The value of patient feedback

Collecting patient feedback is an important component to meeting the RACGP Standards for general practice (the Standards).
 
But to Dr Ken McCroary, Vice Chair of the RACGP Expert Committee – Standards for General Practices, it is about much more.
 
‘[Patient feedback] helps you to develop strategies or plans within the practice to improve quality and patient care,’ he told newsGP.
 
‘It also may bring up issues that, as physicians or admin staff or practice nurses, we don’t often think about or notice – it’s very much like having a consumer rep on a committee, giving a point of view we don’t always see.’
 
Dr McCroary finds effective use of feedback can be a bedrock for providing patient-centred care.
 
‘Primary care is about the individual patient and their journey, and getting their feedback, I think, is really important for that,’ he said.
 
In order to better assist practices to implement effective feedback processes, the RACGP recently refreshed its Patient feedback guide (the Guide) as part of its updated Standards.
 
According to Dr McCroary, one of the main goals of the renewed Guide is to provide practices a greater range of options in choosing a method for collecting and assessing feedback.
 
‘The RACGP has tried to give practices more freedom to get feedback from patients in ways that suit the individual practice, whether it’s through questionnaires, online interviews, focus groups,’ he said.
 
‘The aim is to be less prescriptive and have practices work out their own choice that would best suit them.’
 
Dr McCroary wants to encourage practices to think of feedback collection as a flexible, ongoing process.
 
‘Definitely, with the current Standards, we’re not looking at a fixed document anymore,’ he said.

‘We're looking at an evolving, improving set of standards that provides the ability to make changes throughout a feedback or standard-review cycle.
 
‘We want to incorporate the ability to move around and prioritise and improve standards on a regular basis, and not be tied in to one set for the entire duration, before it’s reviewed again.’
 
In addition to helping design the new Guide, Dr McCroary has personal experience of it, as his practice tried the updated Standards during its recent accreditation.
 
The practice team chose to use a paper-based questionnaire for patient feedback, which was then implemented by the practice nurses. Once the results were collated and analysed, they were presented at a clinical practice meeting to which the administration staff were also invited.
 
‘This meant everybody in the practice – doctors, nurses, allied health, admin, management – would see the results of the patient feedback,’ Dr McCroary said.
 
‘And apart from getting new input from patients, we also discussed it and made a joint decision in a democratically appropriate way about what the practice as a whole thought would be the best type of quality improvement to embark upon over the next 12 months, on the basis of those results.’
 
Dr McCroary found this democratic approach delivered beneficial results, and to a greater degree than he had expected.
 
‘I was really surprised about the engagement it engendered throughout the whole practice,’ he said.
 
‘And I think going forward it helped too, because everyone owned the decisions about the quality improvement we were undertaking.’
 
Dr McCroary also found this holistic approach exposed him to new perspectives on practice processes.
 
‘I was surprised at what different people in the practice had more priority on. It showed that even on the inside, you don’t all see things the same way,’ he said.
 
As well as finding a consensus on the quality improvement processes to embark on in the future, the practice team also decided to further assess the results of those decisions.
 
‘We’re really keen on repeating it … and finding out, not so much the same questions again, but about our performance and how the patients have judged that based upon what they wanted in the first place,’ Dr McCroary said.
 
‘So not just feedback, but also feedback on how we’re responding to the feedback.’
 
The ultimate lesson Dr McCroary feels emerged from this process is that feedback from patients and practice staff can be incredibly valuable to help gain a better understanding of others’ experiences of the practice.
 
‘We may think a certain procedure or practice is going along quite smoothly, but the feedback from the stakeholders may be quite enlightening, and we may have misrepresented them in our ideas of what they’re seeing or feeling or experiencing,’ he said.
 
‘It was a good learning experience, definitely.’
 

Patient feedback Patient-centred care Practice accreditation RACGP standards