Organisational strategies and practices to improve care using patient experience data in acute NHS hospital trusts: an ethnographic study

The NHS collects a lot of information about patients’ experiences of care; however, it is not clear how this information is used to achieve quality improvements. This study had two main aims: one was to explore how this information, also called patient experience data, translates into quality improvements in NHS hospitals, and the other was to understand the role of nurses in collecting, making sense of and using these data for improving care. The study had two phases. In phase 1, we observed practices in five NHS hospitals in England and interviewed key participants (including NHS staff and patient/carer representatives) to study what happened to patient experience data, especially in the areas of cancer and dementia care. In phase 2, we held a series of workshops (the first with participants from all five trusts and policy-makers, and then one workshop at each trust) to discuss how the early findings from our research may be relevant to NHS trusts. We found that (1) each type of data, for example a survey, goes through several transformations – from a paper questionnaire, to an electronic database, to a report – which can lead to care improvements at different stages of this transformation process; (2) when data are part of interactions – either with members of staff or with certain processes in the organisation – characterised by authority and autonomy, and context-awareness, it often leads to care improvements; (3) nurses are largely responsible for how data are collected, made sense of and used to improve care, but other roles – including those of clerical staff and other clinicians – are also important and may need more attention; (4) official quality improvement work may not take into account the less documented ‘everyday quality improvement’ work that happens in the organisation; and (5) holding workshops with participants can help organisational learning.