by rapid data relay to their providers, either patient-level or provider-level as peer-compared, can improve the patient experience of care. Reviewed kiosk-based or self-reported approaches combined with data relay were not effective. Further research should determine which approach (e.g. who conducts the in-person NRTF) will provide better, more efficient improvements and under which circumstances.

P.016 Re-norming medical education: centering patient experience and diverse bodies in Lumbar Puncture (LP) instruction

Background: Medical curricula are often created with limited patient and student input and underrepresent certain body types. Traditional medical education often prepares learners to perform procedures, such as lumbar punctures (LPs), on a young white able-bodied 70kg male. When approaching diverse patients, this educational gap can lead to medical learners’ lack of confidence, skill, and knowledge, resulting in poor patient experiences. Methods: This co-design project involves patient and student input. We interviewed five patients who underwent LPs and explored their experience through a trauma-informed approach. To visualize landmarking across body types, we recruited nine volunteers of diverse body sizes, ages, tattoos, and skin colour (Fitzpatrick Scale). Incorporating patient narratives, as well as videos and photographs showing landmarking on diverse bodies, we crafted an online LP instructional module. Focus groups of 6-10 students will be held to collect student perception of the effectiveness of the module. Results: Our learning module and related media will be built into Western University’s Undergraduate Medical Education curriculum, available under a Creative Commons license through the Western Health Education Media Library. Conclusions: Integrating patient experience and student feedback, we are developing a comprehensive educational tool to better equip medical learners to deliver patient-centered LPs across diverse body types.

8.G. Workshop: Developments in patient experience surveys: how do we maintain relevance and maximise impact?

Abstract Background Patient and service-user experiences of healthcare are a vital component of the monitoring and assessment of the quality and performance of health and social care services and systems, as well as an important predictor of patient outcomes. The National Care Experience Programme (NCEP) is a partnership between the Irish health and social care regulator (Health Information and Quality Authority, HIQA), the national public healthcare provider (Health Service Executive, HSE), and policy makers (Department of Health). The NCEP conducts national care experience surveys with the aim of learning from people's experiences in order to improve the quality of health and social care services in Ireland. The programme includes surveys of acute hospital inpatient, maternity, maternity bereavement, nursing home and end-of-life care. Additional surveys of cancer care and mental health services are currently in development. Objectives Regular review and adaptation of existing surveys, expansion into new areas of care, and development of new methods of data collection, analysis and dissemination of survey findings and stakeholder engagement are required in order to remain agile and responsive to evolving health and social care landscapes and the changing needs of stakeholders, as well as harnessing technological advances and ensuring sustainability. The aim of this workshop is to bring together experts in patient experience from across the health system to stimulate discussion, knowledge sharing and cross-fertilisation of ideas. Presentations will focus on international developments and trends in patient experience, as well as considerations for surveying bereaved parents and families on their experiences of maternity bereavement and end-of-life care. The use of new technologies, including computational text analytics and predictive modelling to facilitate qualitative data analysis and maximise the use of survey findings will be outlined, followed by case studies of how care experience data are used to inform health and social care legislation, policy and practice in Ireland. Experiences from other jurisdictions and potential implications will be discussed with the audience. The workshop will contribute to a better understanding of the value and impact of collecting patient experience feedback and explore how new technologies can be used to generate insights and maximise the use of survey data. Format of the workshop The workshop will include a brief introduction on patient experience and the Irish National Care Experience Programme, followed by five presentations with time for audience contributions and questions after each speaker. The workshop will conclude with a discussion with the audience and presenters. Key messages • Patient experiences are a key component of the monitoring and assessment of the quality and performance of health and social care services and systems. • Regular review and adaptation of surveys and development of new methods are required to remain responsive to evolving health and social care landscapes and ensure sustainability.

"Making Data the Drug": A Pragmatic Pilot Feasibility Randomized Crossover Trial of Data Visualization as an Intervention for Pediatric Chronic Pain.

