The Friends and Family Test: From card sorts to control charts

There is evidence that both quantitative and qualitative data in the National Health Service have been underexploited. Although the quantitative data derived from the Friends and Family Test are well understood and reported, the qualitative data are not so easily analysed nor is it easy to use to make quality improvements. There are methods from other domains that can be used to improve both reporting and utilisation of data. This article will discuss the logical and conceptual issues of combining the two methods, which when used together can lead to a deeper understanding of patient feedback and facilitate quality improvement without requiring advanced skills, thus making it suitable for lay staff and patient groups to use. Card Sorts and control charts, which are separately well-established techniques of analysis, were used together to analyse data from the Friends and Family Test in a general practitioner surgery in a small rural town in England with a patient population of approximately 8000. The use of the methodology showed that the two techniques used together resulted in a more powerful method, which was both easy to use and faster than traditional methods such as discourse analysis, and was easily incorporated into quality improvement discussions. This methodology is easy to use and requires little or no knowledge of statistical analysis, which makes it an ideal way for lay people, such as Patient Participation Groups or administrative staff, to monitor and act upon patient feedback, relieving general practitioners of the burden of analysing patient feedback