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Implementing a digital patient feedback system: an analysis using normalisation process theory.

Bie Nio Ong1, Damian Hodgson2, Nicola Small1

  • 1NIHR School for Primary Care Research, University of Manchester, Manchester, UK.

BMC Health Services Research
|May 9, 2020
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Summary
This summary is machine-generated.

Digital feedback in healthcare is promising but requires careful implementation. Success depends on considering local contexts, patient needs, and organizational support, with patient involvement crucial for adoption.

Keywords:
Acute careDigital methodsMental healthNormalisation process theoryPatient feedbackPrimary care

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Area of Science:

  • Health Informatics
  • Human-Computer Interaction
  • Healthcare Management

Background:

  • Digital patient feedback methods are increasingly used in the UK's National Health Service (NHS).
  • Adoption is influenced by socio-technical factors, context, and user experience.
  • Implementing digital feedback can disrupt existing organizational and clinical routines.

Purpose of the Study:

  • To examine the implementation of a co-designed digital feedback intervention (the DEPEND study).
  • To understand how participants made sense of and engaged with the digital feedback system.
  • To explore the contextual factors influencing the adoption of digital feedback in healthcare settings.

Main Methods:

  • A complex intervention study design was used.
  • Qualitative data collected via interviews and focus groups with 51 staff, 24 patients, and 8 carers across four diverse healthcare sites.
  • 42 observations of the digital feedback system's use; data analyzed using modified grounded theory with Normalisation Process Theory (NPT) as the framework.

Main Results:

  • Healthcare staff found digital feedback attractive, quick, and easy to analyze.
  • Patient views varied, with barriers including visibility, privacy, digital literacy, and technical issues.
  • Participation varied by site due to workload, role perceptions, and organizational changes; mental health users' engagement depended on staff relationships and health status.

Conclusions:

  • Digital feedback has potential, but implementation must consider local contexts, patient diversity, and leadership.
  • Patient involvement in adapting the intervention is key to embedding digital feedback methods.
  • Normalisation Process Theory (NPT) provided deep insights into staff and patient interactions and actions.