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Primecare case study: Feedback loop

This case study relates to the Primecare Health redesign project. Please see that page for more information.

The opportunity

When people who used the service and their families wanted to tell Primecare what was working and what needed to change, they were limited in how they could do this.

At the beginning of the project Primecare was concerned about:

  • Very low numbers of Care Inspectorate evaluation forms that Primecare distributed were filled out and returned
  • High volume of calls, with comments passed on but no official way to capture and act on these
  • A view in the group that more could be done to engage with people in ways that made sense to them

Evidence from inspection showed that there didn’t seem to be ‘throughput’ from feedback to action.

“We saw evidence of instances where the service had responded well to expressions of dissatisfaction. However from complaints activity, service records and conversations with relatives during this inspection this was not consistent. Whilst undertaking this inspection we studied historical complaints made to the Care Inspectorate and could see the issues raised from the complaints made over this last year and areas of improvement identified during this inspection were similar in nature.“
—February 2012 Care Inspection Report

One family member said “I would like there to be an easier way to give feedback – the positive stuff, too.” 

The change

We asked for the group to reflect on their own experiences giving or receiving feedback, and began to understand that there needed to be a pathway for sending feedback to Primecare that resulted in clear action. For example, a compliment about a staff member's practice should make it into their staff file.

The group built two pathways for feedback: 

  1. A feedback box in the office. All calls, visits and comments made will be written down in detail and posted into the feedback box. The quality assurance team will be responsible for sorting the box once a week, and making sure the feedback goes to the appropriate place (online, staff files, staff supervision, etc)  and that a follow up call is made to the person who gave the feedback to let them know what action was taken. This was later supplemented with a ‘sunshine page’ on the Primecare website and a Primecare Facebook page where staff praise was publicly posted.
  2. The development of a new, bright, easy to use and ready-stamped feedback form prototype. This was developed soon after the first session and tested immediately to see whether it was more engaging and easy to use. The group decided that this should sit at the front of all client files and that fresh forms with a prompt should be sent out every quarter. 

The outcomes

There were several outcomes achieved by the new feedback processes including:

  • A huge increase in returns of feedback forms from people who used the support and their families. Where the office was receiving feedback by phone or email two to three times a month, they now regularly get this two to three times a week.  They also have a quality assurance team of three who actively seek feedback every day. 
  • A better overall understanding of the experiences of people who used the support and their families and the quality assurance team.
  • Improved staff morale and confidence because they were being rewarded for their good work . One dedicated staff member contacts staff to let them know about feedback and to celebrate their successes. 
  • A more open channel of communication between the office, care staff and people who access Primecare’s support. 
  • A better evidence trail of ongoing service improvement for inspection purposes.

However, this is just the beginning of a long process. As one family member in the group put it, “It’s evolution, isn’t it? We just need to see what works.”

Take a look