Staff feedback within an acute mental health hospital: a qualitative interview study

Introduction: Bringing about lasting improvements and change to staff practice in mental health (MH) hospitals is urgently needed but difficult to achieve and maintain. Feedback is a common factor supporting interventions to improve MH practice but does not occur within a tabula rasa.

Method: This study explored the existing feedback experiences of 11 staff and managers working in a MH hospital using semi-structured interviews.

Results: Four main themes with sub-themes emerged: Structure and feedback mechanisms varied by role and profession, feedbacks were either formal and procedural or informal during interactive flows, feedback focus and mechanisms differ along professional lines, and feedback can be individualized to roles and personal factors. The overall feedback environment was shown to be complex.

Discussion: Overall organizational feedback interventions may not be effective, and applying the “two systems of thinking” and “teachable moments” ideas to current formal and informal feedbacks may support more effective feedback. Existing formal and informal feedback mechanisms and focus have strengths and weaknesses which can be used to improve care once these have been carefully assessed.

Conclusions: Using concepts such as systems of thinking and teachable moments for linking formal structured and informal “in the moment” feedbacks may present useful approaches to improving professional feedback within MH services.