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Schmocker RK, Cherney Stafford LM, Winslow ER. Satisfaction with surgeon care as measured by the Surgery-CAHPS survey is not related to NSQIP outcomes. Surgery 2018; 165:510-515. [PMID: 30322662 DOI: 10.1016/j.surg.2018.08.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/10/2018] [Accepted: 08/21/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patient satisfaction is a patient-centered outcome of particular interest. Previous work has suggested that global measures of satisfaction may not adequately evaluate surgical care, therefore the surgery-specific Consumer Assessment of Healthcare Providers and Systems survey was developed. It remains unclear how traditional outcome measures, such as morbidity, impact patient satisfaction. Our aim was to determine whether National Surgical Quality Improvement Program-defined complications impacted satisfaction with the surgeon as measured by a surgery-specific survey, the surgery-specific Consumer Assessment of Healthcare Providers and Systems survey. METHODS All patients undergoing a general surgical operation from June 2013-November 2013 were sent the surgery-specific Consumer Assessment of Healthcare Providers and Systems survey after discharge. Retrospective chart review was conducted using the National Surgical Quality Improvement Program variable definitions, and major complications were defined. Data were analyzed as a function of response to the overall surgeon-rating item, and those surgeons rated as the "best possible" or "topbox" were compared with those rated lower. Univariate and logistic regression were used to determine variable importance. RESULTS A total of 529 patients responded, and 71.5% (378/529) rated the surgeon as topbox. The overall National Surgical Quality Improvement Program complication rate was 14.2% (75/529), with 26.7% of those (20/75) being major complications. On univariate analysis, patients who rated their surgeon more highly were somewhat older (59 vs 54 years: P < .001), more often underwent elective surgery (81% vs 57%: P < .001), and had an increased rate of operation for malignancy (31% vs 17%). Neither the complication rate (total or major) nor the number of complications were associated with satisfaction scores. CONCLUSIONS When examined on a patient level with surgery-specific measures and outcomes, the presence of complications after an operation does not appear to be associated with overall patient satisfaction with surgeon care. This finding suggests that satisfaction may be an outcome distinct from traditional measures.
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Affiliation(s)
- Ryan K Schmocker
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Emily R Winslow
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison.
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Nottingham Q, Johnson DM, Russell R. A multi-year SEM model predicting the impact of behavior attributes on overall patient satisfaction. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2018. [DOI: 10.1108/ijqrm-02-2018-0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Pressure from competition; inflexible third-party reimbursements; greater demand from government, regulatory and certifying agencies; discerning patients; and the quest of healthcare entities for greater profitably place demands and high expectations for service quality impacting overall patient experience. Extending a prior multivariate, single-period model of varied medical practices predicting patient experience to a three-year time period to understand whether there was a change in overall assessment using data analytics. The paper aims to discuss these issues.
Design/methodology/approach
SEM was employed on a per year and aggregated, three-year basis to gain insights into qualitative psychometric constructs predicting overall patient experience and strength of the relationships.
Findings
Statistically significant differences were uncovered between years indicating the strength of the relationships of latent variables on overall performance.
Research limitations/implications
Study focused on data gathered from a questionnaire mailed to patients who visited various outpatient medical clinics in a rural community with over 4,000 responses during the three-year study period. A higher percentage of female respondents over the age of 45 may limit the generalizability of the findings.
Practical implications
Practitioners can gain a broader understanding of different factors influencing overall patient experience. Administrative processes associated with the primary care provider are inconsequential. Patients are not as concerned with patient flow as they are with patient safety and health.
Originality/value
This research informs healthcare quality management of psychometrics and analytics to improve the overall patient experience in outpatient medical clinics.
