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Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

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Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study. / Donetto, Sara; Desai, Amit Ashok; Zoccatelli, Giulia; Robert, Glenn Brian; Allen, Davina; Brearley, Sally; Rafferty, Anne Marie.

In: Health Services And Delivery Research, Vol. 7, No. 34, 02.10.2019.

Research output: Contribution to journalArticle

Harvard

Donetto, S, Desai, AA, Zoccatelli, G, Robert, GB, Allen, D, Brearley, S & Rafferty, AM 2019, 'Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study', Health Services And Delivery Research, vol. 7, no. 34.

APA

Donetto, S., Desai, A. A., Zoccatelli, G., Robert, G. B., Allen, D., Brearley, S., & Rafferty, A. M. (2019). Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study. Health Services And Delivery Research, 7(34).

Vancouver

Donetto S, Desai AA, Zoccatelli G, Robert GB, Allen D, Brearley S et al. Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study. Health Services And Delivery Research. 2019 Oct 2;7(34).

Author

Donetto, Sara ; Desai, Amit Ashok ; Zoccatelli, Giulia ; Robert, Glenn Brian ; Allen, Davina ; Brearley, Sally ; Rafferty, Anne Marie. / Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study. In: Health Services And Delivery Research. 2019 ; Vol. 7, No. 34.

Bibtex Download

@article{ff1509e612fb44398aabcec6ab591373,
title = "Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study",
abstract = "Background: Although NHS organisations have access to a wealth of patient experience data in various formats (e.g. surveys, complaints and compliments, patient stories and online feedback), not enough attention has been paid to understanding how patient experience data translate into improvements in thequality of care. Objectives: The main aim was to explore and enhance the organisational strategies and practices through which patient experience data are collected, interpreted and translated into quality improvements in acute NHS hospital trusts in England. The secondary aim was to understand and optimise theinvolvement and responsibilities of nurses in senior managerial and front-line roles with respect to such data.Design: The study comprised two phases. Phase 1 consisted of an actor–network theory-informed ethnographic study of the ‘journeys’ of patient experience data in five acute NHS hospital trusts, particularly in cancer and dementia services. Phase 2 comprised a series of Joint Interpretive Forums (one cross-site and one at each trust) bringing together different stakeholders (e.g. members of staff, national policy-makers, patient/carer representatives) to distil generalisable principles to optimise the use of patient experience data.Setting: Five purposively sampled acute NHS hospital trusts in England.Results: The analysis points to five key themes: (1) each type of data takes multiple forms and can generate improvements in care at different stages in its complex ‘journey’ through an organisation; (2) where patient experience data participate in interactions (with human and/or non-human actors) characterised by the qualities of autonomy (to act/trigger action), authority (to ensure that action is seen as legitimate) and contextualisation (to act meaningfully in a given situation), quality improvements can take place in response to the data; (3) nurses largely have ultimate responsibility for the way in which data are collected, interpreted and used to improve care, but other professionals also have important roles that could be explored further; (4) formalised quality improvement can confer authority to patient experience data work, but the data also lead to action for improvement in ways that are not formally identified as quality improvement; (5) sense-making exercises with study participants can support organisational learning.Limitations: Patient experience data practices at trusts performing ‘worse than others’ on the Care Quality Commission scores were not examined. Although attention was paid to the views of patients and carers, the study focused largely on organisational processes and practices. Finally, the processes and practicesaround other types of data were not examined, such as patient safety and clinical outcomes data, or how these interact with patient experience data.Conclusions: NHS organisations may find it useful to identify the local roles and processes that bring about autonomy, authority and contextualisation in patient experience data work. The composition and expertise of patient experience teams could better complement the largely invisible nursing work thatcurrently accounts for a large part of the translation of data into care improvements.",
keywords = "Patient experience, Actor Network Theory, Ethnography, Quality improvement",
author = "Sara Donetto and Desai, {Amit Ashok} and Giulia Zoccatelli and Robert, {Glenn Brian} and Davina Allen and Sally Brearley and Rafferty, {Anne Marie}",
year = "2019",
month = "10",
day = "2",
language = "English",
volume = "7",
journal = "Health Services And Delivery Research",
issn = "2050-4349",
publisher = "NIHR Journals Library Publications",
number = "34",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

