Affiliation:
1. Shaller Consulting Group Stillwater Minnesota USA
2. Health Care Management Department, The Wharton School University of Pennsylvania Philadelphia Pennsylvania USA
3. Center for Patient Partnerships, Department of Family Medicine and Community Health University of Wisconsin Madison Wisconsin USA
4. Department of Health Policy and Management, Mailman School of Public Health Columbia University New York New York USA
5. New York‐Presbyterian Hospital New York New York USA
6. Department of Health Policy and Management, School of Public Health Yale University New Haven Connecticut USA
Abstract
AbstractObjectiveTo assess whether an online interactive report designed to facilitate interpretation of patients' narrative feedback produces change in ambulatory staff learning, behavior at the individual staff and practice level, and patient experience survey scores.Data Sources and SettingWe studied 22 ambulatory practice sites within an academic medical center using three primary data sources: 333 staff surveys; 20 in‐depth interviews with practice leaders and staff; and 9551 modified CG‐CAHPS patient experience surveys augmented by open‐ended narrative elicitation questions.Study DesignWe conducted a cluster quasi‐experimental study, comparing 12 intervention and 10 control sites. At control sites, narratives were delivered free‐form to site administrators via email; at intervention sites, narratives were delivered online with interactive tools for interpretation, accompanied by user training. We assessed control‐versus‐intervention site differences in learning, behavior, and patient experience scores.Data CollectionStaff surveys and interviews were completed at intervention and control sites, 9 months after intervention launch. Patient surveys were collected beginning 4 months pre‐launch through 9 months post‐launch. We used control‐versus‐intervention and difference‐in‐difference analyses for survey data and thematic analysis for interview data.Principal FindingsInterviews suggested that the interface facilitated narrative interpretation and use for improvement. Staff survey analyses indicated enhanced learning from narratives at intervention sites (29% over control sites' mean of 3.19 out of 5 across eight domains, p < 0.001) and greater behavior change at staff and practice levels (31% and 21% over control sites' means of 3.35 and 3.39, p < 0.001, respectively). Patient experience scores for interactions with office staff and wait time information increased significantly at intervention sites, compared to control sites (3.7% and 8.2%, respectively); however, provider listening scores declined 3.3%.ConclusionsPatient narratives presented through structured feedback reporting methods can catalyze positive changes in staff learning, promote behavior change, and increase patient experience scores in domains of non‐clinical interaction.
Funder
Agency for Healthcare Research and Quality
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