Data tracking is a common feature of pain e-health applications, however, viewing visualizations of this data has not been investigated for its potential as an intervention itself. We conducted a pilot feasibility parallel randomized cross-over trial, 1:1 allocation ratio. Participants were youth age 12-18 years recruited from a tertiary-level pediatric chronic pain clinic in Western Canada. Participants completed two weeks of Ecological Momentary Assessment (EMA) data collection, one of which also included access to a data visualization platform to view their results. Order of weeks was randomized, participants were not masked to group assignment. Objectives were to establish feasibility related to recruitment, retention, and participant experience. Of 146 youth approached, 48 were eligible and consented to participation, two actively withdrew prior to the EMA. Most participants reported satisfaction with the process and provided feedback on additional variables of interest. Technical issues with the data collection platform impacted participant experience and data analysis, and only 48% viewed the visualizations. Four youth reported adverse events not related to visualizations. Data visualization offers a promising clinical tool, and patient experience feedback is critical to modifying the platform and addressing technical issues to prepare for deployment in a larger trial.

P050 GIRFT in action: Advanced Practice Physiotherapist and Advanced Practice Nurse expertise provides valuable triage and assessment clinics for non-urgent Rheumatology referrals

Abstract Background/Aims Rheumatology referrals classified as non-urgent/routine are commonly non-inflammatory conditions or medically non-urgent and can have significant waiting times for appointments. These waits were further escalated by the COVID-19 pandemic. Early intervention for non-inflammatory conditions can be crucial to good outcomes and long wait-times can have significant adverse impacts while appropriate care pathways are determined. Recent UK GIRFT recommendations include using non-medical health professional expertise in assessment and management pathways to support right place, right time, right care. This study evaluated effectiveness, impacts and patient experiences of Advanced Practice Physiotherapist (APP) and Advanced Practice Nurse (APN) Triage and Assessment Clinics for routine new referrals. Methods The non-urgent/routine referral waiting list was e-triaged by a Rheumatology APP and APN supported by clinical record searches. Patients were contacted by telephone to update on clinical status and appointment requirements determined. Triage criteria were applied to determine new referrals suitable for APP and APN Rheumatology clinics, which included low likelihood of inflammatory disease or new referrals for known diagnosis/stable conditions. Clinics were undertaken with collocated Consultant clinical supervision. Assessment findings were discussed and management agreed, or seen if needed. With waiting list attrition, clinics were expanded to include Consultant-determined stable condition reviews and follow-up reviews for non-suspected inflammatory disease. Results At 01 July 2021, 214 new routine referrals were waiting a Consultant appointment (n=103 over 2yrs). Since service initiation, clinic outcomes to date include: 69% (n = 243/358) new routine referrals discharged to GP or directed to right pathway with information, advice and self-management resources; 8% (n=29) escalated to urgent; 3% (11/358) with medical complexity remained on Consultant waitlist. Most common presentations seen included: Osteoarthritis (general or hand); Back and other spinal pain; Fibromyalgia; Persistent Fatigue and Widespread Pain; JHS/hEDS; Positive ANA without clinical features; Musculoskeletal conditions- other. To date, no patients have been re-referred and 329 new patient and 89 follow-up Consultant direct consultations have been spared. There is currently no wait-time for non-urgent/routine appointments. Patient experience feedback on the service has offered a 100% recommendation to continue and expressed highly positive experiences with the MDT approach. Patients value the breadth of expertise and care support, and the timely, thorough and professional service provided. Conclusion Rheumatology non-urgent/routine new referrals with low probability of underlying autoimmune conditions may be effectively and efficiently managed in a collaborative model using an advanced practice physiotherapist and nurse. This innovation has expanded a traditionally medical pathway to an MDT model utilising value-adding non-medical expertise in service delivery. It has enhanced interdisciplinary learning and is a valued, collaborative approach to patient care. The initiative provides support to GIRFT recommendations of using an MDT skill-set to support improved patient access, service efficiencies and earlier intervention. Disclosure C. McCrum: Grants/research support; Funding grant to provide professional education workshops- Novartis, Janssen. B. Zeljkovic: None. C. Perera: None.

