Capturing patient experience: a qualitative study of implementing real-time feedback in primary care.
BACKGROUND
In recent years, hospitals have made use of new technologies, such as real-time feedback, to collect patient experience information. This approach is currently rarely used in primary care settings, but may provide practices with a useful tool that enables them to take prompt, focused action to improve their services.


OBJECTIVE
To identify the factors inhibiting and enabling the implementation of real-time feedback in general practices.


METHODS
Qualitative study embedded within an exploratory trial (July 2014 to February 2015) of a real-time feedback intervention targeting patient experience in general practices in south-west England and Cambridgeshire.


METHODS
Semi-structured interviews (n = 22) and focus groups (n = 4, total of 28 attendees) with practice staff were audiorecorded, transcribed, and analysed thematically, using a framework based on constructs from normalisation process theory.


RESULTS
Staff engagement with real-time feedback varied considerably, and staff made sense of real-time feedback by comparing it with more familiar feedback modalities. Effective within-team communication was associated with positive attitudes towards real-time feedback. Timing of requests for feedback was important in relation to patient engagement. Real-time feedback may offer potential as a means of informing practice development, perhaps as a component of a wider programme of capturing and responding to patients' comments.


CONCLUSIONS
Successful implementation of real-time feedback requires effective communication across the practice team to engender thorough engagement. Feedback processes should be carefully introduced to fit with existing patient and practice routines. Future studies should consider making real-time feedback content relevant to specific practice needs, and support participation by all patient groups.
Department of Primary Care; University of Exeter Medical School, Exeter.
Mary
M
Carter
Primary Care Research Group; University of Exeter Medical School, Exeter.
Antoinette
A
Davey
University of Exeter Medical School, Exeter.
Christine
C
Wright
University of Cambridge School of Clinical Medicine; Primary Care Unit, University of Cambridge, Cambridge.
Natasha
N
Elmore
RAND Europe; Primary Care Unit, University of Cambridge, Cambridge.
Jenny
J
Newbould
Primary Care Unit, University of Cambridge, Cambridge.
Martin
M
Roland
University of Exeter Medical School, Exeter.
John
J
Campbell
Cambridge Centre for Health Services Research, Cambridge.
Jenni
J
Burt
D000328:Adult; D001291:Attitude of Health Personnel; D004739:England; D017144:Focus Groups; D000068156:Formative Feedback; D058006:General Practice / Q000193:education / Q000592:standards*; D006801:Humans; D010348:Patient Care Team; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research
general practice; patient experience; qualitative research; survey