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Rubens FD, Rothwell DM, Al Zayadi A, Sundaresan S, Ramsay T, Forster A. Impact of patient characteristics on the Canadian Patient Experiences Survey-Inpatient Care: survey analysis from an academic tertiary care centre. BMJ Open 2018; 8:e021575. [PMID: 30166297 PMCID: PMC6119436 DOI: 10.1136/bmjopen-2018-021575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the role of patient demographics, care domains and self-perceived health status in the analysis and interpretation of results from the Canadian Patient Experience Survey-Inpatient Care. DESIGN Cross-sectional survey. SETTING Single large Canadian two campus tertiary care academic centre. PARTICIPANTS Random sampling of hospital patients postdischarge. INTERVENTION AND MAIN OUTCOME MEASURES Logistic regression models were developed to analyse topbox scoring on four questions of global care (rate experience, recommend hospital, rate hospital, overall helped). Means of each composite domain were correlated to the four overall scores at the patient level to determine Spearman's rank correlation coefficients which were plotted against the overall (hospital) domain score for the key driver analysis. RESULTS Topbox scoring was decreased with worse degrees of perceived physical and mental health in all four global questions (p<0.05). Female gender and higher levels of education were associated with worse scoring on rate experience, recommend hospital and rate hospital (p<0.001). Whereas there was a significant difference between hospital departments in unadjusted measures, these differences were no longer evident after adjustment with patient covariates. Key driver analysis identified person-centred care, care transition and the domain related to emergency admission as areas of highest potential for improvement. CONCLUSIONS Global measures of overall care are influenced by patient-perceived physical and mental health. Caution should be exercised in using patient-satisfaction surveys to compare performance between different healthcare provision entities, as apparent differences could be explained by variation in patient mix rather than variation in performance.
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Affiliation(s)
- Fraser D Rubens
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Deanna M Rothwell
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Amal Al Zayadi
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sudhir Sundaresan
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Tim Ramsay
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Alan Forster
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Haidar OM, Lamarche PA, Levesque JF, Pampalon R. The Influence of Individuals' Vulnerabilities and Their Interactions on the Assessment of a Primary Care Experience. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2018; 48:798-819. [PMID: 29807483 DOI: 10.1177/0020731418768186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examines the relationship between the vulnerabilities of individuals and their assessments of their primary care experiences in the setting of a universal care system. It focuses on 2 specific objectives: (1) evaluating the influence of each of the 5 vulnerabilities on the assessment of the care experience; (2) evaluating the influence of the interactions between the different types of vulnerabilities on the assessment of the care experience. The study identifies the primary care experience of 9,206 people. The health-related, biological, material, relational, and cultural vulnerabilities are also evaluated. Generally, individuals' vulnerabilities are associated with a positive assessment of the primary care experience except for the cultural vulnerability. Material vulnerability is most frequently associated with a positive assessment of the primary care experience. The interactions between the multiple vulnerabilities present for one individual often modify the effect of vulnerability on the assessment of the experience of care. The positive effect of a vulnerability on the assessment of the care experience often increases in the presence of a second vulnerability, especially the health-related vulnerability. The simultaneous presence of health-related vulnerability cancels the negative influence of cultural vulnerability on the assessment of the primary care experience.
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Affiliation(s)
- Ola M Haidar
- 1 University of Montreal, School of Public Health, Montreal, Canada
| | - Paul A Lamarche
- 2 University of Montreal, School of Public Health, Montreal, Canada
| | - Jean-Frederic Levesque
- 3 Bureau of Health Information and Center for Primary Health Care and Equity, University of New South Wales, New South Wales, Australia
| | - Robert Pampalon
- 4 National Institute of Public Health of Quebec and Department of Social and Preventive Medicine, University of Laval, Quebec, Canada
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Abstract
The objective was to examine associations between patient experience, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, and the sociodemographic, cultural, and access-to-care factors of the surrounding community. Using an empty model, this study found that 27% of the variation in HCAHPS scores was at the level of the county in which the hospital was located. The county factors examined explained about half of this county-level variation. Among community factors most strongly associated with increased HCAHPS scores were higher numbers of primary care physicians per capita, fewer specialists per capita, and smaller percentages of African Americans and Hispanics in the county. A number of community factors beyond the hospitalization experience may influence HCAHPS scores. As HCAHPS gains importance as a measure of quality of care and is linked to higher payments over time, it will be essential to understand the possible effects of community factors.
