Outline of systematic search strategy

MEDLINE and Web of Knowledge were searched on 15 March 2011, using terms such as ‘responsiveness’, ‘customer-focused’, combining these with terms for ‘patient experience’, ‘user needs’, etc. In both databases, a set of terms relating to ‘primary care’ was used to limit results to literature of specific relevance to general practice. A separate search strategy was designed for use in Web of Knowledge to identify literature on responsiveness of services in the public sector. Finally, a simple, one-line search was carried out in Web of Knowledge for literature mentioning the term ‘SERVQUAL’ (a multi-item quality scale developed to assess customer perceptions of service quality in service and retail businesses).

In developing the search strategies, relevant indexing terms were used, where available (such as general practice/, Quality Indicators, Health Care/), in combination with free-text terms (such as family physician$). Publication date filtering was applied, so as to limit results to articles published during the past 10 years (from 2001 until March 2011). In Web of Knowledge, results were restricted to the two general categories: ‘SOCIAL SCIENCES’ OR ‘SCIENCE & TECHNOLOGY’.

Due to the significant volume of literature identified in MEDLINE (in excess of 1600 results), a pragmatic decision was made to further limit search results in this database to literature of particular relevance to the UK by using an unvalidated search filter (lines 57 to 67 in the MEDLINE search strategy).

The database search generated 980 references. These were reviewed for duplicates, and 25 duplicate references were removed, resulting in a set of 955 references.

This initial search was supplemented with searches of the internet, and of reference lists of identified reports and papers, to identify relevant grey literature. This included searches of the websites of key UK commercial and charity organisations for papers on responsiveness of primary care and measures of responsiveness or patient experience of primary care; searches of DH websites for key policy documents on responsiveness; and Google searches (using terms responsiveness/respond/responsive in combination with patient/customer/student; measure/survey/questionnaire).

The search for grey literature generated 207 papers and reports. This meant that a total of 1162 references were identified.

As the parameters of our search were relatively wide and unfocused (in order to try to collect a wide range of work relevant to the meaning and measurement of responsiveness), the initial search generated many irrelevant articles. In order to reduce the number of articles with low relevance, we conducted a search of identified articles to include only those with the terms ‘responsiveness’ or ‘responsive’ in the title or abstract.

This generated 119 references: 85 originating from the database searches and 34 from the grey literature.

These were screened by reading the abstract (by CT and EA), with reference to the inclusion and exclusion criteria described below. As we were interested in gaining an overview of the body of work on this concept, we did not assess quality of included literature, and did not use quality assessments as exclusion criteria.

Inclusion criteria

1. Empirical, review or discussion paper.
2. Concerns responsiveness of organisations to customer/patient/client needs.
3. Relates to the meaning or measurement of responsiveness.

Exclusion criteria

1. Duplicate reference.
2. Papers focusing on clinical aspects of care only, decision-making, interpersonal care in the consultation, physician responsiveness to patients (staff patient relationships, staff–patient communication, shared decision-making, patient-centred consultations, consultation skills, etc.).
3. Papers reporting ‘responsiveness’ as a psychometric attribute of a questionnaire.
4. Papers focusing on responsiveness within organisations (e.g. employer–employee, or organisational responsiveness to the business climate).
5. Papers focusing on responsiveness of technology or environments.
6. Papers focusing on research methodology.
7. Mention of responsiveness only, no discussion of meaning or measurement.

As a result of this process, 87 references were excluded, leaving 32 papers and reports (13 from the database searches and 19 from the search for grey literature).

The full papers/reports were obtained. The paper/reports were summarised into a chart, to give an indication of the disciplinary area and an overview of the features of responsiveness as described in the paper. If the paper reported a survey or questionnaire, information about this was also recorded. The chart was used to generate an overview of the range and nature of work on this concept.

We present a narrative scoping review of the literature on the key fields of work relating to the meaning and measurement of responsiveness, and identify the themes that have emerged within these fields. In writing the narrative review, we have referenced wider literature that was ‘signposted’ by papers identified through the core search.

Formal search strategy

MEDLINE and Web of Knowledge were searched on 15 March 2011, using terms such as ‘responsiveness’, ‘inverse care’, combining these with terms for ‘patient experience’, ‘user needs’, etc. In both databases, a set of terms relating to ‘primary care’ was used to limit results to literature of specific relevance to general practice. A separate search strategy was designed for use in Web of Knowledge to identify literature on responsiveness of services in the public sector. Finally, a simple, one-line search was carried out in Web of Knowledge for literature mentioning the term ‘SERVQUAL’ (a multi-item quality scale developed to assess customer perceptions of service quality in service and retail businesses). RATER, the ‘successor’ to SERVQUAL, was not included.

In developing the search strategies, relevant indexing terms were used, where available (such as general practice/, Quality Indicators, Health Care/), in combination with free-text terms (such as family physician$, inverse care.ti,ab.). Publication date filtering was applied, so as to limit results to articles published during the past 10 years (from 2001 until March 2011). In Web of Knowledge, results were restricted to the two general categories: ‘SOCIAL SCIENCES’ OR ‘SCIENCE & TECHNOLOGY’.

Owing to the significant volume of literature identified in MEDLINE (in excess of 1600 results), a pragmatic decision was made to further limit search results in this database to literature of particular relevance to the UK by using an unvalidated search filter (lines 57 to 67 in the MEDLINE search strategy below).

In addition to the database searches, the NatCen, MORI, Picker Institute and Joseph Rowntree Foundation websites were searched, using the terms ‘responsiveness’ and ‘patient involvement’.