Characteristics of positive feedback provided by UK health service users: content analysis of examples from two databases

Lloyd, Rebecca; Slade, Mike; Byng, Richard; Russell, Alex; Ng, Fiona; Stirzaker, Alex; Rennick-Egglestone, Stefan

Abstract

Background: Most feedback received by health services is positive. Our systematic scoping review mapped all available empirical evidence for how positive patient feedback creates healthcare change. Most included papers did not provide specific details on positive feedback characteristics. Objectives: Describe positive feedback characteristics by (1) developing heuristics for identifying positive feedback; (2) sharing annotated feedback examples; (3) describing their positive content. Methods: 200 items were selected from two contrasting databases: (1) https://careopinion.org.uk/; (2) National Health Service (NHS) Friends and Family Test data collected by an NHS trust. Preliminary heuristics and positive feedback categories were developed from a small convenience sample, and iteratively refined. Results: Categories were identified: positive-only; mixed; narrative; factual; grateful. We propose a typology describing tone (positive-only, mixed), form (factual, narrative) and intent (grateful). Separating positive and negative elements in mixed feedback was sometimes impossible due to ambiguity. Narrative feedback often described the cumulative impact of interactions with healthcare providers, healthcare professionals, influential individuals and community organisations. Grateful feedback was targeted at individual staff or entire units, but the target was sometimes ambiguous. Conclusion: People commissioning feedback collection systems should consider mechanisms to maximise utility by limiting ambiguity. Since being enabled to provide narrative feedback can allow contributors to make contextualised statements about what worked for them and why, then there may be trade-offs to negotiate between limiting ambiguity, and encouraging rich narratives. Groups tasked with using feedback should plan the human resources needed for careful inspection, and consider providing narrative analysis training.

Citation

Lloyd, R., Slade, M., Byng, R., Russell, A., Ng, F., Stirzaker, A., & Rennick-Egglestone, S. (2024). Characteristics of positive feedback provided by UK health service users: content analysis of examples from two databases. BMJ Health & Care Informatics, 31(1), Article e101113. https://doi.org/10.1136/bmjhci-2024-101113

• Journal Article Type: Article
• Acceptance Date: Aug 26, 2024
• Online Publication Date: Sep 17, 2024
• Publication Date: Sep 17, 2024
• Deposit Date: Aug 28, 2024
• Publicly Available Date: Aug 28, 2024
• Journal: BMJ Health & Care Informatics
• Electronic ISSN: 2632-1009
• Publisher: BCS, The Chartered Institute for IT
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Issue: 1
• Article Number: e101113
• DOI: https://doi.org/10.1136/bmjhci-2024-101113
• Keywords: Patient-centred care; Audit and feedback; Healthcare quality improvement; Heath services research; Quality improvement methodologies
• Public URL: https://nottingham-repository.worktribe.com/output/38905542
• Publisher URL: https://informatics.bmj.com/content/31/1/e101113