Role of Patient Feedback in Better Medical Care

Patient satisfaction and experience are important indicators for measuring healthcare quality. The recent widespread use of patientexperience surveys in healthcare settings is based on the fact that feedback has a potentially important role in improving the quality of care, affects clinical outcomes and timely, efficient, patient-centred delivery of quality health. Research into patient experience feedback is a relatively recent phenomenon that began in the 1990s.1 Research into how healthcare providers use this data to improve services is at an early stage. Recent systematic research on patient experience and feedback collection was held at the Armed Forces Institute of Radiology & Imaging (AFIRI), providing evidence to influence debate, policy and practice on patient feedback data.

Patient Experience Feedback In Rehabilitation Quality Improvement And Codesign Activities: Scoping Review

<h3>Research Objectives</h3> To characterize the literature, including reported enablers and gaps, on the use of patient experience (Px) feedback in rehabilitation codesign and quality improvement (QI) activities. <h3>Design</h3> Scoping review. <h3>Setting</h3> Data sources: Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web-of-Science, ProQuest); Greylit database, website searches (e.g., Beryl Institute), snowballing, and key-informant recommendations. <h3>Participants</h3> Study Selection: Two independent reviewers performed title-and-abstract screenings and full-text reviews. Eligibility criteria focused on English-language, peer-reviewed (all time) and grey literature (last 5 years) that engage Px feedback in rehabilitation QI or codesign activities. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Data extraction: The QI aims, settings, methods, patient engagement strategies, findings, implications, and reported limitations were extracted, followed by a content analysis identifying reported enablers and gaps. <h3>Results</h3> Data synthesis: Of 851 unique references and 50 full texts reviewed, ten papers were included: six used codesign to engage patients in QI activities; four used Px survey data to inform and evaluate QI activities. Implementation enablers included securing managerial support, having a designated methodology and facilitator - including for balancing power in codesign, using efficient processes, engaging staff experience feedback, and using appreciative inquiry. Gaps included limited follow-up, low sample sizes, analytical limitations, difficulties engaging patients with severe limitations, or lack of reported limitations. <h3>Conclusions</h3> Conclusion: Few examples of Px feedback engagement in QI or codesign activities were found in the rehabilitation literature, either scientific or grey. Px improvement activities were merely informed by Px survey data, not qualitative or participatory approaches which are often more actionable. The identified enablers and gaps can support the design, use, evaluation, and report of person-centered QI activities that meaningfully engage and use Px feedback. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.

Implementation of telehealth for first-dose device teaching within a health-system specialty pharmacy.

To demonstrate how the integration of a pharmacist-led, telehealth-based first-dose device teaching (FDDT) workflow helped to improve the efficiency of the work system, expand access, and maintain the high quality of care. The telehealth program was designed utilizing existing specialty pharmacy infrastructure and a partnership with a dermatology clinic. The program includes patients receiving a self-injectable specialty medication (SISM) who require an FDDT and fill with our health system's specialty pharmacy. Patients complete a virtual FDDT with a specialty pharmacist following an initial pharmacist consult and medication shipment. Patient experience and program feedback were captured via a standardized 5-point Likert telephone survey. A total of 30 patients completed the FDDT program. Surveys following the FDDT visit completed by 19 patients showed that patients had high satisfaction with the quality and convenience of the telehealth visit (4.53 and 4.79, respectively). Overall care and education received from the pharmacist was also rated highly (5.00). Notable feedback captured in free responses emphasized the helpfulness of the pharmacist and the convenience of the visit. Areas to improve focused on technology difficulties. As SISMs continue to grow in utilization, telehealth services should be considered as part of the clinic workflow. Specialty pharmacists delivered high-quality and convenient care to patients through this patient education program. Expansion of this program into additional clinics may help improve specialty care access and increase the availability of nursing staff for additional clinical needs.