AU - Donetto, Sara

AU - Desai, Amit Ashok

AU - Zoccatelli, Giulia

AU - Robert, Glenn Brian

AU - Allen, Davina

AU - Brearley, Sally

AU - Rafferty, Anne Marie

PY - 2019/10/2

Y1 - 2019/10/2

N2 - Background: Although NHS organisations have access to a wealth of patient experience data in various formats (e.g. surveys, complaints and compliments, patient stories and online feedback), not enough attention has been paid to understanding how patient experience data translate into improvements in thequality of care. Objectives: The main aim was to explore and enhance the organisational strategies and practices through which patient experience data are collected, interpreted and translated into quality improvements in acute NHS hospital trusts in England. The secondary aim was to understand and optimise theinvolvement and responsibilities of nurses in senior managerial and front-line roles with respect to such data.Design: The study comprised two phases. Phase 1 consisted of an actor–network theory-informed ethnographic study of the ‘journeys’ of patient experience data in five acute NHS hospital trusts, particularly in cancer and dementia services. Phase 2 comprised a series of Joint Interpretive Forums (one cross-site and one at each trust) bringing together different stakeholders (e.g. members of staff, national policy-makers, patient/carer representatives) to distil generalisable principles to optimise the use of patient experience data.Setting: Five purposively sampled acute NHS hospital trusts in England.Results: The analysis points to five key themes: (1) each type of data takes multiple forms and can generate improvements in care at different stages in its complex ‘journey’ through an organisation; (2) where patient experience data participate in interactions (with human and/or non-human actors) characterised by the qualities of autonomy (to act/trigger action), authority (to ensure that action is seen as legitimate) and contextualisation (to act meaningfully in a given situation), quality improvements can take place in response to the data; (3) nurses largely have ultimate responsibility for the way in which data are collected, interpreted and used to improve care, but other professionals also have important roles that could be explored further; (4) formalised quality improvement can confer authority to patient experience data work, but the data also lead to action for improvement in ways that are not formally identified as quality improvement; (5) sense-making exercises with study participants can support organisational learning.Limitations: Patient experience data practices at trusts performing ‘worse than others’ on the Care Quality Commission scores were not examined. Although attention was paid to the views of patients and carers, the study focused largely on organisational processes and practices. Finally, the processes and practicesaround other types of data were not examined, such as patient safety and clinical outcomes data, or how these interact with patient experience data.Conclusions: NHS organisations may find it useful to identify the local roles and processes that bring about autonomy, authority and contextualisation in patient experience data work. The composition and expertise of patient experience teams could better complement the largely invisible nursing work thatcurrently accounts for a large part of the translation of data into care improvements.

AB - Background: Although NHS organisations have access to a wealth of patient experience data in various formats (e.g. surveys, complaints and compliments, patient stories and online feedback), not enough attention has been paid to understanding how patient experience data translate into improvements in thequality of care. Objectives: The main aim was to explore and enhance the organisational strategies and practices through which patient experience data are collected, interpreted and translated into quality improvements in acute NHS hospital trusts in England. The secondary aim was to understand and optimise theinvolvement and responsibilities of nurses in senior managerial and front-line roles with respect to such data.Design: The study comprised two phases. Phase 1 consisted of an actor–network theory-informed ethnographic study of the ‘journeys’ of patient experience data in five acute NHS hospital trusts, particularly in cancer and dementia services. Phase 2 comprised a series of Joint Interpretive Forums (one cross-site and one at each trust) bringing together different stakeholders (e.g. members of staff, national policy-makers, patient/carer representatives) to distil generalisable principles to optimise the use of patient experience data.Setting: Five purposively sampled acute NHS hospital trusts in England.Results: The analysis points to five key themes: (1) each type of data takes multiple forms and can generate improvements in care at different stages in its complex ‘journey’ through an organisation; (2) where patient experience data participate in interactions (with human and/or non-human actors) characterised by the qualities of autonomy (to act/trigger action), authority (to ensure that action is seen as legitimate) and contextualisation (to act meaningfully in a given situation), quality improvements can take place in response to the data; (3) nurses largely have ultimate responsibility for the way in which data are collected, interpreted and used to improve care, but other professionals also have important roles that could be explored further; (4) formalised quality improvement can confer authority to patient experience data work, but the data also lead to action for improvement in ways that are not formally identified as quality improvement; (5) sense-making exercises with study participants can support organisational learning.Limitations: Patient experience data practices at trusts performing ‘worse than others’ on the Care Quality Commission scores were not examined. Although attention was paid to the views of patients and carers, the study focused largely on organisational processes and practices. Finally, the processes and practicesaround other types of data were not examined, such as patient safety and clinical outcomes data, or how these interact with patient experience data.Conclusions: NHS organisations may find it useful to identify the local roles and processes that bring about autonomy, authority and contextualisation in patient experience data work. The composition and expertise of patient experience teams could better complement the largely invisible nursing work thatcurrently accounts for a large part of the translation of data into care improvements.

KW - Patient experience

KW - Actor Network Theory

KW - Ethnography

KW - Quality improvement

M3 - Article

VL - 7

JO - Health Services And Delivery Research

JF - Health Services And Delivery Research

SN - 2050-4349

IS - 34

ER -

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