Implementing a near real-time patient experience feedback process in inpatient rehabilitation: mixed-methods process evaluation informed by the Normalization Process Theory

Purpose: Near real-time patient experience feedback (NRTPEF) can enable patient-centric quality improvement. We 1) assess the utility, feasibility, and acceptability of implementing a new NRTPEF, perceived by patients and providers; and 2) understand how the NRTPEF became embedded into routine provider practices. Materials: and Methods: Mixed methods process evaluation of the 8-month implementation of an innovative NRTPEF in an inpatient rehabilitation unit, using interviews and focus groups with all the service-unit leaders and interviews with a randomized sample of patients. Beyond descriptive statistics and content analysis, the Normalization Process Theory (NPT) informed a framework analysis. Results: : Patients and service-unit leaders perceived high utility in the NRTPEF (median: 9 for both; 0-10 scale) and qualitative comments emphasized the value of providing/obtaining timely feedback. The system was found feasible and acceptable for patients (median: 9.5), but with an improvement margin for providers (median: 7.3). Suggestions include strengthening the data-relay format. Even in the pilot form, providers found the NRTPEF became embedded into practice (median 10; average: 8.6). The NPT-informed analysis shows how providers saw differential value, engaged with, and used the patient feedback into reconfigured practices. Conclusion: An innovative NRTPEF was found useful, feasible and acceptable, but with refinement opportunities before scale-up.