scholarly journals Using online patient feedback to improve NHS services: the INQUIRE multimethod study

2019 ◽  
Vol 7 (38) ◽  
pp. 1-150 ◽  
Author(s):  
John Powell ◽  
Helen Atherton ◽  
Veronika Williams ◽  
Fadhila Mazanderani ◽  
Farzana Dudhwala ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Services ◽  
Case Studies ◽  
Current Evidence ◽  
Service Improvement ◽  
Patient Feedback ◽  
Questionnaire Surveys ◽  
The Uk ◽  
Online Feedback

Background Online customer feedback has become routine in many industries, but it has yet to be harnessed for service improvement in health care. Objectives To identify the current evidence on online patient feedback; to identify public and health professional attitudes and behaviour in relation to online patient feedback; to explore the experiences of patients in providing online feedback to the NHS; and to examine the practices and processes of online patient feedback within NHS trusts. Design A multimethod programme of five studies: (1) evidence synthesis and stakeholder consultation; (2) questionnaire survey of the public; (3) qualitative study of patients’ and carers’ experiences of creating and using online comment; (4) questionnaire surveys and a focus group of health-care professionals; and (5) ethnographic organisational case studies with four NHS secondary care provider organisations. Setting The UK. Methods We searched bibliographic databases and conducted hand-searches to January 2018. Synthesis was guided by themes arising from consultation with 15 stakeholders. We conducted a face-to-face survey of a representative sample of the UK population (n = 2036) and 37 purposively sampled qualitative semistructured interviews with people with experience of online feedback. We conducted online surveys of 1001 quota-sampled doctors and 749 nurses or midwives, and a focus group with five allied health professionals. We conducted ethnographic case studies at four NHS trusts, with a researcher spending 6–10 weeks at each site. Results Many people (42% of internet users in the general population) read online feedback from other patients. Fewer people (8%) write online feedback, but when they do one of their main reasons is to give praise. Most online feedback is positive in its tone and people describe caring about the NHS and wanting to help it (‘caring for care’). They also want their feedback to elicit a response as part of a conversation. Many professionals, especially doctors, are cautious about online feedback, believing it to be mainly critical and unrepresentative, and rarely encourage it. From a NHS trust perspective, online patient feedback is creating new forms of response-ability (organisations needing the infrastructure to address multiple channels and increasing amounts of online feedback) and responsivity (ensuring responses are swift and publicly visible). Limitations This work provides only a cross-sectional snapshot of a fast-emerging phenomenon. Questionnaire surveys can be limited by response bias. The quota sample of doctors and volunteer sample of nurses may not be representative. The ethnographic work was limited in its interrogation of differences between sites. Conclusions Providing and using online feedback are becoming more common for patients who are often motivated to give praise and to help the NHS improve, but health organisations and professionals are cautious and not fully prepared to use online feedback for service improvement. We identified several disconnections between patient motivations and staff and organisational perspectives, which will need to be resolved if NHS services are to engage with this source of constructive criticism and commentary from patients. Future work Intervention studies could measure online feedback as an intervention for service improvement and longitudinal studies could examine use over time, including unanticipated consequences. Content analyses could look for new knowledge on specific tests or treatments. Methodological work is needed to identify the best approaches to analysing feedback. Study registration The ethnographic case study work was registered as Current Controlled Trials ISRCTN33095169. Funding This project was funded by the National institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 7, No. 38. See the NIHR Journals Library website for further project information.

scholarly journals Online patient feedback: a scoping review and stakeholder consultation to guide health policy

2019 ◽  
Vol 25 (2) ◽  
pp. 122-129 ◽  
Author(s):  
Anne-Marie Boylan ◽  
Veronika Williams ◽  
John Powell
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Online Reviews ◽  
Care Quality ◽  
Current Evidence ◽  
Care Providers ◽  
Stakeholder Consultation ◽  
Patient Feedback ◽  
Current Evidence Base ◽  
Online Feedback

