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Using patients' experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both?

Using patients' experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both?
Using patients' experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both?
Background: Patients’ experiences have become central to assessing the performance of healthcare systems
worldwide and are increasingly being used to inform quality improvement processes. This paper explores the
relative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process.
Methods: One dataset was collected using a narrative interview approach, (n = 13) and the other using a postal
survey (n = 82). Datasets were analyzed separately and then compared to determine whether similar priorities for
improving patient experiences were identified.
Results: There were both similarities and differences in the improvement priorities arising from each approach. Day
surgery was specifically identified as a priority in the narrative dataset but included in the survey recommendations
only as part of a broader priority around improving inpatient experience. Both datasets identified appointment
systems, patients spending enough time with staff, information about treatment and side effects and more information at the end of treatment as priorities. The specific priorities identified by the narrative interviews commonly related to ‘relational’ aspects of patient experience. Those identified by the survey typically related to more ‘functional’aspects and were not always sufficiently detailed to identify specific improvement actions.
Conclusions: Our analysis suggests that whilst local survey data may act as a screening tool to identify potential
problems within the breast cancer service, they do not always provide sufficient detail of what to do to improve
that service. These findings may have wider applicability in other services. We recommend using an initial
preliminary survey, with better use of survey open comments, followed by an in-depth qualitative analysis to help deliver improvements to relational and functional aspects of patient experience.
experience-based co-design, patient questionnaire, survey, quality improvement, patient experience, Breast cancer, Narrative interviews
1472-6963
Tsianakas, Vicki
74237413-f2e3-4598-b951-e547ddc34504
Maben, Jill
3240b527-420c-498e-9f66-557b96561f40
Wiseman, Theresa
6863fcf4-9789-48ef-8532-783a5222c6ad
Robert, Glenn
baad923d-0b26-492d-bb62-d3038bc662e6
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Madden, Peter
93c0041b-851e-4ed3-8d31-76a41115d5fc
Griffin, Mairead
1490c59b-f193-4787-aa3f-2a2160e80277
Davies, Elizabeth A.
a4c9f3a6-1dc5-48bc-9f1e-1eb5e6588d91
Tsianakas, Vicki
74237413-f2e3-4598-b951-e547ddc34504
Maben, Jill
3240b527-420c-498e-9f66-557b96561f40
Wiseman, Theresa
6863fcf4-9789-48ef-8532-783a5222c6ad
Robert, Glenn
baad923d-0b26-492d-bb62-d3038bc662e6
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Madden, Peter
93c0041b-851e-4ed3-8d31-76a41115d5fc
Griffin, Mairead
1490c59b-f193-4787-aa3f-2a2160e80277
Davies, Elizabeth A.
a4c9f3a6-1dc5-48bc-9f1e-1eb5e6588d91

Tsianakas, Vicki, Maben, Jill, Wiseman, Theresa, Robert, Glenn, Richardson, Alison, Madden, Peter, Griffin, Mairead and Davies, Elizabeth A. (2012) Using patients' experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both? BMC Health Services Research, 12 (271). (doi:10.1186/1472-6963-12-271). (PMID:22913525)

Record type: Article

Abstract

Background: Patients’ experiences have become central to assessing the performance of healthcare systems
worldwide and are increasingly being used to inform quality improvement processes. This paper explores the
relative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process.
Methods: One dataset was collected using a narrative interview approach, (n = 13) and the other using a postal
survey (n = 82). Datasets were analyzed separately and then compared to determine whether similar priorities for
improving patient experiences were identified.
Results: There were both similarities and differences in the improvement priorities arising from each approach. Day
surgery was specifically identified as a priority in the narrative dataset but included in the survey recommendations
only as part of a broader priority around improving inpatient experience. Both datasets identified appointment
systems, patients spending enough time with staff, information about treatment and side effects and more information at the end of treatment as priorities. The specific priorities identified by the narrative interviews commonly related to ‘relational’ aspects of patient experience. Those identified by the survey typically related to more ‘functional’aspects and were not always sufficiently detailed to identify specific improvement actions.
Conclusions: Our analysis suggests that whilst local survey data may act as a screening tool to identify potential
problems within the breast cancer service, they do not always provide sufficient detail of what to do to improve
that service. These findings may have wider applicability in other services. We recommend using an initial
preliminary survey, with better use of survey open comments, followed by an in-depth qualitative analysis to help deliver improvements to relational and functional aspects of patient experience.

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More information

e-pub ahead of print date: 22 August 2012
Keywords: experience-based co-design, patient questionnaire, survey, quality improvement, patient experience, Breast cancer, Narrative interviews
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 344624
URI: http://eprints.soton.ac.uk/id/eprint/344624
ISSN: 1472-6963
PURE UUID: e9aeea28-6bb8-464c-b49f-2a73d34e55c4
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755

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Date deposited: 31 Oct 2012 10:19
Last modified: 15 Mar 2024 03:34

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Contributors

Author: Vicki Tsianakas
Author: Jill Maben
Author: Theresa Wiseman
Author: Glenn Robert
Author: Peter Madden
Author: Mairead Griffin
Author: Elizabeth A. Davies

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