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The authors declare that they have no competing interests.
VT collected and analyzed the interview data, helped to interpret comparison with survey data and wrote the paper. JM helped to analyze and interpret the interview data and helped write the paper. TW helped design the study, collected and analyzed interview data, and helped write the paper. GR was consulted about study design, helped to interpret data and write the paper. PM collected and analyzed the survey data, helped to interpret the comparison, and revised the paper. AR conceived and helped design the study and revised the paper. MG helped to design and pilot the survey, interpret and feedback the results to staff and commented on the paper. ED conceived and helped design the study, helped to analyze and interpret the survey data and its comparison with the interview data, and helped write the paper. All authors read and approved the final manuscript.
Patients’ experiences have become central to assessing the performance of healthcare systems worldwide and are increasingly being used to inform quality improvement processes. This paper explores the relative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process.
One dataset was collected using a narrative interview approach, (n = 13) and the other using a postal survey (n = 82). Datasets were analyzed separately and then compared to determine whether similar priorities for improving patient experiences were identified.
There were both similarities and differences in the improvement priorities arising from each approach. Day surgery was specifically identified as a priority in the narrative dataset but included in the survey recommendations only as part of a broader priority around improving inpatient experience. Both datasets identified appointment systems, patients spending enough time with staff, information about treatment and side effects and more information at the end of treatment as priorities. The specific priorities identified by the narrative interviews commonly related to ‘relational’ aspects of patient experience. Those identified by the survey typically related to more ‘functional’ aspects and were not always sufficiently detailed to identify specific improvement actions.
Our analysis suggests that whilst local survey data may act as a screening tool to identify potential problems within the breast cancer service, they do not always provide sufficient detail of what to do to improve that service. These findings may have wider applicability in other services. We recommend using an initial preliminary survey, with better use of survey open comments, followed by an in-depth qualitative analysis to help deliver improvements to relational and functional aspects of patient experience.