Summary of included studies
| Authors, QA rating | Aim | Setting | Sample size and composition | Data collection | Data analysis | QI Intervention |
|---|---|---|---|---|---|---|
| Barr et al30 QA rating: B | To understand how comparative public reporting on standardised measures of hospital patient satisfaction was used by hospitals for QI | USA General hospitals—11 Specialist hospitals—2 | 13 CEOs 16 Clinical staff 13 Patient satisfaction coordinators | Retrospective, semistructured interviews focusing on QI initiatives related to survey results | Thematic analysis of interview data | Service delivery |
| Davies and Cleary10 QA rating: B | To develop a framework for understanding the factors affecting the use of patient survey data for QI | USA ICSI Self-selected medical groups—8 Primary and secondary care, urban and rural | One team leader from each group plus invited others—14 | Retrospective, semistructured interviews on QI initiatives and current use of survey data | Thematic analysis of interview data | Service delivery Behaviour |
| Davies et al31 QA rating: B | To evaluate the use of a modified survey (CAHPS) to support QI in healthcare, assess changes, and identify barriers and facilitators | USA ICSI group (as above) Self-selected medical groups—8 Primary and secondary, urban and rural | One senior leader from each group plus staff involved in QI and patient experience action groups—50 | Bimonthly meetings to present survey data in comparison to other groups. Patient surveys at 3 time points—100 per group pre and post and 25 per group monthly thereafter | Ethnographic and observational analysis of meetings and interviews with staff involved. Pre-post comparison of patient survey data | Provider behaviour Service delivery Patient education |
| DiGiola and Greenhouse32 QA rating: C | To describe the process of collecting and presenting data from a patient shadowing approach to PREMs collection | USA University of Pittsburgh medical centre | Single case study | 1 patient, 1 observer | Case study presentation of methods and presentation of approach | No QI intervention actions included |
| Friedberg et al15 QA rating: B | To examine whether and how physician groups are using patient experience data to improve patient care | USA Primary care groups | Physician group leaders—72 | Interviews with physicians on use of publicly reported patient experience survey data | Thematic analysis of interview data | Service delivery Service infrastructure |
| King's Fund*33 QA rating: B | To evaluate the effectiveness of EBCD approach | UK Breast and lung cancer centres at 2 London hospitals | Evaluation included patients and staff involved—numbers not given | Process evaluation including observations and interviews with staff and patients | Qualitative analysis of data to determine effectiveness of approach | Clinical intervention Provider behaviour Service delivery Patient education |
| Pickles et al5 QA rating: C | To describe a study using EBCD | UK 1 hospital in Greater London | Case study—number of participants not given | Descriptive case study | NA | Clinical intervention Provider behaviour Service delivery Service infrastructure Patient education |
| Reeves and Seccombe34 QA rating: B | To assess the attitudes towards a national patient survey programme, establish the extent to which they are used, and identify barriers and facilitators | UK 27 NHS Trust hospitals | Patient survey leads—24 | Semistructured interviews | Thematic analysis of interview data | Details of QI interventions not given |
| Reeves et al35 QA rating: B | To test the feasibility of conducting ward level surveys, providing specific feedback and conducting ward meetings on QI actions | UK 2 NHS Trusts 18 wards | Ward staff—numbers not stated | Randomised controlled trial. 3 groups randomly assigned to ‘basic feedback’, ‘feedback plus’ or ‘control’ | Multiple regression analysis of patient survey scores by group. Qualitative analysis of follow-up interviews and observations of meetings | Provider behaviour |
| Tsianakas et al36 QA rating: A | To describe how the EBCD approach was used to identify and implement improvements in experiences of patients | UK 1 cancer centre—breast and lung cancer services | Patients—36 Staff—63 | Ethnographic observational study including patient narratives, staff interviews and observations | Thematic analysis of narrative and interview data and observation data | Provider behaviour Service delivery Service infrastructure Patient education |
| Wensing et al29 QA rating: B | To assess the effects of patient feedback on changes to healthcare processes and outcomes | The Netherlands 43 GP groups | GPs—60 | Randomised controlled trial. 2 groups—‘control’ and ‘feedback’—GP questionnaire to assess changes, barriers and facilitators | t-tests and χ2 to test differences between groups on communication with patients and motivators or barriers to using feedback | Details of QI interventions not given |
*=Grey literature.
CAHPS, Consumer Assessment of Healthcare Providers and Systems; CEO, chief executive officer; EBCD, evidence-based co-design; GP, general practitioner; ICSI, Institute for Clinical Systems Improvement; NA, not available; NHS, National Health Service; PREM, patient-reported experience measure; QA, quality assessment; QI, quality improvement.