Using the Plan, Do, Study, Act cycle to enhance a patient feedback system for older adults

Patient feedback about healthcare experiences has gained increasing attention as an essential and meaningful source of information for identifying gaps and developing effective action plans for improving the quality of care. As experiences differ across patient groups, flexible and responsive feedback systems are essential. The population of older adults is growing rapidly; it constitutes an increasing proportion of the NHS client base. This group wants to have a say in their care and their views are critical in any performance assessment of a modern healthcare system. Nevertheless, collecting feedback data from older adults presents unique challenges, due to chronic conditions and comorbidities involving vision, hearing, speech and cognitive processing. In addition, nurses often find it difficult to act on feedback data in order to make quality improvements. This difficulty is associated with poor leadership, absence of explicit targets and an action plan, and the nature of clinical change required. This article offers insight into the development of a local innovation centred on enhancing the feedback system in a medical rehabilitation ward for older adults. A model for improvement in the form of the Plan, Do, Study, Act (PDSA) cycle provided a structured learning approach to facilitate the planning, testing, analysing and refining of the feedback system.