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Title: Improving the usefulness and use of patient experience feedback
Author: Flott, Kelsey Margarett
ISNI:       0000 0004 7658 0136
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2018
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Patient experience is recognised as a pillar of healthcare quality equal to safety and effectiveness (1)(2). In the UK National Health Service (NHS), this paradigm has supported robust feedback collection, leading to a repository of nationally-collected patient experience data (3)(4). However, such data has not been effectively used to drive local quality improvements (4)(5)(6). This work addresses the question, how can the usefulness and use of patient experience feedback be improved? In order to contribute a clear body of knowledge in response, this work ascertains the root causes of limited data use; tests how novel analytic techniques can enhance data utility; and explores how experience data can be used in conjunction with other data to improve organisational responsiveness to patient feedback. First, this work systematically appraises the evidence relied upon to design patient surveys. This confirms a deficit of patient input into the evidence base, and subsequently insufficient information about how patients' priorities differ. Population segmentation techniques are then employed to identify patient groups and their varying concerns, and present feedback in a disaggregated way that facilitates targeted improvement. Furthermore, interviews with NHS staff elucidate what adaptations they feel are necessary in order to embed national patient survey results within their local improvement strategies. This work then leverages existing data to generate a new patient experience composite score that challenges current national benchmarking metrics. The composite score is used to cluster acute NHS organisations, revealing organisational patterns in patient experience. Furthermore, multi-linear regression analysis delineates which organisational factors predict positive patient experience, intimating the importance of cultural variables. A translational research case study then captures the process towards achieving the organisational culture necessary to act on patient experience data. Individually, these findings convey a series of policy recommendations, while cumulatively they showcase the possibilities for a more patient-centric health service.
Supervisor: Mayer, Erik ; Darzi, Ara Sponsor: Imperial College London
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral