Fredrik Vivian: Learning from (my) patient experience

After 10 years cycling in London I've had my first major crash. A pothole on a rainy morning converted my commute into a journey to A&E. It was also one of my first experiences since becoming a doctor of being on the other side of the stethoscope. It was certainly interesting seeing my workplace from the other side. While generally the experience was good with very caring staff, there were some aspects that made me reflect on my own practice and on the wider system.

In my four hours in A&E I relayed my clinical history to five people. While they all introduced themselves, understanding everybody's role and the need to repeatedly retell my story would have been very challenging without my prior knowledge. Likewise, for the several moves through the department and periods of waiting. Systems and processes are second nature to staff, so we fail to appreciate how they are perceived by patients. I will certainly be striving to be better at explaining these in future.

Another point of learning was how tricky it was, in pain and with an arm out-of-action, getting basic comforts. Adjusting the bed position, getting something to drink or getting to the bathroom suddenly became a challenge with staff members’ attention understandably focussed elsewhere. We all have to prioritise things on busy shifts, but I will try to find time to address simple comforts first to enable my patients to relax and focus on our consultation.

My experiences made me reflect on how we collect and utilise patient feedback. The Care Quality Commission’s annual patient surveys do provide useful insights. However, as pointed out in a King’s Fund report into patient feedback mechanism in 2015, the intermittent nature of these and high annual variability in some metrics means these are of limited value for locally-led improvement. Collecting more frequent patient feedback can enable trends to be tracked and utilised to improve care. They can also highlight areas of particular concern enabling these to be addressed in a timely manner. It is important to engage front-line staff, as well as managers, in using this data for iterative improvement. Over time technological advances will reduce the administrative burden of data capture and enable analysis of rich clinical data through machine learning. This will bring a future with data-driven improvement playing a much more prominent role leading to significant patient experience and safety benefits.

Reflecting on my experience as a patient has highlighted valuable insights into both my own practice and the system more broadly. By fostering a culture of empathy, implementing clearer communication around hospital processes, and leveraging technology for data-driven improvement, we can enhance the patient experience and clinical outcomes. As healthcare professionals it is our responsibility to listen to patient feedback, advocate for systemic improvements and continuously strive for excellent patient-centred care.