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Aim:

Using secondary analysis, this study aims to provide evidence for patient-centred improvements in the quality of health and social care. 

Why this is important:

This study builds on two existing initiatives:

  1. An archive of 3,000 qualitative video and audio interviews on over 80 topics with users about their health and illness experiences held by the Health Experiences Research Group. These are disseminated online via HEXI.ox.ac.uk.
  2. Experience-Based Co-Design (EBCD), a participatory action research approach which actively involves patients and carers in the design of health services. This has been implemented in over 60 care services in six different countries since being piloted in 2006.  Past evaluations have shown EBCD to be effective in achieving quality improvement and cultural change. 

Both initiatives include video-recorded in-depth interviews with people talking about their experiences.  In EBCD, analysis of specific areas of health services (called touchpoints) where there is potential for quality improvement is used to create a trigger film, which staff and patients watch together to start a discussion about improving care locally, before setting up co-design working groups to plan and implement changes together. 

Evidence from this research will support care organisations seeking to apply experience-based quality improvement in an affordable and timely way across a range of conditions.

Method:

We will reanalyse ten of our existing interview collections. In each case the primary research question for the secondary analysis will be: What touchpoints do patients identify in their experiences of care where quality could be improved?

Alongside the analysis for touchpoints in each condition, we will also ask: What are the touchpoints for a) outpatient care and b) interactions between health and social care across a range of different conditions which could be used to redesign services?

The secondary analyses will involve a researcher going back to the full transcript collection to identify touchpoints. On HEXI - Health Experience Insights, we also have a set of lay summaries identifying key topics of importance to interview participants in each condition (though not specifically analysed for touchpoints). A key further empirical question to ask is therefore: What touchpoints would emerge from a re-analysis of the website summaries, compared to re-analysis of the full transcripts? Can further time savings be made in identifying touchpoints by this method or is too much lost in the process?

We will also involve patients and the public in the secondary analysis process, supporting them in analysing both selected transcripts and selected website summaries, and discussing with them similarities and differences in the touchpoints they identify compared to the social science researcher.

We will disseminate findings from the secondary analysis in the form of a series of catalyst films, using our existing video recordings to illistrate the touchpoints we identify, and make these available through both HEXI.ox.ac.uk and the Point of Care Foundation online EBCD toolkit.

How will this benefit patients?

With the close and active support of NHS England, findings from our research will have a clear route to impact on health policy and practice

Further information:

Full project title:

Secondary analysis of qualitative video health experience interviews to inform policy and practice - what matters most to users about quality of care? 

Length of project:

December 2014 – May 2016

Funded by:

ESRC

External collaborators:

  • Point of Care Foundation
  • NHS England