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Affiliation(s)
- Jeph Herrin
- Yale University, New Haven, CT
- Health Research & Educational Trust/American Hospital Association, Chicago, IL
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Quigley DD, Elliott MN, Setodji CM, Hays RD. Quantifying Magnitude of Group-Level Differences in Patient Experiences with Health Care. Health Serv Res 2018; 53 Suppl 1:3027-3051. [PMID: 29435975 DOI: 10.1111/1475-6773.12828] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Review approaches assessing magnitude of differences in patient experience scores between different providers. DATA SOURCES 1990-2016 literature. STUDY DESIGN Systematic literature review. DATA EXTRACTION METHODS Of 812 articles mentioning "CAHPS," "patient experience," "patient satisfaction," "important(ce)," "difference," or "significance," we identified 79 possible articles, yielding 35 for data abstraction. We included 22 articles measuring magnitude of differences in patient experiences. PRINCIPAL FINDINGS We identified three main ways of estimating magnitude of differences in patient experience scores: (1) by distribution/range of patient experience variable, (2) against external anchor, and (3) comparing a difference in patient experience on one covariate to differences in patient experience on other covariates. CONCLUSIONS We suggest routine estimation of magnitude in patient experience research. More work is needed documenting magnitude of differences between providers to make patient experience data more interpretable and usable.
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Affiliation(s)
| | | | | | - Ron D Hays
- Division of General Internal Medicine & Health Services Research, UCLA, Los Angeles, CA
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Wallace S, Hanson KT, Dowdy SC, Habermann EB. Impact of surgical approach and patient factors on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scoring in gynecologic surgery. Gynecol Oncol 2018; 148:28-35. [DOI: 10.1016/j.ygyno.2017.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 11/05/2017] [Accepted: 11/10/2017] [Indexed: 10/18/2022]
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Impact of Cross-level Measurement Noninvariance on Hospital Rankings Based on Patient Experiences With Care in 7 European Countries. Med Care 2017; 55:e150-e157. [PMID: 29135779 DOI: 10.1097/mlr.0000000000000580] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hospital-level findings on patient experiences with care are increasingly reported publicly. A critical aspect left unexamined is the commonality of composite measures of patient experiences across different groups of patients, nursing units, hospitals, and countries. Absence of commonality is termed measurement noninvariance and is hypothesized to have a strong impact on performance assessment. AIM The aim of this study is to examine measurement invariance across groups and levels under study (patients, nursing units, hospitals, and countries) and illustrate the degree to which this method of analysis impacts hospital rankings. RESEARCH DESIGN Data were collected from 11,289 patients in 7 European countries, 186 hospitals, and 824 nursing units. Multilevel factor analytic models were applied to evaluate measurement invariance across the hierarchical levels of the study and across groups at specific levels (self-perceived health at patient level; unit speciality at nursing unit level). Hospital rankings for the final multilevel model were compared with those from a single-level factor model that is unsuspecting of measurement invariance. RESULTS Cross-group invariance was shown for levels of self-perceived health and to a large degree also for nursing unit speciality. Patient experience composite measures were, however, not invariant across patient, unit, and hospital levels. Hospital rankings were largely impacted when accounted for this cross-level invariance. The percentage of hospitals with discordant ranks by >10 percentile points varied from 26.7% in Spain to 70% in Poland. CONCLUSIONS Leaving unexamined possible noninvariance across groups and hierarchical levels may have far reaching consequences for how the public perceives hospitals' position relative to other hospitals.