The use of patient experience feedback in rehabilitation quality improvement and codesign activities: Scoping review of the literature

Objective To characterize the literature, reported enablers, and gaps on the use of patient experience feedback for person-centered rehabilitation quality improvement and codesign activities. Design Scoping Review. Data sources Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web of Science, ProQuest), website searches (e.g. Beryl Institute), snowballing, and key-informant recommendations. Methods Two independent reviewers performed title and abstract screenings and full-text reviews. Eligibility focused on English-language, peer-reviewed (all time) and gray literature (last five years) that used patient experience feedback in rehabilitation improvement activities. The aims, settings, methods, findings, implications, and reported limitations were extracted, followed by content analyses identifying reported enablers and gaps. Results Among the 901 unique references and 52 full texts reviewed, ten were included: four used patient experience surveys for improving patient experiences; six used codesign methodologies to engage patient feedback in service improvement activities. Implementation enablers included securing managerial support, having a structured methodology and facilitator, using efficient processes, engaging staff experiences, and using appreciative inquiry. Reported study gaps included limited follow-up, low sample sizes, analytical limitations, lack of reported limitations, or narrow range of perspectives (e.g. not from people with severe impairments). Conclusion Few examples of the use of patient experience feedback in quality improvement or codesign activities were found in the rehabilitation literature. Patient experience improvement activities relied exclusively on retrospective survey data, which were not combined with often more actionable forms (e.g. qualitative, real time) of patient experience feedback. Further research might consider design of activities that collect and use patient experience feedback for rehabilitation service improvements.

Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study.

ObjectivesDespite established standards and guidelines, substantial variation remains in the delivery of hip fracture care across the United Kingdom. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the months following hip fracture.MethodsWe examined a national record-linkage cohort of 178,757 patients aged ≥60 years who sustained a hip fracture in England and Wales in 2016–19. Patient-level hospital admissions datasets, National Hip Fracture Database and mortality data were linked to metrics from 18 hospital-level organisational-level audits and reports. Multilevel models identified organisational factors, independent of patient case-mix, associated with three patient outcomes: length of hospital stay (LOS), 30-day all-cause mortality and emergency 30-day readmission.ResultsAcross hospitals mean LOS ranged from 12 to 41.9 days, mean 30-day mortality from 3.7 to 10.4% and mean readmission rates from 3.7 to 30.3%, overall means were 21.4 days, 7.3% and 15.3%, respectively. In all, 22 organisational factors were independently associated with LOS; e.g. a hospital’s ability to mobilise >90% of patients promptly after surgery predicted a 2-day shorter LOS (95% confidence interval [CI]: 1.2–2.6). Ten organisational factors were independently associated with 30-day mortality; e.g. discussion of patient experience feedback at clinical governance meetings and provision of prompt surgery to >80% of patients were each associated with 10% lower mortality (95%CI: 5–15%). Nine organisational factors were independently associated with readmissions; e.g. readmissions were 17% lower if hospitals reported how soon community therapy would start after discharge (95%CI: 9–24%).ConclusionsReceipt of hip fracture care should be reliable and equitable across the country. We have identified multiple, potentially modifiable, organisational factors associated with important patient outcomes following hip fracture.

