Why do staff find it hard to act on patient feedback?


In my last post I talked about our hope that by sharing stories widely, we can help to engender learning and change in services.

But a simple search of providers on Patient Opinion shows that there’s no automatic connection between the amount of feedback and the amount of (visible) change.

For example, at Surrey and Sussex Healthcare, there’s plenty of feedback and a fair amount of change as a result:

Meanwhile, not far away at the Royal Surrey County Hospital, there’s a third of the amount of feedback – with no visible changes at all.

Why is it hard to make changes as a result of patient feedback?

recent paper by Laura Sheard, Claire Marsh and colleagues at Bradford Institute of Health Research, based on observing 17 ward-based staff teams, helps to explain why.

Over a period of six months, staff worked with feedback from patients about safety issues on their wards. Some teams were able to use the feedback to initiate changes, while other teams did not use it, or tried to make changes but failed.

The authors developed a model (the “patient feedback response framework”) to describe what was needed for change to occur. I’ve taken the liberty (with permission) of summarising the model into a simple flowchart.

Although the flowchart is simple, it makes clear what is needed for feedback to lead to change. Staff must feel that patient feedback is worth acting on. They must feel both willing and able to do so. If they have control over the changes needed, they may then go ahead.

But hospitals are complex places and many improvements will require others to make changes too. And if the organisation does not permit or encourage that kind of wider change, or if other teams in turn are unable or unwilling to make changes, then nothing will happen.

Given this context it is remarkable that we see as many changes as we do on Patient Opinion. And it also prompts us to ask: how could we develop Patient Opinion further in ways which would support the likelihood of change?

Finally, I would highlight a warning from Sheard and colleagues which resonated strongly with me:

“We believe that until ward staff are given robust organisational support to implement changes then the value of Trusts collecting patient feedback is questionable.”

This blog was originally posted here.