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A Hospital Recommendation System Based on Patient Satisfaction Survey. APPLIED SCIENCES-BASEL 2017. [DOI: 10.3390/app7100966] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Löbner M, Stein J, Luppa M, Konnopka A, Meisel HJ, Günther L, Meixensberger J, Stengler K, Angermeyer MC, König HH, Riedel-Heller SG. Choosing the right rehabilitation setting after herniated disc surgery: Motives, motivations and expectations from the patients' perspective. PLoS One 2017; 12:e0183698. [PMID: 28829828 PMCID: PMC5567662 DOI: 10.1371/journal.pone.0183698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 08/09/2017] [Indexed: 12/04/2022] Open
Abstract
Objectives This study aims to investigate (1) motives, motivations and expectations regarding the choice for a specific rehabilitation setting after herniated disc surgery and (2) how rehabilitation-related motivations and expectations are associated with rehabilitation outcome (ability to work, health-related quality of life and satisfaction with rehabilitation) three months after disc surgery. Methods The longitudinal cohort study refers to 452 disc surgery patients participating in a subsequent rehabilitation. Baseline interviews took part during acute hospital stay (pre-rehabilitation), follow-up interviews three months later (post-rehabilitation). Binary logistic regression and multiple linear regression analyses were applied. Results (1) Motives, motivations and expectations: Inpatient rehabilitation (IPR) patients stated “less effort/stress” (40.9%), more “relaxation and recreation” (39.1%) and greater “intensity of care and treatment” (37.0%) regarding their setting preference, whereas outpatient rehabilitation (OPR) patients indicated “family reasons” (45.3%), the wish for “staying in familiar environment” (35.9%) as well as “job-related reasons” (11.7%) as most relevant. IPR patients showed significantly higher motivation/expectation scores regarding regeneration (p < .001), health (p < .05), coping (p < .001), retirement/job (p < .01), psychological burden (p < .05) and physical burden (p < .001) compared to OPR patients. (2) Associations with rehabilitation outcome: Besides other factors (e.g. age, gender and educational level) rehabilitation-related motivations/expectations were significantly associated with rehabilitation outcome measures. For example, patients with less motivations/expectations to achieve improvements regarding “physical burden” showed a better health-related quality of life (p < .01) three months after disc surgery. Less motivations/expectations to achieve improvements regarding “psychological burden” was linked to a better mental health status (p < .001) and a greater satisfaction with rehabilitation (OR = .806; p < .05). Conclusion Rehabilitation-related motivations and expectations differed substantially between IPR and OPR patients before rehabilitation and were significantly associated with rehabilitation outcome. Taking motivational and expectation-related aspects into account may help to improve allocation procedures for different rehabilitation settings and may improve rehabilitation success.
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Affiliation(s)
- Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
- * E-mail:
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans Jörg Meisel
- Department of Neurosurgery, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Germany
| | - Lutz Günther
- Department of Neurosurgery, Klinikum St. Georg gGmbH, Leipzig, Germany
| | | | - Katarina Stengler
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, HELIOS Park Hospital Leipzig, Leipzig, Germany
| | - Matthias C. Angermeyer
- Center for Public Mental Health, Gösing am Wagram, Austria
- Department of Public Health, University of Cagliary, Cagliary, Italy
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
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Parry S, Lloyd M, Simpson J. Experiences of therapeutic relationships on hospital wards, dissociation, and making connections. J Trauma Dissociation 2017; 18:544-558. [PMID: 27689788 DOI: 10.1080/15299732.2016.1241852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An interpretive phenomenological analysis sought to explore how people reporting moderate to high levels of dissociation experienced relationships with multidisciplinary hospital ward staff. Three superordinate themes were developed. First, the theme "multiple me and multiple them" explores the instability experienced by the participants as they managed their dissociative experiences alongside many inconsistencies. Second, "recognizing, meeting, or neglecting interpersonal and care needs" reflects on participants' needs within therapeutic relationships. Third, "between the needs of the internal system: navigating between 'better on my own' and 'someone to talk to'" discusses the confusion and understanding around dissociation and the importance of working with parts, not around them. Findings suggested that the current culture of some hospital wards directly influenced participants' distress, which could lead to further dissociation as a means of coping with perceived threats. Reflections on relational complexities and developing ward-based treatment are discussed.
