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Identifying Quality Indicators Used by Patients to Choose Secondary Health Care Providers: A Mixed Methods Approach.

King D, Zaman S, Zaman SS, Kahlon GK, Naik A, Jessel AS, Nanavati N, Shah A, Cox B, Darzi A - JMIR Mhealth Uhealth (2015)

Bottom Line: In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant.Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access.

View Article: PubMed Central - HTML - PubMed

Affiliation: Imperial College London, London, United Kingdom. dominic.king@imperial.ac.uk.

ABSTRACT

Background: Patients in health systems across the world can now choose between different health care providers. Patients are increasingly using websites and apps to compare the quality of health care services available in order to make a choice of provider. In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.

Objective: To investigate what factors were considered most important when choosing nonemergency secondary health care providers in the United Kingdom with the purpose of translating these insights into a ratings platform delivered through a consumer mHealth app.

Methods: A mixed methods approach was used to identify key indicators incorporating a literature review to identify and categorize existing quality indicators, a questionnaire survey to formulate a ranked list of performance indicators, and focus groups to explore rationales behind the rankings. Findings from qualitative and quantitative methodologies were mapped onto each other under the four categories identified by the literature review.

Results: Quality indicators were divided into four categories. Hospital access was the least important category. The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant. Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access. All quality indicators within the hospital statistics category were equally important. Focus groups elaborated that users find it difficult to judge staff competence despite its importance.

Conclusions: A mixed methods approach is presented, which supported a patient-centered development and evaluation of a hospital ratings mobile app. Where possible, mHealth developers should use systematic research methods in order to more closely meet the needs of the end user and add credibility to their platform.

No MeSH data available.


Screenshot of Wellnote ratings platform.
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figure3: Screenshot of Wellnote ratings platform.

Mentions: Participants could not differentiate level of importance between various types of hospital statistics. Hospital-wide statistics may be of limited use to users who would be more interested in department-specific statistics. Moreover, users appreciate that overall hospital statistics may not be an accurate representation of an their department of interest due to interdepartmental variation. Conversely it may be argued that an inability to compare the importance of statistical descriptors may reflect that they are poorly understood by users. This may explain equal significance attributed to individual statistics within this category and highlights the need for the careful inclusion of statistics that are relevant to the user’s individual health encounter in mHealth platforms (See Figure 3). Care must be taken by developers to ensure that presentation of statistics, including color coding or a glossary of terms, aids user interpretation. These subtleties may not be appreciated without formal research methods informing these strategies.


Identifying Quality Indicators Used by Patients to Choose Secondary Health Care Providers: A Mixed Methods Approach.

King D, Zaman S, Zaman SS, Kahlon GK, Naik A, Jessel AS, Nanavati N, Shah A, Cox B, Darzi A - JMIR Mhealth Uhealth (2015)

Screenshot of Wellnote ratings platform.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526909&req=5

figure3: Screenshot of Wellnote ratings platform.
Mentions: Participants could not differentiate level of importance between various types of hospital statistics. Hospital-wide statistics may be of limited use to users who would be more interested in department-specific statistics. Moreover, users appreciate that overall hospital statistics may not be an accurate representation of an their department of interest due to interdepartmental variation. Conversely it may be argued that an inability to compare the importance of statistical descriptors may reflect that they are poorly understood by users. This may explain equal significance attributed to individual statistics within this category and highlights the need for the careful inclusion of statistics that are relevant to the user’s individual health encounter in mHealth platforms (See Figure 3). Care must be taken by developers to ensure that presentation of statistics, including color coding or a glossary of terms, aids user interpretation. These subtleties may not be appreciated without formal research methods informing these strategies.

Bottom Line: In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant.Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access.

View Article: PubMed Central - HTML - PubMed

Affiliation: Imperial College London, London, United Kingdom. dominic.king@imperial.ac.uk.

ABSTRACT

Background: Patients in health systems across the world can now choose between different health care providers. Patients are increasingly using websites and apps to compare the quality of health care services available in order to make a choice of provider. In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.

Objective: To investigate what factors were considered most important when choosing nonemergency secondary health care providers in the United Kingdom with the purpose of translating these insights into a ratings platform delivered through a consumer mHealth app.

Methods: A mixed methods approach was used to identify key indicators incorporating a literature review to identify and categorize existing quality indicators, a questionnaire survey to formulate a ranked list of performance indicators, and focus groups to explore rationales behind the rankings. Findings from qualitative and quantitative methodologies were mapped onto each other under the four categories identified by the literature review.

Results: Quality indicators were divided into four categories. Hospital access was the least important category. The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant. Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access. All quality indicators within the hospital statistics category were equally important. Focus groups elaborated that users find it difficult to judge staff competence despite its importance.

Conclusions: A mixed methods approach is presented, which supported a patient-centered development and evaluation of a hospital ratings mobile app. Where possible, mHealth developers should use systematic research methods in order to more closely meet the needs of the end user and add credibility to their platform.

No MeSH data available.