Objective To provide a synthesis of the current evidence base of online patient feedback using a scoping review and a consultation of stakeholders in England, UK. Methods We searched MEDLINE, EMBASE, PsycINFO, CINAHL and the Social Science Citation Index and conducted hand searches up to January 2018. We included primary studies of internet-based reviews and other online feedback (e.g. social media and blogs) from patients, carers or the public about health care providers (individuals, services or organizations). Key findings were extracted and tabulated for further synthesis guided by the themes arising from a stakeholder consultation. Results The review found that awareness and usage of online feedback is increasing. Most feedback is about physicians, and is typically positive. Online reviews and ratings are used by some service users to inform choice of provider or treatment while providers tend to be concerned about the validity and representativeness of feedback. Reviewed studies found that those who post feedback are generally not representative of the general population, tending to be younger and more educated, but online feedback does broadly correlate with some other measures of health care quality. Conclusions In an increasingly digital society, where citizens provide and use feedback for a range of goods and services, online patient feedback can offer a convenient, low cost and widely accessible mechanism to capture experiences of health care, while being mindful to avoid issues of digital exclusion. This review provides important insights to inform policy development seeking to harness the opportunities offered by online feedback.

The personal experience of cancer

2007 ◽  
pp. 79-98
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Services ◽  
Health Care Professionals ◽  
Service User ◽  
Fear Of Recurrence ◽  
Local Health ◽  
Government Health ◽  
The Uk ◽  
Living With Cancer

Introduction 80 The cancer journey 82 Calendars 84 Diagnosis 86 Reactions to diagnosis and treatment 88 Living with cancer 90 Fear of recurrence 92 Recurrence and facing death 94 Survivorship 96 Government health policy in the UK aims to put the patient, or service user, at the heart of local health services. For this to happen, health care professionals must gain an appreciation of what it is like to be a person with cancer, or a carer of someone with cancer. It is hard to know or understand the experience of another person, but there are various ways that we can gain insights into their experience. This section reviews ways of understanding the experience of cancer, and then goes on to look at different aspects of that experience for individuals, using the words of people with cancer....

Re-Balancing the Roles of Public and Private Health Sectors in Wales

2013 ◽  
Vol 3 (3) ◽  
pp. 29-43
Author(s):  
Malcolm John Prowle
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Northern Ireland ◽  
Health Services ◽  
Private Sector ◽  
Health Care Provision ◽  
Care Provision ◽  
Public And Private ◽  
Health Budget ◽  
The Uk

In 1989 the UK implemented a form of political devolution to Wales, Scotland and Northern Ireland such that certain public policy areas, including health, became the responsibility of devolved Parliament or Assemblies and not the London based Parliament and Government. In the case of Wales, the Welsh Government is faced with a series of daunting challenges in relation to the future provision of health care but, unlike the situation in England, has rejected any significant increase in the involvement of the private sector in health care provision. The magnitude of the challenges faced in coping with the impacts of financial austerity on the Welsh health budget suggest there may be a role for the private sector to play in relation to the provision of health care in Wales. This paper explores those potential roles concerning: the supply of services to the NHS in Wales, the supply of health services to the Welsh population and the financing of Welsh health services.

Evaluation of the use of a Healthy Weight Discussion Tool by a health visiting team

2019 ◽  
Vol 7 (6) ◽  
pp. 272-278
Author(s):  
Tess Hickson
Keyword(s):  
Focus Group ◽  
Universal Service ◽  
Excess Weight ◽  
World Health ◽  
Service Improvement ◽  
Healthy Weight ◽  
Group Evaluation ◽  
Increased Risk ◽  
Health Organization ◽  
The Uk

A quarter of children in the UK are entering primary school either overweight or obese ( NHS Digital, 2017 ). These children have an increased risk of serious health consequences during their childhood years, which often continues into adulthood ( World Health Organization (WHO, 2017 ). A Healthy Weight Discussion Tool was created and introduced into a health visiting service to assist staff to identify and manage children presenting with excess weight. Three teams trialled its use, but uptake of this tool was low. A focus group evaluation was therefore carried out to examine the experience of staff using the tool. Although the tool was effective when implemented as intended, certain factors prevented its use in practice. These findings need to be addressed and the use of the tool re-evaluated to ascertain whether this service improvement will enhance the management of children with excess weight within the Universal service.