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Affiliation(s)
- Sarah Parry
- a Division of Health Research , Lancaster University , Lancaster , United Kingdom
| | - Mike Lloyd
- b Vale Royal Adult Mental Health Service , Vale House Resource Centre , Winsford , United Kingdom
| | - Jane Simpson
- a Division of Health Research , Lancaster University , Lancaster , United Kingdom
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Peres-da-Silva A, Kleeman LT, Wellman SS, Green CL, Attarian DE, Bolognesi MP, Seyler TM. What Factors Drive Inpatient Satisfaction After Knee Arthroplasty? J Arthroplasty 2017; 32:1769-1772. [PMID: 28274618 DOI: 10.1016/j.arth.2017.01.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/15/2017] [Accepted: 01/22/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, developed by the Centers for Medicare & Medicaid Services, is directly tied to hospital reimbursement. The purpose of this study is to analyze survey responses from patients who underwent primary knee arthroplasty in order to identify factors that drive patient dissatisfaction in the inpatient setting. METHODS HCAHPS responses received from patients undergoing elective total and unicompartmental knee arthroplasty at our institution between January 1, 2013 and January 1, 2016 were obtained and expressed as a percentage of overall satisfaction. Satisfaction scores were correlated to patient demographics. RESULTS Overall, responses from 580 patients were obtained (554 total knee arthroplasties, 26 unicompartmental knee arthroplasties). There was a statistically significant difference in overall satisfaction when comparing sex (P = .034), race (P = .030), and socioeconomic status (P = .001). Men reported a higher average satisfaction score than women (77.8% vs 74.2%). Patients in the 1st quartile of socioeconomic status reported a higher average satisfaction than those in the 4th quartile (81.3% vs 71.3%). African American patients reported a higher satisfaction than Caucasian and other races (81.6% vs 75.3% vs 66.3%, respectively). There was an inverse relationship between increased length of stay and reported satisfaction (r = -0.113, P = .006). CONCLUSION Our data indicate that patients who are likely to report higher levels of inpatient satisfaction after knee arthroplasty are male, African American, of lower socioeconomic status, and with shorter length of stay. To our knowledge, this is the first reported analysis of the HCAHPS survey in relation to total joint arthroplasty.
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Affiliation(s)
| | - Lindsay T Kleeman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Samuel S Wellman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Cynthia L Green
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - David E Attarian
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Michael P Bolognesi
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Thorsten M Seyler
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
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Mennuni M, Gulizia MM, Alunni G, Francesco Amico A, Maria Bovenzi F, Caporale R, Colivicchi F, Di Lenarda A, Di Tano G, Egman S, Fattirolli F, Gabrielli D, Geraci G, Gregorio G, Francesco Mureddu G, Nardi F, Radini D, Riccio C, Rigo F, Sicuro M, Urbinati S, Zuin G. ANMCO Position Paper: hospital discharge planning: recommendations and standards. Eur Heart J Suppl 2017; 19:D244-D255. [PMID: 28751845 PMCID: PMC5526471 DOI: 10.1093/eurheartj/sux011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The hospital discharge is often poorly standardized and affected by discontinuity and fragmentation of care, putting patients at high risk of both post-discharge adverse events and early readmission. The present ANMCO document reviews the modifiable components of the hospital discharge process related to adverse events or re-hospitalizations and suggests the optimal methods for redesigning the whole discharge process. The key principles for proper hospital discharge or transfer of care acknowledge that the hospital discharge: • is not an isolated event, but a process that has to be planned as soon as possible after the admission, ensuring that the patient and the caregiver understand and contribute to the planned decisions, as equal partners; • is facilitated by a comprehensive systemic approach that begins with a multidimensional evaluation process; • must be organized by an operator who is responsible for the coordination of all phases of the hospital patient journey, involving afterward the general practitioner and transferring to them the information and responsibility at discharge; • is the result of an integrated multidisciplinary team approach; • appropriately uses the transitional and intermediate care services; • is carried out in an organized system of care and continuum of services; and • programs the passage of information to after-discharge services.
