When data reflects badly on your staff
Putting information into context is vital if feedback is to be judged fairly, says Toby Knightley-Day.
Frontline staff are often asked to respond to, or make changes as a result of, patient feedback. However, before you respond, you need to ensure the right context is provided.
Surveys are likely to be a snapshot of what a patient felt at that time. Their experience may be atypical because of something that happened on that particular day. As a result the data that is used to evaluate your ward is likely to be a reasonable record of what patients say but will not shed any light on their reasons for saying it.
For example, if patients indicate that they have to wait too long for attention after pressing their buzzer, it may demonstrate a poor service level. Looking at this in isolation, management could be tempted to simply tell the ward to improve on this result next month and to produce an action plan. However, the context may well be that due to a headcount freeze or a localised infection outbreak, staffing levels were down by 20% for that period.
The reality is that the performance may actually be strong and it is the context with which the data is viewed that identifies whether the result should be deemed good or bad.
There is another element to consider - the feeling of injustice that many staff feel when they have poor results presented to them is often driven by the knowledge that they cannot always influence the score.
A good example is noise at night. We worked with a trust, looking at its data to understand why scores were poor for noise at night - the answer turned out to be the proximity of a busy accident and emergency department. The scorecard showed a poor score but this reflected unfairly on staff because they were not able to control or have any influence over the cause of the score.
The ability to respond effectively to patient feedback has its foundation in three core areas:
- Having a sound understanding of the questions asked on your ward;
- There being a clear explanation as to what, if any, weighting or scoring criteria is applied to your results before you get them;
- Understanding which elements of the patient survey your staff and controllable functions directly affect.
This process may take a little time and will require some close staff involvement; there is no point in the sister being the only one to know how this works. The outcome will be a greater appreciation of how to manage and respond to patient feedback data.
Toby Knightley-Day is managing director of Fr3dom Health, which provides patient involvement and feedback tools and strategies in acute, community and mental health settings. Fr3dom Health works with patients, NHS and not-for-profit organisations, and the Department of Health
Tips for responding to patient feedback data
- Think carefully with staff about the work environment and factors that influence scores – can any staff directly affect these?
- Ask how and why data is weighted before being presented to you
- Never make excuses but do provide a context to your responses
- Know the surveys that are used
- Talk to your colleagues before responding to any stakeholders
- Make sure action plans reflect operational aspects you can influence
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