Mental health care in London

2005 ◽  
Vol 20 (S2) ◽  
pp. s274-s278 ◽  
Author(s):  
P. De Ponte ◽  
G. Hughes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
National Policy ◽  
Health Staff ◽  
Mental Health Staff ◽  
The Uk ◽  
Occupancy Rates

AbstractAimTo describe principles and characteristics of mental health care in London.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsLondon experiences high levels of need and use of mental health services compared to England as a whole. Inpatient andcompulsory admissions are considerably higher than the national average. Despite having more psychiatric beds and mental health staff, London has higher bed occupancy rates and staffing shortages. At the same time there is a trend away from institutionalised care to care in the community.ConclusionMental health services in the UK are undergoing considerable reform. These changes will not remove the greater need formental health services in the capital, but national policy and funding lends support to cross-agency and pan-London work to tackle some of the problems characteristic of mental health in London. Whilst various issues of mental health care in London overlap with those in other European capitals, there also are some specific problems and features.

scholarly journals Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Gubela Mji ◽  
Stine H. Braathen ◽  
Richard Vergunst ◽  
Elsje Scheffler ◽  
Janis Kritzinger ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Case Studies ◽  
Health Care Services ◽  
Public Health Care ◽  
Activity Limitations ◽  
Personal Factors ◽  
Access To Health Services ◽  
Public Health Services

Background: There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user.Aim: This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa.Setting: We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts.Methods: One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point.Results: First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services.Conclusion: The revitalisation of primary health care and the introduction of national health insurance by the Health Department of South Africa open a window of opportunity for policy makers and policy implementers to revisit and address the areas of access to public health services for people with activity limitations.

Assessment and management of vulnerable patients

2019 ◽  
pp. 141-148
Author(s):  
Sophie Behrman ◽  
Dorcas Dan-Cooke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Services ◽  
Inpatient Care ◽  
Discharge Planning ◽  
Management Strategies ◽  
Holistic Treatment ◽  
Complex Patients ◽  
Vulnerable Patients ◽  
The Uk

Staff working on mental health wards are well accustomed to assessing and managing vulnerable patients. With the current organization of mental health care in the UK, where only 5.7% of patients in contact with mental health services received inpatient care in a year, only the most unwell and/or complex patients are seen on mental health wards. These patients may well have numerous vulnerabilities, which require assessment and management as part of the holistic treatment of the patient during their admission and for discharge planning. This chapter discusses who these particularly vulnerable patients are, examines what sort of vulnerabilities patients might experience, and suggests possible management strategies.

scholarly journals High value manufacturing (HVM) in the UK: case studies and focus group insights

2019 ◽  
Vol 30 (1) ◽  
pp. 60-75
Author(s):  
Luisa Huaccho Huatuco ◽  
Veronica Martinez ◽  
Thomas F. Burgess ◽  
Nicky E. Shaw
Keyword(s):  
Focus Group ◽  
Case Studies ◽  
The Uk

scholarly journals A Corpus-Driven Approach to Sentiment Analysis of Patient Narratives

10.29007/rs9b ◽  
2018 ◽  
Author(s):  
Keith Stuart ◽  
Ana Botella ◽  
Imma Ferri-Miralles
Keyword(s):  
Health Care ◽  
Social Media ◽  
Sentiment Analysis ◽  
Patient Feedback ◽  
Patient Narratives ◽  
Growing Body ◽  
Rich Data ◽  
The Uk ◽  
The Relationship ◽  
Clinical Domain

This paper describes the linguistic analysis of a corpus of patient narratives that was used to develop and test software to carry out sentiment analysis on the aforementioned corpus. There is a growing body of research on the relationship between sentiment analysis, social media (for example, Twitter) and health care, but less research on sentiment analysis of patient narratives (being longer and more complex texts). The motivation for this research is that patient narratives of experiences of the National Health Service (NHS) in the UK provide rich data of the treatment received.The corpus threw up some unexpected results that may be of benefit for researchers of sentiment analysis. The linguistic problems encountered have been divided into three sections: the noisy nature of large corpora; the idiomatic nature of language; the nature of language in the clinical domain. This article gives an overview of the project and describes the linguistic problems that arose out of the project, which tried to find a means to automate the analysis of patient feedback on health services.