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Affiliation(s)
- Mauro Mennuni
- Cardiology Department - UTIC, Ospedale L. Parodi Delfino, Piazza Aldo Moro, 00034 Colleferro (RM), Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Ospedale Garibaldi-Nesima – Azienda Rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy
| | - Gianfranco Alunni
- Integrated Heart Failure Unit, Ospedale di Assisi, Assisi (PG), Italy
| | | | | | - Roberto Caporale
- Interventional Cardiology Department, Ospedale Santissima Annunziata, Cosenza, Italy
| | - Furio Colivicchi
- CCU-Cardiology Department, Ospedale San Filippo Neri, Roma, Italy
| | | | | | | | | | | | - Giovanna Geraci
- Cardiology Unit, AOR Villa Sofia-Cervello, P.O. Cervello, Palermo, Italy
| | - Giovanni Gregorio
- CCU-Cardiology Department, Ospedale San Luca, Vallo della Lucania (SA), Italy
| | - Gian Francesco Mureddu
- Cardiology and Cardiac Rehabilitation Department, AO San Giovanni Addolorata, Roma, Italy
| | - Federico Nardi
- Cardiology Department, Ospedale Castelli, Verbania, Italy
| | | | - Carmine Riccio
- Azienda Ospedaliera S. Anna e S. Sebastiano, Caserta, Italy
| | - Fausto Rigo
- Cardiology Unit, Ospedale dell'Angelo, Mestre (VE), Italy
| | - Marco Sicuro
- Cardiology and Cardiac Care Unit, Ospedale Generale Regionale-PO U. Parini, Aosta, Italy
| | | | - Guerrino Zuin
- Cardiology Unit, Ospedale dell'Angelo, Mestre (VE), Italy
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Beaird G, Dent JM, Keim-Malpass J, Muller AGJ, Nelson N, Brashers V. Perceptions of Teamwork in the Interprofessional Bedside Rounding Process. J Healthc Qual 2017; 39:95-106. [DOI: 10.1097/jhq.0000000000000068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Boxell EM, Amoaku WM, Bradley C. Healthcare experiences of patients with age-related macular degeneration: have things improved? Cross-sectional survey responses of Macular Society members in 2013 compared with 1999. BMJ Open 2017; 7:e012790. [PMID: 28196945 PMCID: PMC5318558 DOI: 10.1136/bmjopen-2016-012790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate healthcare experiences of patients with age-related macular degeneration (AMD) and determine whether a previous survey and Royal College of Ophthalmologists (RCOphth) management guidelines brought improvements. DESIGN Cross-sectional survey of Macular Society members in 2013 compared with previous 1999 survey. SETTING UK Postal Questionnaires. PARTICIPANTS 1169 respondents in 2013 (1187 in 1999). INTERVENTION Publication of 1999 survey results (2002), and RCOphth AMD guidelines (2009). MAIN OUTCOME MEASURES Respondents answered questions about experiences at diagnosis. Five questions were replicated from the 1999 survey for direct comparison in the 2013 survey which included additional questions based on 2009 RCOphth recommendations for information and support provision for patients with AMD. RESULTS Most 2013 survey respondents were given the name of their macular condition (91%), felt the healthcare professional was interested in them (71%) and were satisfied overall with the diagnostic consultation (76%). These outcomes show significant improvement since 1999. Within the 2013 sample, multivariable analyses showed gradual trends of improvement over time in: provision of written information, Macular Society information and receiving appropriate help, support and advice at diagnosis. Only overall satisfaction with the diagnostic consultation (but not the other nine areas of information and support provision studied) significantly improved in the time after publication of the RCOphth 2009 guidelines. There were no significant improvements associated with the publication of the 1999 survey results. Low information and support provision remained, for example, 44% of respondents diagnosed after the RCOphth 2009 guidelines reported not receiving information on what to do if vision deteriorated. Lack of such information at diagnosis was significantly associated with registration as sight impaired (p<0.01). Reports of general practitioner (GP) knowledge of AMD remained low: 39% reported their GP was 'not at all well informed'. The 2013 respondents reported lower levels of help and support from GPs than 1999 respondents (p<0.001). CONCLUSIONS Patients diagnosed with AMD after 1999 (vs before 1999) reported better experiences at diagnostic consultation. However, information and support provision at diagnosis, and satisfaction with GPs remained low.
