Using parent-reported experience measures as quality improvement tools in paediatric cardiothoracic services: making it happen

Objective: Patient experience is a core component of quality and service improvement. In the case of child health, it is parents who often report on their experiences of the child's healthcare. However, these parent experiences are rarely used to drive change. Our aim was to develop and implement the systematic collection of parent experience data across a range of cardiothoracic services, using quality improvement methodology to implement change. Design: Plan-Do-Study-Act methodology was used to develop parent-reported experience measures. Setting: Specialist children's hospital. Participants: Parents of children under the care of one of a number of cardiothoracic services at the hospital. Intervention(s): Completion of questionnaires about hospital experience comprising quantitative and qualitative questions. Main Outcome Measure(s): Response rates and completion of a specific-measurable-achievable-realistic-timely (SMART) action plan by the individual clinical teams. Results: During the first cycle 17 surveys were developed for different clinical services and questionnaires sent/given to 1876 parents. The overall response rate was 30% (15-100%). Clinical teams developed SMART plans following eight (47%) surveys; three teams have reviewed and reported back on their progress against their plan and started on the second cycle of questionnaires. Challenges included lack of resources (time, finances and electronic data collection tools) and problems with actioning SMART plans. However, teams engaged positively, recognizing the importance of parent experience and actively seeking solutions to problems. Conclusions: Parent-reported experience measures are practical and acceptable quality improvement tools in healthcare but challenges need to be addressed, primarily related to resources, training and sustainability.