Happy to be asked: Tips on asking patients to be part of your Multi-Source Feedback (MSF) program

Multi-source, or 360-degree feedback programs have been used to help business leaders and executives build their skills and leadership for decades. Fundamentally, multi-source feedback involves receiving feedback from those around you to get a complete picture of your performance. This is compared to more traditional models of feedback where you receive feedback from only one person, typically a supervisor. When done correctly, multi-source feedback programs facilitate expanded self-awareness and an increased likelihood of change.¹

The multi-source feedback model has been used for physicians and healthcare workers to varying levels of success. Along with aspects including how the results are presented and whether the development of an action plan is supported, how feedback is collected is critical to a successful multi-source feedback program. But, asking someone to complete a feedback survey can have its challenges. In a medical care context, and especially when requesting patient feedback, these challenges can feel more acute.

This article provides practical guidance on asking patients for feedback as part of a multi-source feedback program based on the Medical Council of Canada’s organizational experience administering the MCC 360 program to physicians across the country. Regardless of whether you see your patients once, or you see them on a recurring basis, this article offers strategies that can help you feel prepared, improve feedback quality, and increase your patients’ comfort with the ask.

1

Address selection bias

One of the most common questions when participating a multi-source feedback program is how to address our natural tendency to request feedback from those who we feel are more likely to give us a positive review. A simple, but highly effective and practical strategy, to mitigate potential bias is to set yourself a timeframe to invite patients to provide feedback. During this period, any patient you see you would request they complete the feedback survey. This strategy can also help you collect the surveys quickly and effectively. When deciding your timeframe, consider:

• The program requirements for patient feedback (i.e., how many patients need to provide feedback)
• The volume of patients you typically see in a day
• The number of requests that could be declined or just not completed (to be safe, calculate using a rate of about 20%)

Even with the timeframe strategy, it can be helpful to remind yourself of what you hope to achieve from the time investment you are making in the program if you find yourself hesitating to request feedback from a patient.

2

Prepare a script

If you are unsure about how to ask patients for feedback, preparing a brief script to make sure you cover off the important points in your request can help. You can also consider having materials on hand that the patients can look through when you ask them to complete a feedback survey. There are a few talking points to consider including in your script:

• What is the program and why are you participating?
  Outline at a high-level which organization is running the program, who you are requesting feedback from and why you are participating. Everyone has their own reasons for doing a multi-source feedback program. Communicate what you hope to achieve from the program to your patients. As a starting point, many physicians want candid feedback to help them better understand their practice so that they can make meaningful changes to help them be an even better physician.
• How their feedback is valuable and how it will help you as a physician?
  While it may feel obvious that patient feedback is important, it is impactful for a patient to hear from you that their candid feedback can help you improve your practice.
• Is their feedback confidential and how it will be used?
  If the multi-source feedback program you are enrolled in keeps responses anonymous, make sure to highlight that to your patient, and vice-versa. For example, in the MCC 360 program all responses are confidential. Qualitative data is aggregated, while narrative comments are available individually in the report but anonymized. The MCC 360 report is reviewed with the physician in two one-on-one coaching sessions so that an action plan can be developed.
• Is there a deadline for patients to complete the survey?
  Suggest a specific deadline for completion, especially if the survey is online. Most patients will complete the survey in the first 24 hours, so, encourage them to tackle it quickly.

Finally, be prepared for some patients to have questions or to say no. Have additional resources or contact information on hand so patients can learn more. If someone declines to provide feedback, be also prepared to express your understanding.

3

Adapt to the unique circumstances
and situation for each patient

Although you have a script as a starting point, try to adapt your request to the context of your practice and the unique circumstances of each your patients. Here are few practical considerations you can take into account:

1. Concerns about confidentiality of feedback
   While this has already been discussed, it is worthwhile to again underscore the importance of highlighting if patient feedback is confidential and how it will be used. For some patients this will be a deciding factor for if they feel comfortable to provide feedback. If that is the case, take your time going through the process and how their feedback is processed and used.
2. Options on how to complete the survey
   Surveys are typically online or hardcopy. Depending on the demographics of your patients (i.e., elderly patients) and how you see your patients (i.e., virtual or in-person), you may find one option is more appropriate than the other.Online surveys can offer enhanced perceptions of confidentiality, be more convenient for physicians as well as patients, and offer more flexibility on when/where they are completed. Hardcopy surveys can be more appropriate if technology is limited or if those completing the survey feel more comfortable with pen and paper. Check with your program to see what options are available. For example, depending on your MCC 360 package, you will be automatically provided with or can request paper surveys in addition to online surveys.
3. Consider language barriers
   Depending on your practice, you may want to consider having surveys and program information in different languages if they are available through your program. You can also inquire about translation support services that may be offered through your employer. The MCC 360 program offers surveys and support materials in both the official languages in Canada.

4

Use available communication channels

Consider leveraging additional communication channels, if available, to help increase awareness about the program to your patients before you even make the request and follow-up. There are a couple common communication channels you may be able to take advantage of:

1. Posting or leaving materials in waiting rooms
   If you can post or leave materials about the program in waiting rooms, consider doing so. This gives your patients the chance to learn about the program before your request, which can make your job easier. MCC 360 has soft-copies of both posters and information sheets available.
2. Let others in your office know about the program
   Depending on the environment you work; it may be necessary or a good idea to let your co-workers and colleagues know about the program. Office administrators may be able to include communication about the program before or after your appointment.

5

Learn more about MCC 360

MCC 360 was developed to provide physicians with meaningful and actionable feedback that leads to positive practice changes. In addition to a self-assessment, survey responses gathered from patients, physician colleagues, and non-physician co-workers ensure a 360-degree perspective. Qualitative, narrative comments and paired coaching time with a trained peer-physician complete the program and prompt an objective and constructive action plan. The program is recognized as a Health Standard Organization Leading Practice. It is also recognized by the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada for up to 15 Continued Professional Development (CPD) credits.

Visit the MCC 360 program for individual physicians or organizations. You can also request to see your short demonstration today.

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¹ Zenger, J., & Folkman, J. (2020, December 23). What Makes a 360-Degree Review Successful?  Harvard Business Review.