What methods do stakeholders prefer for feeding back performance data: a qualitative study in palliative care.
OBJECTIVE
To investigate the opinions of stakeholders (service commissioners and providers) on how performance data should be presented, in order to develop effective feedback methods to facilitate the use of these data in decision making.


METHODS
A qualitative analysis of semi-structured face-to-face and telephone interviews. League tables and fictional box plots were presented as an illustrative guide. The themes covered in the interviews were the effectiveness of these two feedback formats, their positive and negative characteristics, and ideas for new and improved feedback mechanisms.


METHODS
Thirty-six stakeholders representing a range of clinical and non-clinical roles within palliative care and the wider health care system across a variety of statutory and non-statutory organizations from London and the West Midlands.


RESULTS
Box plots were received more positively than league tables, and qualitative information was considered more appropriate than pictorial feedback. Conventional methods such as league tables and box plots were judged to lack essential information on which important decisions could be based, such as additional contextual information and the methodological assumptions of the instrument. Both feedback methods were considered useful as an impetus to further discussion. There was a consensus that feedback should be constructive and able to be adapted to the organizational realities in which UK health services function.


CONCLUSIONS
Qualitative research was viewed as the right evidence for gaining an understanding of the quality of end of life care. Stakeholders highlighted the importance of the lay perspective, which requires approaches that illuminate the subjective meanings of patient experience.
Gysels
Marjolein
M
Department of Palliative Care and Policy, King's College, London, UK. marjolein.gysels@kcl.ac.uk
Hughes
Rhidian
R
Aspinal
Fiona
F
Addington-Hall
Julia M
JM
Higginson
Irene J
IJ
D001291:Attitude of Health Personnel; D004739:England; D005246:Feedback; D006801:Humans; D015279:Organizational Culture; D010166:Palliative Care / Q000592:standards*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D013222:State Medicine; D013727:Terminal Care / Q000592:standards*