Implementing a near real-time patient experience feedback process in
inpatient rehabilitation: mixed-methods process evaluation informed by
the Normalization Process Theory
Abstract
Purpose: Near real-time patient experience feedback (NRTPEF)
can enable patient-centric quality improvement. We 1) assess the
utility, feasibility, and acceptability of implementing a new NRTPEF,
perceived by patients and providers; and 2) understand how the NRTPEF
became embedded into routine provider practices. Materials and
Methods: Mixed methods process evaluation of the 8-month implementation
of an innovative NRTPEF in an inpatient rehabilitation unit, using
interviews and focus groups with all the service-unit leaders and
interviews with a randomized sample of patients. Beyond descriptive
statistics and content analysis, the Normalization Process Theory (NPT)
informed a framework analysis. Results: Patients and
service-unit leaders perceived high utility in the NRTPEF (median: 9 for
both; 0-10 scale) and qualitative comments emphasized the value of
providing/obtaining timely feedback. The system was found feasible and
acceptable for patients (median: 9.5), but with an improvement margin
for providers (median: 7.3). Suggestions include strengthening the
data-relay format. Even in the pilot form, providers found the NRTPEF
became embedded into practice (median 10; average: 8.6). The
NPT-informed analysis shows how providers saw differential value,
engaged with, and used the patient feedback into reconfigured practices.
Conclusion: An innovative NRTPEF was found useful, feasible and
acceptable, but with refinement opportunities before scale-up.