Patient survey flaws could undermine performance review

Variations in the way surveys are completed could undermine attempts to develop performance benchmarks, researchers have warned.

The timing and method of administration of questionnaires affects the way patients evaluate the service they received, according to a study published in Primary Health Care Research and Development.

Researchers reviewed the GMC’s Patient Questionnaire, which could be used in revalidation. They found that differences in data collection methods, such as whether an exit survey or postal survey was used, led to variations in the way patients viewed services.

The report found that postal responses were more critical of doctors’ performance than exit surveys. It said one explanation for this could be that patients in their own home feel less inhibited about providing a critical assessment than those completing a questionnaire in a surgery waiting room.

It added that the post-consultation survey was the preferred method of administration, but that a touch-tone telephone approach was ‘prone to bias’ through substantially higher non-response rates.

The report concluded: ‘At present, caution is required towards mixing administration methods when creating and applying benchmarks against which a doctor’s performance is assessed until further research is undertaken.

‘This is of particular importance should such patient questionnaires become a routine component of multi-source feedback in the UK’s current plans for the revalidation of doctors.’

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