The co-creation of a new patient and visitor hospital experience feedback protocol : a pragmatic action research study

Increasing demand for patient-centred care has seen developments in the science of capturing hospital experience feedback as a means of assessing quality care. The majority of published findings regarding experiences of hospital care are based on quantitative surveys, with data being collected after patients have been discharged. Despite this, there is growing recognition that the collection of real-time qualitative experience data (during patient admission) provides richer and more useful information to improve care provision. However, virtually no published approaches for capturing and measuring experience feedback data include guidance about how to deliver this feedback in a way which is meaningful to nurses. Moreover, key stakeholders, such as nurses, patients, and family members, are rarely involved in all stages of planning how feedback should be collected and shared. This research aimed to explore how these stakeholders might co-create a new protocol to collect patient and family hospital experience feedback and share this feedback with nurses so that patients' and families' perspectives can be heard. The study employed a pragmatic action research approach, wherein patients, family members and nurses (n=16) formed an action research advisory group (the Advisory Group). With a desire to improve upon current methods of collecting feedback data, the Advisory Group designed a protocol to capture in-patient unit-level, qualitative, real-time experience feedback. Phase one of the study consisted of problem identification and reconnaissance. Phase two (Action Cycles 1 to 9) consisted of the creation and evaluation of a new feedback protocol, referred to as RHEPORT (Real-time Hospital Experience Posters). Two data sets were collected during the field work: 1. hospital experience feedback data from patients and family members (visitors), and 2. evaluation data on the RHEPORT Protocol and its development. The RHEPORT Protocol was refined through field-testing, which comprised nine Action Cycles across three years. Two hundred and forty-one participants (178 patients, 60 visitors, and three of unknown status) provided hospital experience data. The three dominant themes in the hospital experience feedback data were: 1. Physical comfort, 2. Respect for patients' values, preferences and expressed needs, and 3. Information, communication, and education. Four hundred and seven evaluation responses (227 patient responses, 70 visitor responses and 110 nurse responses) regarding the RHEPORT Protocol were collected, and the data were shared with the 16-member Advisory Group for their reflection and evaluation. Three principle findings that emerged from evaluation data collected about the RHEPORT Protocol and its development were: 1. a pragmatic action research approach resulted in the successful co-creation of a new experience feedback protocol (RHEPORT), 2. the final version of the RHEPORT Protocol comprised five core components to support the collection and distribution of meaningful patient or visitor feedback, and 3. a willingness to recommend the hospital to friends or family is not necessarily representative of a patient or visitor's hospital experience. This study illustrates the challenges and successes of creating a new hospital experience feedback protocol with key stakeholders. However, perhaps more importantly, this research contributes to the field of patient and family hospital experience by allowing the voices of these stakeholders to be both heard and acknowledged.