Assessing Patients’ Hospital Experiences through Participatory Action Research

The next speaker in this ACSPRI 2024 conference session is Kelly Edwards, whose focus is on healthcare provision: how do we measure what actually matters to patients? Surveying experiences rather than merely satisfaction is important here: qualitative, real-time surveys that were co-created with patients and are used to share feedback with nurses should be seen as the most desirable aim here, but are uncommon in everyday practice.

This is a call for participatory action research, then: a collaborative, iterative approach that is action-oriented. Such research is not easy, however, especially within standard ethics frameworks that require the research project to be well-defined from the start; this kind of research requires consistent adherence to a specific mindset of growth, adaptability, and the co-creation of solutions with participants.

This project involved 16 participants in a private hospital in Sydney; it recruited patients for experience interviews (asking them about their most memorable experiences in the hospital), evaluated those interviews and used them to inform the design of posters and brochures distributed throughout the hospital (for nurses, patients, and family members to see, and containing both positive and negative feedback); these sometimes led both nurses and patients to be quite defensive of the hospital staff who had been criticised. A second round of interviews led to further feedback on the process, and in total some 240 participants provided feedback on the hospital experience.

Results were captured in a report, and focussed on physical comfort, respect for patients’ values and preferences, and information, communication, and education. There was also positive feedback on the process itself. Reading about positive experiences also made other patients feel more positive about their own experience. Assessments of patients’ willingness to recommend the hospital (known as the ‘net promoter score’) showed that such intentions did not necessarily line up with patients’ own (positive or negative) experiences, so this is not a useful metric.