What are the sources of patient experience feedback in the UK prison setting, and what do patients and healthcare staff think about giving and receiving feedback in prison? A qualitative study

Background: The collection of patient experience feedback (PEF) has seen a marked global increase in the past decade. Research about PEF has concentrated mainly on hospital settings albeit a recent interest in primary care. There has been minimal research about PEF in the prison healthcare setting. The aim of this study was to explore the role of prison PEF, the different forms it might take and the perceptions of healthcare staff and people in prison. Methods: Qualitative face to face interview study involving 24 participants across two prisons (male and female) in the North of England, involving 12 healthcare staff and 12 patients. Framework analysis was undertaken. Results: PEF sources were variable, from informal and verbal through to formal and written. The willingness of people in prison to give PEF related to whether they felt sufficiently comfortable to raise concerns, with some feeling too frightened and having apprehension about anonymity. It was viewed as disheartening to give PEF but not be informed of any outcome. Healthcare staff opinions about PEF were divergent but they found PEF unhelpful when it was about prison regime issues rather than healthcare. Suggestions for improving the PEF process were put forward and included accessibility, anonymity and digitalisation. Conclusions: This is the first study to report findings about prison PEF. There are broad similarities between our findings and research examining hospital-based PEF. Prison healthcare services seem to be listening to patients but the ways in which PEF is collected, considered and used could be improved.

The role of feedback in emergency ambulance services: a qualitative interview study

BackgroundSeveral international studies suggest that the feedback that emergency ambulance service (EMS) personnel receive on the care they have delivered lacks structure, relevance, credibility and routine implementation. Feedback in this context can relate to performance or patient outcomes, can come from a variety of sources and can be sought or imposed. Evidence from health services research and implementation science, suggests that feedback can change professional behavior, improve clinical outcomes and positively influence staff mental health. The current study aimed to explore the experience of EMS professionals regarding current feedback provision and their views on how feedback impacts on patient care, patient safety and staff wellbeing.MethodsThis qualitative study was conducted as part of a wider study of work-related wellbeing in EMS professionals. We used purposive sampling to select 24 frontline EMS professionals from one ambulance service in the United Kingdom and conducted semi-structured interviews. The data was analyzed in iterative cycles of inductive and deductive reasoning using Abductive Thematic Network Analysis. The analysis was informed by psychological theory, as well as models from the wider feedback effectiveness and feedback-seeking behavior literature.ResultsParticipants viewed current feedback provision as inadequate and consistently expressed a desire for increased feedback. Reported types of prehospital feedback included patient outcome feedback, patient-experience feedback, peer-to-peer feedback, performance feedback, feedforward: on-scene advice, debriefing and investigations and coroners’ reports. Participants raised concerns that inadequate feedback could negatively impact on patient safety by preventing learning from mistakes. Enhancing feedback provision was thought to improve patient care and staff wellbeing by supporting personal and professional development.ConclusionsIn line with previous research in this area, this study highlights EMS professionals’ strong desire for feedback. The study advances the literature by suggesting a typology of prehospital feedback and presenting a unique insight into the motives for feedback-seeking using psychological theory. A logic model for prehospital feedback interventions was developed to inform future research and development into prehospital feedback.

Enriching the Value of Patient Experience Feedback: Web-Based Dashboard Development Using Co-design and Heuristic Evaluation.

BackgroundThere is an abundance of patient experience data held within health care organizations, but stakeholders and staff are often unable to use the output in a meaningful and timely way to improve care delivery. Dashboards, which use visualized data to summarize key patient experience feedback, have the potential to address these issues.ObjectiveThe aim of this study is to develop a patient experience dashboard with an emphasis on Friends and Family Test (FFT) reporting, as per the national policy drive.MethodsA 2-stage approach was used—participatory co-design involving 20 co-designers to develop a dashboard prototype, followed by iterative dashboard testing. Language analysis was performed on free-text patient experience data from the FFT, and the themes and sentiments generated were used to populate the dashboard with associated FFT metrics. Heuristic evaluation and usability testing were conducted to refine the dashboard and assess user satisfaction using the system usability score.ResultsThe qualitative analysis from the co-design process informed the development of the dashboard prototype with key dashboard requirements and a significant preference for bubble chart display. The heuristic evaluation revealed that most cumulative scores had no usability problems (18/20, 90%), had cosmetic problems only (7/20, 35%), or had minor usability problems (5/20, 25%). The mean System Usability Scale score was 89.7 (SD 7.9), suggesting an excellent rating.ConclusionsThe growing capacity to collect and process patient experience data suggests that data visualization will be increasingly important in turning feedback into improvements to care. Through heuristic usability, we demonstrated that very large FFT data can be presented in a thematically driven, simple visual display without the loss of the nuances and still allow for the exploration of the original free-text comments. This study establishes guidance for optimizing the design of patient experience dashboards that health care providers find meaningful, which in turn drives patient-centered care.

