Introduction
Feedback helps the care team understand patient and family perspectives about their experiences receiving care and information. This information is then used to guide the practice and/or delivery network in making improvements to enhance the patient and caregiver experience. A similar process may be used within practice or delivery networks to gain insight from the members of the care team, however, our focus here is on the patient and caregiver.
Preparing for Feedback
Before engaging the patient and family caregiver in providing feedback, all care team members, including providers, should commit to being open to the ideas and concerns. This means being open to a bottom-up approach for change.
The practice should also have a mission which is strengthened by obtaining patient and family feedback and believe in patient-centered care (West, M., & Brown, L,n.d.).
There are many ways to obtain patient and family caregiver feedback and each method lends itself to obtaining specific types of feedback. Before selecting a method for obtaining feedback, consider what you are trying to accomplish:
- What type of information are you seeking?
- How in depth do you want the feedback to be?
- If considering a survey, what format would be most appropriate?
- Is there a program or initiative requiring patient feedback? If so, does it specify the need to use a certain tactic?
Tactics for Obtaining Feedback
Surveys
Patient surveys are can be used to gather information on the patient’s experience, feedback on a new service or potential new service, feedback on communication materials. Surveys are flexible in format and can be done on paper in the office, over the phone, through text message, email, telephone interview, or a link to a survey online.
- Survey questions can be practice specific based on concerns that may have been previously discussed or they can be CAHPS questions which are available on the Agency for Healthcare Research and Quality (AHRQ) website
- Surveys may reveal information regarding areas of opportunity or areas of strength
- Often the information is broad, and unless specific comments are made, it may be difficult to narrow down the problem or the successful factor
- They can be implemented to assess a variety of aspects including: access, provider, clinical assistant (RN, MA, etc.), front desk staff, processes, and any other aspect of experience.
- Surveys can also be used to collect data on patient reported outcomes including: symptoms, functional status, etc.
Consumer Assessment of Health Plans Study (CAHPS)
The Consumer Assessment of Health Plans Study (CAHPS) survey is a standardized survey tool, used survey patients on behalf of the practice and aggregate the data, for benchmarking and other comparisons. The information from these surveys is often reviewed for opportunities for improvement however, the surveys may not provide enough information to pinpoint a needed improvement. Additional information is often needed to determine what changes could potentially impact the next results. However, keep in mind, a different population will be surveyed each time the CAHPS survey is conducted as it is often distributed based on patient visits. One group may have different interests or concerns than the next.
- CG-CAHPS is the clinician and group survey
- H-CAHPS is the hospital based survey
There are additional CAHPS surveys for other entities that are considering surveying patients.
Patient-Family Advisory Council (PFAC)
A PFAC is a group of patients and family caregivers convened by the staff for a period of time to gain insight on the patient and family experience within the care delivery network. Patient needs and wants differ based on many factors so it is important to work with a diverse group. Through the PFAC, the care team often obtains more specific information regarding a change initiative or challenge as there is an opportunity for follow-up questions and digging deeper into a subject. In addition, the group can brainstorm ideas, help prioritize change initiatives, and review patient educational material to determine if it is useful and easy to understand.
Focus Groups
Focus groups are like a PFAC but often convene for a single meeting. This meeting is often focused on a single topic or a certain group of people. When conducting a focus group, it is recommended to use someone outside the care team to facilitate the group. It is also important to have someone with experience with facilitating focus groups to make sure questions are not leading but are getting to the root of the concern.
Project Teams
Project teams focus on completing a certain task such as compiling a list of community resources, vetting community resources, or developing and evaluating education or communication materials.
Patient Attendance to Quality Team Meetings
Include a patient or patients in the internal quality meetings. While this team will try to consider multiple perspectives, it is difficult to provide the patient perspective. Inviting patients to participate in standing meetings allows for clarification on points that may have come up in a survey, committee or PFAC meeting and can give immediate feedback on any new topics discussed.
Once you have begun receiving feedback, you can alter and advance your tactic based on the practice capability and readiness for feedback. It is also important to actively work on improving what the feedback reveals as an area of opportunity. It is also important to be transparent with the staff and patients what is learned through the feedback whether it is an area of strength or an area of opportunity. Transparency of data helps to encourage quality improvement efforts and helps patients to understand the practice or entities commitment to patient experience and patient centered care.
