Patient experience feedback in rehabilitation quality improvement and codesign activities: scoping review

Research Objectives: To characterize the literature, including reported enablers and gaps, on the use of patient experience (Px) feedback in rehabilitation codesign and quality improvement (QI) activities.

Design: Scoping review.

Setting: Data sources: Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web-of-Science, ProQuest); Greylit database, website searches (e.g., Beryl Institute), snowballing, and key-informant recommendations.

Participants: Study Selection: Two independent reviewers performed title-and-abstract screenings and full-text reviews. Eligibility criteria focused on English-language, peer-reviewed (all time) and grey literature (last 5 years) that engage Px feedback in rehabilitation QI or codesign activities.

Interventions: NA

Main Outcome Measures: Data extraction: The QI aims, settings, methods, patient engagement strategies, findings, implications, and reported limitations were extracted, followed by a content analysis identifying reported enablers and gaps.

Results: Data synthesis: Of 851 unique references and 50 full texts reviewed, ten papers were included: six used codesign to engage patients in QI activities; four used Px survey data to inform and evaluate QI activities. Implementation enablers included securing managerial support, having a designated methodology and facilitator - including for balancing power in codesign, using efficient processes, engaging staff experience feedback, and using appreciative inquiry. Gaps included limited follow-up, low sample sizes, analytical limitations, difficulties engaging patients with severe limitations, or lack of reported limitations.

Conclusions:

Conclusion: Few examples of Px feedback engagement in QI or codesign activities were found in the rehabilitation literature, either scientific or grey. Px improvement activities were merely informed by Px survey data, not qualitative or participatory approaches which are often more actionable. The identified enablers and gaps can support the design, use, evaluation, and report of person-centered QI activities that meaningfully engage and use Px feedback.

Author(s) Disclosures: The authors declare no conflict of interest.