Healthcare organisations engage with public online feedback differently and here’s why

Research conducted by Ramsey et al (2022), from the Bradford Institute for Health Research (UK), examined three large NHS Trusts to determine not only how they respond to and use public online feedback, but also the underlying factors that contributed to their approach.

Their research is titled ‘Exploring the sociocultural contexts in which healthcare staff respond to and use online patient feedback in practice: In-depth case studies of three NHS Trusts’ and you can read more about it here https://journals.sagepub.com/doi/10.1177/20552076221129085?icid=int.sj-full-text.similar-articles.3

The first organisation did not respond to or use online patient feedback as staff were busy firefighting volumes of concerns received in other ways. The second organisation adopted a generic responding style due to resource constraints, fears of public engagement and focus on resolving known issues raised via more traditional feedback sources such as questionnaires and the complaints system. The third organisation provided transparent, conversational responses to patients online and described a 10-year journey enabling their desired culture to be embedded.

A key aspect that the paper addresses is the fears felt by some organisations about having their interactions with patients out in the public view where "the whole world and their dog can see". These were views mostly adopted by the first and second organisations. However, the paper counters these views with some powerful quotes from the staff of the third organisation:

• "If you’re not hearing negative feedback, it’s because it’s being said elsewhere."
• "It’s one of the strongest forms of governance... You can think, 'Well I’ve heard this from the staff and I’m hearing this from the patients. What is this all really telling me?".
• "Two years, and nothing really happened. But when the story was placed on Care Opinion we were able to resolve it in 6 weeks."

Furthermore, what was interesting was the identification of a range of barriers facing organisations who ignore or provide generic responses to patient feedback online. Some of the barriers identified included:

• Staff, because of internal pressures and firefighting volumes of feedback, wanting to prioritise feedback initiated by their organisations rather than 3rd party feedback.
• Paying close attention to immediate patient safety concerns, while being blind to the wider picture has also been termed ‘collective myopia’.
• The responsibility for improvement activity was fundamentally an expectation of those at the sharp end of care, yet often, clinical staff were distanced from the exclusivity of patient experience work, such as it belonging to the patient experience team only.

So what can be said about the sociocultural context that would enable organisations to better engage with public online feedback? In short, It’s about broadening the way feedback is gathered, and involving a variety of staff in the listening and responding process.

• Organisations that engaged with a wider variety of patient feedback mechanisms tended to be better at using the information to inform improvement, and noted the significance of building trusting relationships from a patient perspective.
• Engage a wider variety of staff to demonstrate how they are publicly responding and listening to patients. This is also a way to nurture patient trust.

Whilst the above research was undertaken in the UK, the lessons for Australian healthcare organisations are similar. Care Opinion Australia has identified organisations across the country that demonstrate all three approaches.  These findings are valuable in helping organisations to identify and address where they are on the continuum of public online feedback.