A Novel Method of Patient Narrative Feedback Reporting and Learning: Results from a Field Experiment.

Many healthcare organizations are exploring the use of patient narratives--feedback from patients in their own words-- to inform their efforts to improve patient care experiences. They have observed that leveraging narratives requires an effective method of reporting them to administrators, staff, and clinicians, which is often missing. We applied research on performance feedback design, organizational behavior, and innovation implementation to create an intervention composed of an online reporting interface with active user support. We then conducted an experiment in which we used patient surveys, staff surveys, and staff interviews from 12 intervention and 10 comparison ambulatory care sites in one system to assess intervention effects and lessons for organizational theory. We found positive and significant differences in intervention sites' patient survey scores for three out of four measures targeted for improvement. Staff surveys indicated two mechanisms underlying effects: increasing useful information and motivating behavior changes. Interviewees indicated that the intervention reduced the complexity of accessing, interpreting, and using narrative feedback. We discuss implications of our results for healthcare management and organizational learning theory, particularly about learning from successes and failures and from customers. Our study is an example of using theory to evolve practice and practice to inform theory. [ABSTRACT FROM AUTHOR]