Social Media as a Tool for Consumer Engagement in Hospital Quality Improvement and Service Design: Barriers and Enablers for Implementation

Document Type : Original Article

Authors

1 Centre for Health Communication and Participation, La Trobe University, Bundoora, VIC, Australia

2 La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia

3 Independent Researcher, Melbourne, VIC, Australia

4 Orygen, Parkville, VIC, Australia

5 Albury Woonga Health, Wodonga, VIC, Australia

6 Safer Care Victoria, Melbourne, VIC, Australia

7 Northern Health, Bundoora, Australia

Abstract

Background 
Social media can be used to engage consumers in hospital service design and quality improvement (QI) activities, however its uptake may be limited by a lack of guidance to support implementation. This article presents the perceived barriers and enablers in using social media for consumer engagement derived from an interview study with public hospital stakeholders.

Methods 
Semi-structured interviews with 26 Australian hospital service providers and consumer representatives. Data were analysed using a deductive content analysis method.

Results 
Data were collected between October 2019 and April 2020. Facebook was the platform most commonly used for consumer engagement activities. Barriers and enablers to social media-based consumer engagement were identified. The barrier themes were (1) fears and concerns; (2) lack of skills and resources for social media engagement; (3) lack of organisational processes and support; and (4) problems with social media platforms and the changing social media landscape. The enabler themes were: (1) hospitals facilitating access and use; (2) making discussions safe; (3) cultivating a social media community; and (4) building on success.

Conclusion 
Using social media to facilitate consumer engagement in hospital service design and QI activities is feasible and acceptable to service providers and consumers. Hospitals and their executives can create a supportive environment for social media-based engagement activities through developing clear governance systems and providing training and support to all users. Consumers need to be involved in co-designing social media-based activities and determining which forms of engagement are accessible and acceptable. For some consumers and service providers, barriers such as a lack of resources and distrust of social media companies might mean that social media-based engagement will be less acceptable for them. Because of this it is important that hospitals provide complementary methods of engagement (eg, face-to-face) alongside social media-based methods.