scholarly journals Persepsi Peserta JKN Terhadap Penyelenggara Pelayanan Kesehatan Rujukan

2018 ◽  
pp. 38-46
Author(s):  
Iin Nurlinawati ◽  
Rosita Rosita
Keyword(s):  
Public Health ◽  
Health Care ◽  
Focus Group ◽  
Health Service ◽  
Health Services ◽  
Health Center ◽  
Health Facility ◽  
Public Perception ◽  
Group Discussion ◽  
Public Health Center

Abstrak Permenkes 71 tahun 2013 tentang Pelayanan Kesehatan pada Jaminan Kesehatan Nasional menyebutkan bahwa penyelenggara pelayanan kesehatan meliputi semua fasilitas kesehatan yang bekerja sama dengan BPJS Kesehatan berupa fasilitas kesehatan tingkat pertama dan rujukan tingkat lanjutan. Minat masyarakat untuk memanfaatkan penyelenggara pelayanan kesehatan dengan JKN akan dipengaruhi beberapa faktor diantaranya persepsi pasien akan mutu pelayanan kesehatan, baik pada pelayanan kesehatan tingkat pertama ataupun pada fasilitas kesehatan rujukan. Penelitian ini bertujuan untuk mengetahui persepsi pasien rawat jalan peserta JKN terhadap penyelenggara pelayanan kesehatan rujukan di Puskesmas X Kota Depok. Penelitian bersifat deskriptif dengan pendekatan kualitatif yang dilaksanakan di Puskesmas X Kota Depok, pada bulan Agustus 2017. Informan dikumpulkan di Puskesmas, kemudian dilakukan focus group discussion (FGD). Data yang dikumpulkan meliputi karakteristik informan, persepsi masyarakat terhadap pelayanan kesehatan di Puskesmas dan rumah sakit yang menjadi rujukan Puskesmas X. Pemilihan informan adalah pasien yang pernah berobat di Puskesmas X dan melakukan rujukan ke rumah sakit dalam kurun waktu satu tahun terakhir. Hasil penelitian menunjukkan bahwa persepsi masyarakat terhadap pelayanan kesehatan di Puskesmas X cukup baik, informasi alur rujukan disampaikan secara jelas. Permohonan rujukan di Puskesmas menurut informan lebih nyaman karena proses rujukan mudah dan pasien mendapatkan rujukan langsung untuk beberapa kali kunjungan ke rumah sakit sehingga tidak harus sering kembali ke Puskesmas. Namun persepsi masyarakat terhadap pelaksanaan pelayanan kesehatan pada rumah sakit rujukan kurang baik karena pelayanan yang diberikan masih jauh dari harapan masyarakat. Kata kunci: Persepsi, Pelayanan kesehatan, Puskesmas, Rujukan Abstract Permenkes 71 of 2013 on Health Services on National Health Insurance states that the providers of health services include all Health Facility in cooperation with BPJS Health in the form of first rate health facilities and advanced level referral. Public interest to utilize health service providers with JKN will be influenced by several factors such as the patient’s perception on the quality of health service, either at first level health service or at referral health facility. To determine the outpatient JKN member’s perception to referal health services at X Public Health Center Depok. The research was descriptive with qualitative approach which was carried out at X Public Health Center Depok, in August 2017. Informants were collected at Puskesmas, then conducted focus group discussion (FGD). The data collected include the characteristics of informants, public perceptions of health services at health centers and hospitals that became the reference of X Community Health Center. Selection of informants were patients who had been treated at X Health Center and made referral to the hospital within the last one year. The results showed that public perception of health service at X Public Health Center was good enough, the referral flow information was presented clearly. Referral application at Puskesmas according to informant is more convenient because the referral process is easy and the patient get direct referral for several visit to hospital so that they do not have to return to Puskesmas often. However, the public perception on the implementation of health service at referral hospital is not good because the service given is still far from the expectation of society. Keywords : Perception, Health Care, Primary Health Care, Referral

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