Provider and Staff Responses to Non-Facility Specific Patient Experience Feedback with Post-Acute Care Transitions

While a large portion of efforts related to improving patient experience, reducing medical errors, and improving clinical outcomes have focused on acute care settings, improvements in the quality of post-acute care and patient experience with transitions from general acute care settings to post-acute levels of care are key to accomplishing population health goals. While patient experience surveys are utilized nationwide, there is evidence of a need for deliberate efforts to create and implement recommendations derived from analyzing patient experience data with healthcare staff and providers. In 2019, 14 focus group sessions were conducted with providers and staff, including nursing, pharmacy, therapy, and case management from skilled nursing facilities, long-term acute care hospitals, and inpatient rehabilitation facilities. To minimize bias while studying reactions to patient comments regarding care transitions, participants from different facilities were placed into groups together and provided de-identified patient comments to review and discuss key themes and potential solutions. Attribution, discourse, and summative content analyses were performed to identify the key themes. A framework was developed to understand provider and staff reactions to non-facility-specific patient experience feedback as well as recommendations for improving post-acute care transitions

Indigenous Māori experiences of fundamental care delivery in an acute inpatient setting: A qualitative analysis of feedback survey data.

This study aimed to explore inpatient healthcare delivery experiences of Māori (New Zealand's Indigenous people) patients and their whānau (extended family network) at a large tertiary hospital in New Zealand to (a) determine why Māori are less satisfied with the relational and psychosocial aspects of fundamental care delivery compared to other ethnic groups; (b) identify what aspects of care delivery are most important to them; and (c) contribute to the refinement of the Fundamentals of Care framework to have a deeper application of Indigenous concepts that support health and well-being. Bi-annual Fundamentals of Care audits at the study site have shown that Māori are more dissatisfied with aspects of fundamental care delivery than other ethnic groups. Retrospective analysis of narrative feedback from survey data using an exploratory descriptive qualitative approach. Three hundred and fifty-four questionnaires containing narrative patient experience feedback were collected from the study site's patient experience survey reporting system. Content analysis was used to analyse the data in relation to the Fundamentals of Care framework and Māori concepts of health and well-being. The research complies with the SRQR guidelines for reporting qualitative research. Four themes were identified: being treated with kindness and respect; communication and partnership; family is the fundamental support structure; and inclusion of culture in the delivery of care. The current iteration of the Fundamentals of Care framework does not reflect in depth how indigenous groups view health and healthcare delivery. The inclusion of an Indigenous paradigm in the framework could improve healthcare delivery experiences of Indigenous peoples. Research around the application and relevance of the Fundamentals of Care framework to Indigenous groups provides an opportunity to refine the framework to improve health equity, and healthcare delivery for Indigenous people.

Identifying factors that promote and limit the effective use of real-time patient experience feedback: a mixed-methods study in secondary care

ObjectivesThe Friends and Family Test (FFT) is commissioned by the National Health Service (NHS) in England to capture patient experience as a real-time feedback initiative for patient-centred quality improvement (QI)....

Applying natural language processing and machine learning techniques to patient experience feedback: a systematic review

ObjectivesUnstructured free-text patient feedback contains rich information, and analysing these data manually would require a lot of personnel resources which are not available in most healthcare organisations.To undertake a systematic...

