Claire Copeland: Opening ourselves up to Patient Opinion

claire_copelandOn 25 October Patient Opinion invited me to a “learning and sharing event for clinicians” in Edinburgh. It was an opportunity to hear from those who have made this feedback service for UK care what it is today.

However, this was no ordinary talking shop. No, more than that it was an opportunity to get a bunch of like minded people in a room with a view to actually doing something. This is what I love about Patient Opinion: its ability to follow through on things.

Founded in 2005, Patient Opinion formed when Dr Paul Hodgkin decided to seek and collect feedback (or stories) from patients and/or their families and carers. What made it different was that each story would trigger a response from the health service, which would translate into action. Sometimes that action may be to acknowledge good care, but the important part was that whatever the outcome was, it would be shared with the whole team, and not just sit in the inbox of someone higher up in the organisation.

When there was what could be perceived as “negative feedback” then it too would be taken back to the team to act upon.

An important point to make about this so called negative feedback is not to confuse it with the term complaint—rather think of it as constructive feedback. It’s an opportunity to appreciate a different perspective. Our landscape at work is very familiar to those of us working in it. However, to the family of person with dementia or delirium it can be a scary and confusing place. We should be listening to what they have to say and not just impose our way of doing things or our systems on them.

An example shared on the day was the meal trolley that was parked outside the room of a patient who had survived stroke and who was unable to eat or drink anything. Staff were doing what they always do, which wasn’t wrong or causing harm. However, when it was pointed out to them by the family it became obvious that the trolley should be moved. You can see how it’s these small acts that can make a difference to a patient’s experience.

While everyone agreed that these stories did not represent complaints, there was palpable anxiety from many in the room. Many were concerned that this initiative meant one poor sod in their organisation would be deluged with hundreds of posts to respond to—never mind the backlog of actual formal complaints that had yet to be acted upon.

As the discussion went on, this anxiety was replaced by bravery. While that may sound a little melodramatic, I do think it takes a brave person to put themselves out there and be willing to engage with people, especially when things haven’t gone well. Moreover, it takes a brave organisation to support people in doing this.

Gill Ogden, a clinical nurse manager in endoscopy, shared her experience of Patient Opinion. Her organisation has found it to be an extremely positive experience. They receive three to four posts a week and that’s with every patient receiving a flyer (15 000 a year). It’s also been great for staff morale, she said.

So when I read back the tweets #poClinical the main theme that came through was that of culture change. We need to change our mindset and start to see that hearing from our patients and those that have experience of the service we work in is not something to be feared. We already have duty of candour so I don’t see this as anything different. It’s also worth highlighting that 54% of the stories shared on Patient Opinion are positive.  However, I don’t think that should be the main reason for embracing this initiative.

Patient Opinion offers a mechanism for feedback that just doesn’t exist otherwise. I think the increased staff morale comes from a sense that every person can make a difference and bring about real time change.

So on that day, the 20 people gathered made a commitment to take Patient Opinion back to their clinical area and try to embrace it. The plan: start small; lead by example; and maybe, just maybe, show how much positivity can come out of opening yourself up.

Claire Copeland works as a consultant geriatrician in Forth Valley Royal Hospital, Larbert. She is the education lead for the Scottish Delirium Association. You can find her on Twitter @Sparklystar55 or clcopeland.wordpress.com.

Competing interests: I have read and understood BMJ policy on declaration of interests and declare the following interests: None.