Keywords


  1. Kaplan AM, Haenlein M. Users of the world, unite! the challenges and opportunities of social media. Bus Horiz. 2010;53(1):59-68. doi:1016/j.bushor.2009.09.003
  2. Obar JA, Wildman SS. Social media definition and the governance challenge-an introduction to the special issue. Telecomm Policy. 2015;39(9):745-750. doi:2139/ssrn.2663153
  3. Fox S, Purcell K. Social Media and Health. Washington, DC: Pew Research Centre; 2010.
  4. Househ M. The use of social media in healthcare: organizational, clinical, and patient perspectives. Stud Health Technol Inform. 2013;183:244-248. doi:3233/978-1-61499-203-5-244
  5. Naslund JA, Bondre A, Torous J, Aschbrenner KA. Social media and mental health: benefits, risks, and opportunities for research and practice. J Technol Behav Sci. 2020;5(3):245-257. doi:1007/s41347-020-00134-x
  6. Gupta P, Khan A, Kumar A. Social media use by patients in health care: a scoping review. Int J Healthc Manag. 2020:1-11. doi:1080/20479700.2020.1860563
  7. De Clercq E, Rost M, Gumy-Pause F, Diesch T, Espelli V, Elger BS. Moving beyond the friend-foe myth: a scoping review of the use of social media in adolescent and young adult oncology. J Adolesc Young Adult Oncol. 2020;9(5):561-571. doi:1089/jayao.2019.0168
  8. Patel R, Chang T, Greysen SR, Chopra V. Social media use in chronic disease: a systematic review and novel taxonomy. Am J Med. 2015;128(12):1335-1350. doi:1016/j.amjmed.2015.06.015
  9. Smailhodzic E, Hooijsma W, Boonstra A, Langley DJ. Social media use in healthcare: a systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Serv Res. 2016;16(1):442. doi:1186/s12913-016-1691-0
  10. Bornkessel A, Furberg R, Lefebvre RC. Social media: opportunities for quality improvement and lessons for providers-a networked model for patient-centered care through digital engagement. Curr Cardiol Rep. 2014;16(7):504. doi:1007/s11886-014-0504-5
  11. Walsh L, Hyett N, Juniper N, Li C, Rodier S, Hill S. The use of social media as a tool for stakeholder engagement in health service design and quality improvement: a scoping review. Digit Health. 2021;7:2055207621996870. doi:1177/2055207621996870
  12. Nilsen ES, Myrhaug HT, Johansen M, Oliver S, Oxman AD. Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material. Cochrane Database Syst Rev. 2006;2006(3):CD004563. doi:1002/14651858.CD004563.pub2
  13. Ocloo J, Matthews R. From tokenism to empowerment: progressing patient and public involvement in healthcare improvement. BMJ Qual Saf. 2016;25(8):626-632. doi:1136/bmjqs-2015-004839
  14. Richter JP, Muhlestein DB, Wilks CE. Social media: how hospitals use it, and opportunities for future use. J Healthc Manag. 2014;59(6):447-460.
  15. Walsh L, Hyett N, Howley J, et al. The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders. BMC Health Serv Res. 2021;21(1):876. doi:1186/s12913-021-06927-x
  16. de Leeuw E. The rise of the consucrat. Int J Health Policy Manag. 2021;10(4):176-180. doi:34172/ijhpm.2020.36
  17. DeCamp M, Brewer SE, Dukhanin V. Patient, public, consumer, and community engagement: from consucrat to representative comment on "the rise of the consucrat". Int J Health Policy Manag. 2020. doi:34172/ijhpm.2020.148
  18. DeCamp M, Dukhanin V, Hebert LC, Himmelrich S, Feeser S, Berkowitz SA. Patients' views about patient engagement and representation in healthcare governance. J Healthc Manag. 2019;64(5):332-346. doi:1097/jhm-d-18-00152
  19. Hill S. Report of the Victorian 2014 Consultation on Health Literacy. Melbourne: Centre for Health Communication and Participation, La Trobe University. 2014.
  20. Internet usage in Australia. Statista website. https://www.statista.com/topics/5261/internet-usage-in-australia/. Accessed September 3, 2021. Updated November 17, 2020.
  21. Active social media users as percentage of the total population in Australia from 2015 to 2021. Statista website. https://www.statista.com/statistics/680201/australia-social-media-penetration/. Accessed September 3, 2021. Updated February 2021.
  22. Australian Commission on Safety and Quality in Health Care (ACSQHC). National Statement on Health Literacy. Canberra: ACSQHC; 2014.
  23. Australian Commission on Safety and Quality in Health Care (ACSQHC). National Safety and Quality Health Service Standards. 2nd ed. Version 2. Sydney: ACSQHC; 2021.
  24. Australian Commission on Safety and Quality in Health Care (ACSQHC). Development of a Consumer Engagement Statement for the Commission: Consultation Report. Sydney: ACSQHC; 2008.
  25. Ayres L. Semi-structured interviews. In: Given LM, ed. The SAGE Encyclopedia of Qualitative Research Methods. Thousand Oaks, California: SAGE Publications Inc; 2008. p. 810-811.
  26. Bradshaw C, Atkinson S, Doody O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res. 2017;4:2333393617742282. doi:1177/2333393617742282
