How do we make patient experience data more useful?
21 May 2018
Louise Locock describes the development of a new guide to help frontline NHS staff make better use of patient experience data.
In 2015, we embarked on a study funded by the Health Service and Delivery Research programme of the National Institute for Health Research. We wanted to understand how frontline NHS staff use different types of patient experience data for patient-centred quality improvement, and what we can do to make these different types of data more useful and credible for staff.
We know that surveys are what spring to mind for most people when they think of patient experience data. But there are many other sources of information that staff can also use, including patient stories, complaints and comments cards, online feedback (such as Care Opinion), and qualitative observations. Often this type of information is more appealing and engaging for staff, giving powerful insights into what patient experience is really like. Yet staff may be concerned about how to collect and analyse it, and whether it is a reliable guide to improvement compared to more numerical data.
In our study we set out to work with frontline staff in six medical wards, supporting their learning about different types of data, encouraging them to design their own quality improvement projects and observing what happened. We started with a two-day facilitated ‘Learning Community’. Each ward sent a team of staff (including for example nurses, ward clerks, healthcare assistants and local patient experience office staff who would be working closely with the ward). We ran a series of ‘market stalls’ which staff could visit to find out about different types of data and how they might use them. We had sessions on organisational change, and on specific types of patient-centred improvement approaches such as Experience-Based Co-Design and Patient and Family Centred Care (both of which already have toolkits on the Point of Care Foundation website).
To support this Learning Community, we produced a written ‘resource book’ covering much of the same ground, so that staff had something they could refer back to when needed. One patient experience officer involved in the study described it as ‘our bible’. We held two further Learning Community events to support staff, share emerging findings and celebrate their work, some of which was happening at a time of extreme workload pressure in the winter of 2016-17.
New guide for NHS staff
A key part of the dissemination strategy for our research was to develop an online resource for NHS staff to give practical guidance on understanding and using patient experience data for quality improvement. We decided to work on this in partnership with the Point of Care Foundation.
What you will see in the guide has evolved from our original ‘resource book’, and incorporates key messages from the research. For example, we found that teams which had a patient experience officer closely embedded with the work tended to make progress more quickly. Involving staff from a wide range of disciplines and levels of seniority in the frontline team also strengthened their ability to enact change. Some wards chose to focus explicitly on improving staff experience as an indirect route to improving patient experience: ‘happy staff means happy patients’, as one participant put it. This is increasingly supported by quantitative evidence suggesting that staff experience – good or bad – is one of the most important predictors of measured patient experience scores.
We also found that staff drew on a wide range of information when planning QI activities, not just what we traditionally understand as ‘data’ but also their own daily experiences and observations of care; informal contact with patients, families and each other; even thank you cards and passing comments. Making sense of these multiple influences is a complex and sometimes subconscious process.
We discussed draft ideas for the online guide at our third and final Learning Community with frontline teams, and offered participating staff a chance to take part in short interviews to illustrate the guide if they wished. You will see them talk about what they did, what they found helpful and challenging, and their advice for other NHS colleagues.
Developing role of patient experience officers
One of our recommendations from the study is that supportive patient experience officers can make a big difference to frontline improvement work. But they are an emerging professional group, in need of more formal recognition, training and support. Often their role in Trusts has been more to collect data (for example Friends and Family Test) than to use the data for improvement, but that is changing fast. At the same time as we have been developing the guide, the Point of Care Foundation has been designing a training course in the Foundations of Patient Experience. This proved to be a great opportunity for synergy. Our findings have been built into the course, and the first cohort of trainees have been able to access the test version of the online guide as an extra resource.
Lead responsibility for writing the guide and sourcing the illustrative case study material was taken by Eleanor Stanley, and we would like to thank her for putting it all together.
The new guide is now available. Please contact to share your thoughts on the resources.
Research presented here was funded by the National Institute for Health Research Health Services and Delivery Research Programme (project number 14/156/06). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health.