Although there are studies on the use of social media and palliative and end-of-life care (PEOLC), there are no studies specifically investigating the content of online public feedback about PEOLC services. This study sought to understand experiences of end-of-life care provided in hospitals in the West of Scotland by exploring the main themes within the content of stories posted on a nationally endorsed nonprofit feedback online platform, Care Opinion, within a 2-year period. We used \"Appreciative Inquiry\" as a theoretical framework for this study to determine what works well in end-of-life care, while also identifying areas for further improvement. Of the 1428 stories published on \"Care Opinion\" from March 2019 to 2021 regarding hospitals in the West of Scotland, 48 (3.36%) were related to end-of-life care, of which all were included in data analysis. Using the software package NVivo and thematic analysis, we identified 4 key themes. We found that people overwhelmingly posted positive feedback about their experiences with end-of-life care. People reported positively about staff professionalism in providing compassionate and person-centered care to meet their loved ones needs at end of life. Other experiences of care related to challenges facing healthcare services, particularly during the COVID-19 pandemic. Quality appraisal of staff responses highlighted areas for improving feedback. This study can add to the aim of improving staff response to people\'s concerns about end-of-life care. This study has provided a novel perspective of patients\' experiences of end-of-life care in hospitals in the West of Scotland. Novel insights were the appreciation of quality of care, staff professionalism, effective communication, and meeting patient\'s needs at end-of-life particularly by nursing staff.

OBJECTIVE: To gain a deeper understanding of online patient feedback moderation through the organisation of Care Opinion in Scotland.
METHODS: An ethnographic study, initially using in-person participant observations, switching to remote methods due to the pandemic. This involved the use of remote observations and interviews. Interviews were carried out with the whole Scottish team (n = 8).
RESULTS: Our results identify three major themes of work found in online patient feedback moderation. The first is process work, where moderators make decisions on how to edit and publish stories. The second is emotional labour from working with healthcare experiences and with NHS staff. The third is the brokering/mediation role of Care Opinion, where they must manage the relationships between authors, subscribing healthcare providers and Scottish Government. Our results also capture that these different themes are not independent and can at times influence the others.
CONCLUSIONS: Our results build on previous literature on Care Opinion and provide novel insights into the emotional and brokering/mediation work they undertake. Care Opinion holds a unique position, where they must balance the interests of the key stakeholders. Care Opinion holds the power to amplify authors\' voices but the power to make changes to services lies with NHS staff and services. Online moderation work is complex, and moderators require support to carry out their work especially given the emotional impact. Further research is planned to understand how patient stories are used by NHS Scotland, and the emotional labour involved with stories, from both the author and NHS staff perspective.

UNASSIGNED: Online patient feedback is becoming increasingly prevalent on an international scale. However, limited research has explored how healthcare organisations implement such feedback. This research sought to explore how an acute hospital, recently placed into \'special measures\' by a regulatory body implemented online feedback to support its improvement journey.
UNASSIGNED: Semi-structured interviews were conducted with eleven key stakeholders involved in the implementation and/or use of online patient feedback. Data was analysed using deductive thematic analysis with Normalisation Process Theory used as the analytical framework. Research findings are translated into the Engage, Support and Promote (ESP) model, a model of rapid feedback adoption.
UNASSIGNED: Participants viewed the implementation of online feedback as an opportunity to learn, change and improve. Factors found to facilitate implementation were often linked to engagement, support and promotion. Although less frequently described, barriers to implementation included staff anxieties about time pressures, moderation processes and responding responsibilities. Such anxieties were often addressed by activities including the provision of evidence based responder training. Overall, staff were overwhelmingly positive about the value of online feedback with 24 impacts identified at an individual and organisational level, including the ability to boost staff morale, resilience and pride.
UNASSIGNED: The rapid implementation of online patient feedback can be achieved in a \'special measures\' organisation. However, the difficulties of implementing such feedback should not be underestimated. In order to embed online feedback, staff members need to be engaged and feel supported, with opportunities to provide, respond and invite patient feedback frequently promoted to both patients and staff members.

OBJECTIVE: To analyse how staff in one Scottish hospital respond to anonymised patient feedback posted on the nationally endorsed feedback platform Care Opinion; and to understand staff experiences of, and attitudes towards, engaging with Care Opinion data.
METHODS: This was a multi-method study comprising: (a) numerical and thematic analysis of stories posted during a six-month period, using a published framework; (b) thematic analysis of interviews with a range of 10 hospital staff responsible for organisational responses to feedback.
RESULTS: Seventy-seven stories were published during the six-month period. All received a response, with a mean response time of 3.9 days. Ninety-six responses were made in total, from 20 staff members. Personalisation and tailoring was mostly assessed as performing well against the published framework. Only two \'changes made\' were reported. While staff interviewed were mostly understanding of why patients might prefer giving anonymised feedback, some found it uncomfortable and challenging. Participants described instances where they might seek to de-anonymise the individual, in order to pass on personal thanks to the relevant staff member, or to investigate the issue raised and seek resolution offline. Patients did not always want to identify themselves; this could sometimes lead staff to query the veracity or importance of issues raised. Sometimes staff could identify individuals anyway, including one described as \'our regular person\'.
CONCLUSIONS: Staff used to engaging directly with patients and families, both clinically and in dealing with feedback, need support in dealing with anonymous feedback, and the uncomfortable situation of unequal power it may create.