  27. Battaglia M. Convenience sampling. In: Lavrakas P, ed. Encyclopedia of Survey Research Methods. (Vol 1-0). Thousand Oaks, California: SAGE Publications Inc; 2008. p. 149.
  28. Sandelowski M. Theoretical saturation. In: Given LM, ed. The SAGE Encyclopedia of Qualitative Research Methods. Thousand Oaks, California: SAGE Publications Inc; 2008. p. 875-876.
  29. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-115. doi:1111/j.1365-2648.2007.04569.x
  30. Krefting L. Rigor in qualitative research: the assessment of trustworthiness. Am J Occup Ther. 1991;45(3):214-222. doi:5014/ajot.45.3.214
  31. Linneberg MS, Korsgaard S. Coding qualitative data: a synthesis guiding the novice. Qual Res J. 2019;19(3):259-270. doi:1108/QRJ-12-2018-0012
  32. NVivo 12 [computer program]. 2018.
  33. Yellow Social Media Report 2020 - Consumers. Melbourne: Sensis; 2020.
  34. Health Strategy Innovation Cell. Using Social Media to Improve Healthcare Quality: Part 1 Introduction and Key Issues in the Current Landscape. Ontario: The Change Foundation; 2011.
  35. Lim WM. Social media in medical and health care: opportunities and challenges. Mark Intell Plan. 2016;34(7):964-976. doi:1108/mip-06-2015-0120
  36. Amann J, Rubinelli S. Views of community managers on knowledge co-creation in online communities for people with disabilities: qualitative study. J Med Internet Res. 2017;19(10):e320. doi:2196/jmir.7406
  37. Cornwall A. Unpacking ‘participation’: models, meanings and practices. Community Dev J. 2008;43(3):269-283. doi:1093/cdj/bsn010
  38. Luxford K, Safran DG, Delbanco T. Promoting patient-centered care: a qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience. Int J Qual Health Care. 2011;23(5):510-515. doi:1093/intqhc/mzr024
  39. Ocloo J, Garfield S, Dawson S, Dean Franklin B. Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a protocol for a systematic review of reviews. BMJ Open. 2017;7(10):e018426. doi:1136/bmjopen-2017-018426
  40. Murray Z. Community representation in hospital decision making: a literature review. Aust Health Rev. 2015;39(3):323-328. doi:1071/ah14016
  41. Cargo M, Potaka-Osborne G, Cvitanovic L, et al. Strategies to support culturally safe health and wellbeing evaluations in Indigenous settings in Australia and New Zealand: a concept mapping study. Int J Equity Health. 2019;18(1):194. doi:1186/s12939-019-1094-z
  42. Goodridge D, Isinger T, Rotter T. Patient family advisors' perspectives on engagement in health-care quality improvement initiatives: power and partnership. Health Expect. 2018;21(1):379-386. doi:1111/hex.12633
  43. Renedo A, Marston CA, Spyridonidis D, Barlow J. Patient and public involvement in healthcare quality improvement: how organizations can help patients and professionals to collaborate. Public Manag Rev. 2015;17(1):17-34. doi:1080/14719037.2014.881535
  44. Vroman KG, Arthanat S, Lysack C. “Who over 65 is online?” older adults’ dispositions toward information communication technology. Comput Human Behav. 2015;43:156-166. doi:1016/j.chb.2014.10.018
  45. Delello JA, McWhorter RR. Reducing the digital divide: connecting older adults to iPad technology. J Appl Gerontol. 2017;36(1):3-28. doi:1177/0733464815589985
  46. Hill SJ, Sofra TA. How could health information be improved? recommended actions from the Victorian Consultation on Health Literacy. Aust Health Rev. 2018;42(2):134-139. doi:1071/ah16106
  47. Newman L, Biedrzycki K, Baum F. Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services. Aust Health Rev. 2012;36(2):125-129. doi:1071/ah11042
  48. A Right to Access the Internet. Australian Human Rights Commission. Website: https://humanrights.gov.au/our-work/8-right-access-internet. Accessed September 3, 2021.
  49. Lowe D, Merner B, Graham‐Wisener L, Walsh L, Hill S. The effects of consumers and health providers working in partnership as an intervention for the promotion of person‐centred health services. Cochrane Database Syst Rev. 2019(7). doi:1002/14651858.CD013373
  50. Johnson A. Consumer and Community Engagement in Health Services: A Literature Review to Support the Development of an Evidence Based Consumer and Community Engagement Strategy for the Women's and Children's Health Network. Adelaide: Government of South Australia; 2015.
  51. Kemp E, Trigg J, Beatty L, et al. Health literacy, digital health literacy and the implementation of digital health technologies in cancer care: the need for a strategic approach. Health Promot J Austr. 2021;32 Suppl 1:104-114. doi:1002/hpja.387
Volume 11, Issue 10
October 2022
Pages 2287-2298
  • Receive Date: 09 April 2021
  • Revise Date: 21 October 2021
  • Accept Date: 02 November 2021
  • First Publish Date: 03 November 2021