Patient compliment letters reveal the value of ‘extra-role’ behaviours and if properly utilised can improve patient safety and staff well-being, a new study from the London School of Economics and Political Science (LSE) suggests.
The study, published in BMJ: Quality & Safety, analysed 1,267 compliment letters from fifty-four NHS hospitals in England written by patients to front-line healthcare workers or to senior staff. Of these, 77% highlighted the importance of individual, personal relationships and the behaviours that merited their letter: 39% focussed on ‘extra-role’ behaviours including staff staying late to conduct tests, giving emotional support, checking-in and organising social events.
Patients are uniquely placed to give valuable insights into care and delivery, including identifying problems and unsafe behaviours. The effective use of compliments provides another simple and cost-effective route to involve patients in healthcare by helping to motivate staff and inform decisions and the individual and organisational levels.
Lead author Dr Alex Gillespie says: “A lot of research has focused on things going wrong. In this research we analysed things going right. We found that it is not only staff going the extra mile, but also patients going the extra mile in writing thoughtful letters of compliment. This social recognition can motivate staff and thus feedforward into better healthcare."
The authors note that when compliments are analysed systematically, they “close the feedback loop between staff and patients and they can strengthen the community of practice leading to ‘proactive relationships.’” The authors caution, however, that while healthcare organisations could make better use of written compliments, they should not be used as a metric to monitor performance. Rather local managers and regulators should let staff have more freedom for extra-role behaviours, and be sure to feed the good news back to staff.
Behind the story
Gillespie A, Reader TW, Identifying and encouraging high-quality healthcare: an analysis of the content and aims of patient letters of compliment, BMJ Quality & Safety Published Online First: 08 July 2020. doi: 10.1136/bmjqs-2019-010077 https://qualitysafety.bmj.com/content/qhc/early/2020/07/07/bmjqs-2019-010077.full.pdf
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