Background Understanding patient/service-user experience is mission critical for hospices. This is achieved by conducting surveys. However, following the COVID-19 pandemic, the hospice sector witnessed a sectoral drop in feedback rates. This was exacerbated by the fact that existing tools are neither fit-for-purpose nor inclusive. To overcome this challenge, researchers at the University of Leicester collaborated with LOROS hospice.

Aims To design, validate, and implement an inclusive and frictionless survey tool.

Methods To understand the hospice sector-based requirements for effective user-feedback we used ‘house of quality’ (Hauser, Clausing. Harv Bus Rev. 1988;66:63–73): an engineering tool used to map design specifications to customer requirements and prioritise product specifications. We used these product specifications and followed the Web Content Accessibility Guidelines to create the digital survey tool. Finally, LOROS hospice validated the tool with 46 users across three services.

Results First, the ‘house of quality’ recommended a hospice-specific feedback model (Orsini, Rodrigues, Tricio, et al. J Educ Eval Health Prof. 2022;19:35) for optimal user experience. We created the feedback model that suggested effective feedback is underpinned by ensuring patient dignity, ‘linearising’ the questionnaire, and encouraging positive self-esteem in the hospice care provider. Consequently, we adopted a ‘dignity by design’ approach to build the digital tool. Second, we interviewed 18 hospice sector experts to identify barriers to the implementation of digital tools. In the UK, key barriers included reluctance to embrace technology amongst hospice workers and disinterest in technology amongst patients. Last, LOROS successfully validated the tool, which performed well on the following measures: increased feedback rate, real-time data analysis and reporting, and reduction in costs. This showed that the two barriers can be overcome by training staff members and appointing ‘digital champions’ who can interface with service users.

Conclusion We showed how an inclusive survey tool can enhance feedback rates. We anticipate our inclusive, frictionless, ethical survey tool will be of significant interest to the global hospice community.