How can I collect feedback when my patients are too young to respond?
This case study will help if you:
- work in paediatrics or neonatology
- have patients who are infants, children or young people
- have patients who can't give you feedback themselves.
Key points to consider
- It’s important to reflect on patient feedback for revalidation, whatever your role or specialty. If you see a small number of patients, or patients who can’t give you feedback because of their age, you should still assume you have to collect patient feedback and consider how best you can do this.
- You should consider the needs of your patients and adapt the process so that you receive a good number of responses from a representative sample of your patients.
- If the patient is unable to respond you can seek feedback from the patient’s family or carer instead.
- If you think it may not be appropriate to ask a patient or their family for feedback because they are too distressed, use your professional judgement to consider the most appropriate time to ask them for feedback.
- You should not collect or collate feedback responses yourself, or ask your responsible officer or appraiser to do this.
Dr Jez is an Associate Specialist in neonatology working in an NHS hospital. She works in a low dependency unit supervising transitional neonatal care and provides neonatal support to the special care baby unit (SCBU).
Her role is focused on inpatient care with the occasional outpatient clinic. Because of the age of her patients, Dr Jez has to ask their parents or carers for feedback.
Gathering enough feedback is challenging due to the low turnover of patients receiving inpatient care. On the postnatal ward Dr Jez sees approximately two to three patients per day, and on the SCBU approximately ten new patients per week. She finds it challenging to ask parents for feedback who have received upsetting news.
How the doctor met our requirements
Dr Jez used a tool developed by the Royal College of Paediatrics and Child Health (RCPCH) for use in intensive care unit settings called the Paediatric Carers of Feedback (PaedCCF) tool. It is a feedback form designed for use with parents and carers, but children and young people can also complete it if they’re able to.
Respondents are asked to give the doctor ratings of between 1 and 5 and there is space for comments. Doctors need to collect 40 responses over a year, to make sure their results are reliable.
Dr Jez asked two experienced nurses on the neonatal ward and SCBU to give feedback forms to parents and carers on her behalf. She let the nurses know when she’d spoken to parents on the ward, or asked them to approach parents they saw her having discussions with in the SCBU.
She used her professional judgement to decide when and how soon to ask parents who had received upsetting news for feedback, and asked the nursing staff to approach the parents at an appropriate time. The form included a weblink so families could give feedback at a time that suits them.
She regularly reminded the nurses to hand out the forms to make sure she received enough responses. Asking for feedback on both the postnatal ward and the SCBU meant she was able to get enough responses covering her whole practice.
She arranged for any completed questionnaires to be returned to the nurses’ station in a sealed envelope with her name on it. Patients could also post responses directly to the RCPCH using a freepost envelope. This meant the she was not directly involved in the administration, to make sure responses were anonymous.
The completed questionnaires were sent to the RCPCH for collation so that a personalised report could be produced for the doctor, summarising the feedback and comparing her scores against results of a cohort of peers.
Dr Jez was able to reflect on the scores and comments , which gave a boost to her confidence about her patient interactions and reinforced existing good practice.