Care pathway and organisational features driving patient experience: statistical analysis of large NHS datasets

Abstract

ObjectiveThe aim of this study was to identify the care pathway and organisational factors that predict patient experience.DesignStatistical analysis of large National Health Service (NHS) datasets.Setting andparticipantsEngland; acute NHS organisational-level data.Primary and secondary outcome measuresThe relationship of care pathway and organisational variables to organisation-level patient experience.ResultsA framework of 18 care pathway and organisational variables were created based on the existing literature. 11 of these correlated to patient experience in univariate analyses. Multicollinearity tests resulted in 1 of the 11 variables holding a correlation to another variable larger than r=0.70. A significant multilinear regression equation, including the final 10 variables, was found (F(10,108)=6.214, p<0.00), with anR2of 0.365. Two variables were significant in predicting better in patient experience: Amount of support to clinical staff (beta=0.2, p=0.02) and the proportion of staff who would recommend the trust as a place to work or receive treatment (beta=0.26, p=0.01). Two variables were significant in predicting a negative impact on the patient’s rating of their experience: Number of patients spending over 4 hours from decision to admit to admission (beta=−1.99, p=0.03) and the percentage of estates and hotel services contracted out (beta=−0.23, p=0.01).ConclusionsThese results indicate that augmenting clinical support and investing in the mechanisms that facilitate positive staff experience is essential to delivering appropriate, informative and patient-centric care. Reducing wait times and the extent of external contracting within hospitals is also likely to improve patient ratings of experience. Understanding the relationship between patient experience and objective, measurable organisational features promote a more patient-centric interpretation of quality and compel a better use of patient experience feedback to drive improvement.