Implementing a real-time patient experience feedback in inpatient rehabilitation: Process evaluation informed by the normalisation process theory

PurposeNear real-time patient experience feedback (NRTPEF) can enable a patient-centric, immediate service recovery but has not been widely used in inpatient rehabilitation. We 1) assess the utility, feasibility, and acceptability of implementing a new NRTPEF, perceived by patients and providers; and 2) understand how the NRTPEF became embedded into routine provider practices.Materials and MethodsMixed methods process evaluation of the 8-month implementation of an innovative NRTPEF in an inpatient rehabilitation unit, using interviews and focus groups with all the service-unit leaders and interviews with a randomised sample of patients. Beyond descriptive statistics and content analysis, the Normalisation Process Theory (NPT) informed a framework analysis.ResultsPatients and service-unit leaders perceived high utility in the NRTPEF (median: 9 for both; 0-10 scale) and qualitative comments emphasised the value of providing/obtaining timely feedback. The system was found feasible and acceptable for patients (median: 9.5), but with an improvement margin for providers (median: 7.3). Suggestions include strengthening the data-relay format. Even in the pilot form, providers found the NRTPEF became embedded into practice (median 10; average: 8.6). The analysis based on the NPT shows how providers saw differential value, engaged with, and used the patient feedback into reconfigured practices.ConclusionAn innovative NRTPEF was found useful, feasible and acceptable, but with refinement opportunities before scale-up. Near real-time patient experience feedback is a promising way for enabling immediate, individualised quality improvement. A mixed methods process evaluation assessed an innovative application of this process in inpatient rehabilitation. The process was found useful and acceptable but also unravelled improvement suggestions for greater feasibility and likelihood integration into routine practice.