Introduction
People who are not accustomed to working with data often have a set notion of what ‘data’ is. They may have an image of busy charts detailing complex statistical analysis.
Our study findings
In most of our study sites, it was not immediately obvious to frontline staff how to use patient experience data for improvement. At first, most considered the term ‘patient experience data’ to mean quantitative survey results, but many came to see other types of data, such as observations and narratives, as a rich source of ideas.
This section of the guide highlights a wide range of data. Some are indeed numerical, but many are simple approaches that stem from a conversation with a patient or family member. Some types of data in this guide are overlooked by people in healthcare because they are not seen as valid data. This can lead to missed opportunities to understand people’s experiences and make things better.
Nurses often struggle to find the time to collect the data, but it’s really important, so that you can focus on meaningful areas for change.
Grant Mann
Charge nurse, clinical integration, University College London Hospital
The types of data set out here all have the potential to highlight important aspects of care in order to improve the patient experience.
For each type of data, we show:
- how you collect and analyse it
- what it can tell us
- how it can help quality improvement work.
Selecting data: qualitative or quantitative?
A common question is whether quantitative or qualitative patient experience data is ‘better’.
In healthcare, we rightly attach great importance to evidence-based medicine. But we sometimes see evidence of different types in a hierarchy.
- Quantitative evidence – especially from randomised controlled trials – is usually seen as best
- Qualitative evidence – such as patient stories or narratives – is seen as ‘anecdotal’ or unreliable, because it does not represent a wide sample.
But we need to ask ourselves:
Better for what?
Patient experience researchers generate evidence using a range of different methods. Numbers and narratives have their strengths for particular purposes, so this guide encourages you to use both.
Dashboards are visual representations of different aspects of patient experience. They can combine different sources of patient experience evidence to produce a more rounded picture than a single data source. A dashboard might include different kinds of survey results, extracts from comments and complaints and Care Opinion postings.
Informal data and wisdom
In many healthcare organisations, data is only used if it is structured, sought and officially approved by the organisation. Anything that does not fit into those categories may be discounted even if it has much to offer in terms of shedding light on the patient experience.
If this sounds like your organisation, it is important that you develop the confidence to gather informal data alongside those more formal data sources. Family members’ observations during visiting hours, what patients think about during their stays, messages in thank-you cards, staff discussions in the canteen – all these are examples of informal data. There is a richness to this ‘soft intelligence’. It may be hard to spot, harness and analyse, but if you can identify it, it can play an important role in identifying what is working well in your service, and what is not.
Where there is a widely held shared understanding of what needs to change, backing these views up with a range of data can help get buy-in from senior staff and agreement to make the changes needed.
Our study findings
Staff could not always point to a specific source of patient experience ‘data’ that led to a particular improvement project. Sometimes they reported acting on what they felt they already knew needed changing, from caring for and observing people on a daily basis and talking to colleagues. These ‘soft’ or intuitive forms of intelligence – often unrecognised as data – proved to be a rich resource for quality improvement ideas.
Who to focus on – patients or staff?
In patient experience work, staff experience has tended to be neglected in favour of patient experience. This, in turn, is because traditionally the patient voice was not heard at all. Nevertheless, there is a growing recognition of the value of the experience and insights of frontline staff. Staff may have a good sense of knowing what needs improving on a ward. And while it is important to check those findings against other data – both from patients and across the organisation – this is an important source of insight.
When it comes to improvement work, there is a growing understanding of the importance of improving the experience of staff as well as patients. The very business of improvement work can improve staff experience, by giving staff a voice and bringing them together as a team. It can help staff feel reinvigorated and reconnected with their values as a caring professional. Improvement work that meets staff needs – such as providing coat hooks, as the team in one case study site did – is, in turn, going to produce further improvements. A happy workforce is more likely to provide positive, empathetic patient care.
Our study findings
The act of undertaking quality improvement activity could in itself improve staff morale, appealing to staff’s intrinsic motivation to provide good patient care.
At the same time, improvement work that results in a service that better meets patient needs is likely to have a positive impact on staff as well as patients. Working in a better-run environment with happy patients is going to have a positive impact on staff too.
Our study findings
Improvements to patient experience may reduce their boredom and create more positive staff–patient relationships, thereby improving the work experience for staff.
Tapping into the wider organisation
When you begin to think about data, it is very important to make connections through the organisation with anyone else using data. This may include a patient experience team or quality improvement team.
Our study findings
Some clinical staff found it daunting to reach out to colleagues outside the ward or at a more senior level. It can help to think about who the stakeholders are and who could give you the support you need.
Where project activities can be aligned with organisational strategies or priorities at board level, it is easier for a project to attract attention, funding and support from across the trust, including at senior levels. There is also increased scope for a small-scale intervention to be rolled out, contributing to widescale organisational change.
Our study findings
In some sites, the project led to broader changes in culture, attitude and behaviour on the wards, and within the wider Trust. Some chose to focus more on cultural change and improving staff experience as an indirect route to improving patient experience.
Working with the patient experience team
Not all clinical teams are aware of central functions such as the patient experience team (which has different names in different Trusts). This team can provide a range of support – from accessing and analysing data to sourcing items for quality improvement initiatives. There are sometimes tensions between clinical and central functions and it is important to build relationships before launching into a project. Because of the time pressures that clinical teams face, the patient experience lead can play a pivotal role in ensuring the success of a project.
Our study findings
Teams that actively involved someone from the patient experience team tended to be more ambitious, focused on a higher number of improvement projects and had fewer challenges with implementation – even in the challenging winter months.