The health service needs to take a new approach – retailers are wary of boring their customers, so hospitals should be too
From in-store questionnaires to online surveys, giving feedback is an accepted part of our high street shopping experience. Retailers dedicate a huge amount of effort and money towards finding out our views on every aspect of a visit to their stores because it provides managers with crucial information to make improvements that keep them ahead of their competitors.
But in the NHS there is a public and clinical suspicion that answering patient surveys is a fast-track way to file unread feedback into a hospital cabinet; this perception needs to change.
The government's focus on patient choice means that hospitals have to check whether patients are satisfied with the quality of their service as much as retailers do. Otherwise we risk missing out on the patient feedback-led improvements that help prevent serious breakdowns in clinical care.
I work for a company that provides feedback solutions to both hospitals and the high street. This organisation takes customer experience models it has developed from longstanding relationships with multimillion pound businesses, such as Argos, and applies them to the health sector.
This work is supported by my four years' experience as a mental health nurse in the NHS where I saw first-hand how hard it is to implement new ways of doing things onto a ward from a management directive. But some of the greatest mistakes made by hospitals happen even before a response is collected.
Too often, hospitals create questionnaires that capture information that is useless in driving service improvements. The retail sector, on the other hand, is fully aware that to gather feedback it is asking customers to donate their own time. So realises that every second should be put to best use.
Demographic questions are a prime example of poor questioning in the NHS. It seems natural to ask identifiers such as age or gender, but I often challenge hospitals whether this will yield any useful data. Unless you can identify a clear reason to identify a certain group for the sample there may be little or no point. Especially when this information may be available through other hospital data systems.
Instead, questions must be geared towards the things that matter most to customers (or in this case patients) and to areas that can actually be improved upon, if and when shortcomings are identified. There is no magic formula, nor a perfect set of questions for every hospital. But if the answers cannot feed directly into an action plan for improvements then they may not be worth asking.
In his article on the Guardian Healthcare Network, Stephen Dunn advocates the power of the of the "net-promoter" question: "Would you recommend us to friends and family?" He makes a good case, but I would argue that there is a healthy middle ground between this simple, but limited, litmus test and the plethora of questions we see in many NHS surveys.
Retailers are wary of boring their customers, so hospitals should be too. Even if feedback is being given in the middle of a four-hour wait in A&E, patients' time should never be taken for granted.
Once the right type and number of questions are in place, the real work begins. As information streams in from the wards the biggest challenge is turning the data into meaningful actions. For this to happen hospitals need to encourage two fundamental changes to their cultures.
First, patients' experiences need to be treated as real-time data not as material for a retrospective evaluation. News that there's been a sudden dip in standards of care in a certain ward, for instance, should not be filed away until the next board meeting. Second, this information needs to be acted upon immediately.
In our work with Argos we collect and process over 150,000 pieces of individual feedback a week. This is useful for understanding long-term trends, but at its most powerful when treated as a stream of information that staff react to continuously. For example, an Argos store tracking its daily feedback realised that satisfaction levels dropped between 1pm and 2pm, identified that this was when managers tended to take their lunch break and was promptly able to increase staffing levels at this time.
This first cultural change for the NHS will take time, but can only emerge in conjunction with the second. Staff at all levels need to be engaged with the feedback process, not just management. Nurses, healthcare assistants and doctors should know how to check how satisfied patients were in a particular shift, for example. This is a tool for ward and board.
There is much for the NHS to learn about patient experience, but though it currently lags behind other sectors, there should also be a great deal of optimism. While people might not have a vested interest in the success of one private retailer over another, people genuinely care about making the NHS better. Hospitals that use handheld feedback devices, kiosks and online surveys will attest that there is no shortage of opinions on wards and in waiting rooms. There is a wealth of useful patient data ready to be collected for those who ask the right questions and make the most of the answers.
Samantha Hewlett is account manager for Customer First Solutions and Patient Focus
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