Automated analysis of ambulatory surgery patient experience comments using artificial intelligence for quality improvement: A patient centered approach

BackgroundQuality improvement in healthcare is limited by both the quality and quantity of data available in the electronic health records or self reported by clinicians. Appropriate and timely reporting can help identify opportunities for quality improvement and deployment of mitigation steps but many of these process remain manual. Negative patient experience comments can potentially be used in identifying opportunities for quality improvement. Artificial intelligence (AI) techniques, like natural language processing (NLP) including sentiment analysis and topic modeling can be used to characterize patient experience comments in near real time, thus making the process timely, efficient and measurable. MethodsWe analyzed 15,453 de-identified patient experience comments from the Press Ganey™ survey of adult patients undergoing outpatient surgeries with anesthesia at Cleveland Clinic from 01/01/2012-05/03/2016. We used open source NLP including sentiment analysis and topical modeling to analyze post-discharge patient experience survey comments and feedback verbatim. For sentiment analysis we used an open source sentiment analyzer called VADER. For topic modeling we used Latent Dirichlet Allocation (LDA) algorithm. ResultsSentiment analysis of patient comments using VADER was highly accurate with F1 score ranging from 0.83 to 0.84 for positive comments and 0.71–0.73 for negative comments compared to clinician's assessment. Two clinicians reviewed 1955 random comments as positive or negative with good agreement, with Cohen's k test score of k = 0.92 (p < 0.001). Six thematic areas were identified based on LDA algorithms topic analysis with interpretable and measurable weighable of words extracted from the comments associated with poor patient satisfaction, thus defining targeted opportunities for improvement. ConclusionWe conclude that artificial intelligence can help in near real-time analysis of patient experience surveys. Commonly used open source algorithms can possibly be utilized in healthcare for quality improvement negating the need for significant development resources with the opportunity to generalize and scale.

Use of the patient-reported outcomes measurement information system (PROMIS\xae) to assess late-onset Pompe disease severity

BackgroundPatient-Reported Outcomes provide an opportunity for patients to establish dialogue with pharmaceutical or biotechnology companies about their health conditions without interpretation by a clinician or anyone else. However, Patient-Reported Outcomes that can be widely applicable for use in patient-focused drug development or clinical trial designs are not yet validated for all diseases. The aim of this study report was to provide supportive evidence of the construct and content validity of selected Patient-Reported Outcomes Measurement Information System (PROMIS®) questionnaires compared with other disease-relevant clinical outcome measures, including the 6-Minute Walk Distance, forced vital capacity, and Manual Muscle Test, in late-onset Pompe disease and to provide supportive evidence that the selected PROMIS measures are relevant and important to these patients.MethodsThirty patients with late-onset Pompe disease completed five PROMIS questionnaires that were chosen based on patient and provider feedback, along with discussion with key opinion leaders who are experts in Pompe disease. The Amicus Pompe Patient Advisory Board also provided patient experience feedback using the PROMIS questionnaires. Clinical outcome measures (6-Minute Walk Distance, forced vital capacity, and Manual Muscle Test) were collected at the Duke University Pompe Disease Clinical Research Program during a single visit.ResultsThe Patient Advisory Board rated the questionnaires as representative of an unmet need. Correlation data demonstrated moderate to strong correlations of PROMIS questionnaires with the specified clinical outcome measures (6-Minute Walk Distance, forced vital capacity, and Manual Muscle Test). These data supported the construct and content validity of the PROMIS questionnaires because they confirmed the motor signs and symptoms of functional disability observed in patients with Pompe disease.ConclusionsThe correlations indicate that the clinical outcome measures assess important concepts related to patient-reported experiences. The Patient Advisory Board findings suggest that the selected PROMIS questionnaires are meaningful and address important concepts to patients with Pompe disease. The data were collected from a small number of patients at a single time point; further studies are needed with additional PROMIS questionnaires, which should include measures of motor function and health-related quality of life, in a larger number of patients followed up longitudinally.