Can the value and acceptability of a patient feedback tool for revalidating psychiatrists be improved for both patients and psychiatrists through its co-production? An action research approach.

Abstract

Background: Co-production is often suggested as an alternative approach to patient feedback design. However, critical exploration of how co-production may affect the perceived value and acceptability of a patient feedback tool is severely limited, particularly in the context of revalidation for practising psychiatrists.

Aim: This research sought to address four research questions: i) how are patients and the public involved in the design, delivery and evaluation of patient feedback tools for practising psychiatrists, if at all; ii) what are patient and psychiatrist perceptions, experiences and aspirations for patient feedback tools in revalidation; iii) how do these compare and iv) can co-production improve the perceived value and acceptability of a patient feedback tool for both patients and psychiatrists? Methods: Seven cycles of action research were conducted in co-production with a mental health patient-research partner.

Results: Patients are rarely involved in the design, delivery or evaluation of patient feedback tools for practising psychiatrists. Comparison of 152 online reviews demonstrates that patients frequently describe different psychiatric care domains with different terminology to that used in existing feedback tools. Inductive thematic analysis of focus groups and interviews with 77 patients and 29 psychiatrists identified a number of shared concerns and suggestions that often related to improving existing feedback design, content and processes. Finally, following a co-production and refinement workshop with 28 participants, 16 patients and psychiatrists stated that co-production had improved the perceived value and acceptability of the patient feedback tool. Benefits of co-production identified by participants included enhanced relevance, provision of more accessible information and increased sense of ownership.

Conclusion: Co-production can enhance the perceived value and acceptability of a patient feedback tool. However, the integration of co-produced knowledge ultimately remains at the organisations’ discretion. Research impacts include the national implementation of the feedback tool and international implementation of the co-produced response framework.