Improving Aged Care Through Feedback and Complaints Systems: Lessons from Healthcare Research

The efficacy of feedback and complaints systems in healthcare is increasingly well-documented, with multiple studies pointing to its pivotal role in enhancing quality care. But how does this body of evidence apply to aged care, a subsector with its unique challenges and opportunities? This article delves into five significant studies in healthcare and explores how their findings could be seamlessly transferred to elevate the quality of aged care, both in residential facilities and in home-based care settings.

Study 1. Using patient feedback to drive quality improvement in hospitals: a qualitative study

(Berger S, Saut AM, Berssaneti FT Using patient feedback to drive quality improvement in hospitals: a qualitative studyBMJ Open 2020;10:e037641. doi: 10.1136/bmjopen-2020-037641)

This first study showed that using patient feedback to drive quality improvement requires:

1. Involvement and buy-in of staff at all levels, 
2. Patients should be able to provide feedback through a variety of channels; and 
3. Quality tools should be used.

Perhaps the most interesting nugget was this:

Goals related to the reduction of complaints may inhibit feedback registration, jeopardising the achievement of the objectives of the feedback process.

Whilst you naturally want to reduce the number of complaints because a complaint means something went wrong, this must not be a goal. Using this as a goal means when things go wrong (and they inevitably do sometimes) the issue is more likely to be not reported and this leads to bigger issues. 

Another highlight is somewhat more obvious:

Patients are more likely to express their opinion if they are aware of the care process and if they find the feedback process confidential, reliable and transparent.

Study 2. Wisdom of patients: predicting the quality of care using aggregated patient feedback 

(Griffiths A, Leaver MP Wisdom of patients: predicting the quality of care using aggregated patient feedback BMJ Quality & Safety 2018;27:110-118.)

The main finding here was that aggregating feedback scores is a highly reliable measure for identifying high-risk areas of your organisation. That is, it helps identify areas that need improvement. 

Study 3. Using Patient Feedback for Quality Improvement

(Tasa, Kevin; Baker, G. Ross; Murray, Michael. Using Patient Feedback for Quality Improvement. Quality Management in Health Care 4(2):p 55-67, Winter 1996.)

This study provides a number of propositions:

1. Several organisational characteristics interact in a complex manner to create an environment that either supports or discourages the use of patient feedback.
2. A patient feedback system that provides both qualitative and quantitative data is advantageous for organisation-wide, patient-focused improvement strategies.
3. The intensity, savviness and quality of patient feedback dissemination strategies influence the usefulness of the feedback.
4. Patient feedback provides germane information that can be used in a wide range of organisational activities and improvement efforts.
5. An organisational strategy for collecting and using patient feedback is required to ensure optimal use of the results.

There is nothing earth-shattering, rather it is further reinforcement that feedback should be encouraged organisation-wide.

Study 4. The impact of patient feedback on the medical performance of qualified doctors: a systematic review

(Baines, R., Regan de Bere, S., Stevens, S. et al. The impact of patient feedback on the medical performance of qualified doctors: a systematic review. BMC Med Educ 18, 173 (2018).)

This study found, no surprises, that patient feedback does positively impact quality of care. Specifically, for the feedback to be effective, it needs to be specific, collected through credible methods, and should clearly highlight what can be done to improve. Additionally, a supportive cultural environment that understands the purpose of patient feedback is crucial for its effective implementation.

Study 5. Challenges to the credibility of patient feedback in primary healthcare settings: a qualitative study

(Anthea Asprey, John L Campbell, Jenny Newbould, Simon Cohn, Mary Carter, Antoinette Davey and Martin Roland. British Journal of General Practice 2013; 63 (608): e200-e208.)

This is an interesting one. On the surface it is critical of the impact that feedback can have on the benefit of feedback. When you look at how the define feedback, it is purely surveys. It was this insight that lead Tell Touch to place less emphasis on surveys and more in collecting "instant feedback". 

Conclusion

The research supporting the role of feedback and complaints systems in healthcare can offer valuable insights for aged care. These systems can be transformative, offering providers the tools needed to ensure the well-being of our aging population. That said, there is surprisingly little research in the area with respect to healthcare as a whole. All studies identified that it is an area the needs future research. We will keep monitoring the space!