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Affiliation(s)
- Emily M Boxell
- Health Psychology Research Unit, Royal Holloway, University of London, Egham, UK
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Winfried M Amoaku
- Ophthalmology, DCN, University of Nottingham, B Floor Eye and ENT Centre, University Hospital, QMC, Nottingham,UK
| | - Clare Bradley
- Health Psychology Research Unit, Royal Holloway, University of London, Egham, UK
- Health Psychology Research Ltd, Royal Holloway, University of London, Egham, UK
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Otani K, Buchanan PR, Desai SP, Herrmann PA. Different Combining Process Between Male and Female Patients to Reach Their Overall Satisfaction. J Patient Exp 2016; 3:145-150. [PMID: 28725851 PMCID: PMC5513654 DOI: 10.1177/2374373516685953] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patient satisfaction and how it is measured is an important field of study in healthcare. Consequently, there have been many patient satisfaction studies. However, there is a lack of studies that focused on how male and female patients perceive, or weigh, their overall satisfaction. Determining the weights of these attributes by gender is an important outcome to determine overall patient satisfaction and quality of care. Data were collected by applying the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey instrument to record regular patient experience at 70 United States hospitals. The data were collected between July 1, 2011 and June 30, 2012, and there are 43,938 cases in the data set. This study found that all five of the attributes (Nursing Care, Physician Care, Staff Care, Room, and Help) had an association with patient satisfaction. Among them, nursing Care had the largest influence on patient satisfaction of all of the five attributes. This study also showed a statistically significant interaction effect by gender for the interaction between Nursing care x Gender, Physician care x Gender, and Help x Gender. Female patients rated their relationship with their nurses as being more important to their overall satisfaction, while male patients rated their relationship with their doctor as being more important to overall satisfaction. Male patients also rated their relationship with help as being more important to overall satisfaction when compared with the results from female patients. Suggestions to healthcare managers are also discussed.
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Affiliation(s)
- Koichiro Otani
- Department of Public Policy, College of Education and Public Policy, Indiana University-Purdue University Fort Wayne, Fort Wayne, IN, USA
| | - Paula R Buchanan
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Samir P Desai
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
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The Relationship Between Nurse-Reported Safety Culture and the Patient Experience. ACTA ACUST UNITED AC 2016; 46:662-668. [DOI: 10.1097/nna.0000000000000423] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mullings L, Sankaranarayanan J. Quality of communication about medicines in United States hospitals: A national retrospective study. Res Social Adm Pharm 2016; 13:849-856. [PMID: 27913084 DOI: 10.1016/j.sapharm.2016.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 09/22/2016] [Accepted: 09/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. OBJECTIVES To evaluate ComMed quality variations by hospital characteristics. METHODS In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys). RESULTS After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=<0.0001), hospitals with HIT infrastructure (OR = 1.29, 95% CI: 1.05-1.59, p = 0.02) were more likely while Northeast vs. Western region hospitals (OR = 0.67, 95% CI: 0.50-0.89, p=<0.0001) and hospitals in metropolitan areas with 1 million or more population vs. Nonmetro area with less than 2500 population were less likely (OR = 0.68, 95% CI: 0.48-0.95, p=<0.0001), to be associated with high ComMed quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality. CONCLUSIONS One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care.
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Affiliation(s)
- Lauren Mullings
- Department of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs, CT, USA
| | - Jayashri Sankaranarayanan
- Department of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs, CT, USA; Department of Pharmacy Services, Hartford Hospital, Harford, CT, USA.
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71
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Admission Through the Emergency Department Is an Independent Risk Factor for Lower Satisfaction With Physician Performance Among Orthopaedic Surgery Patients: A Multicenter Study. J Am Acad Orthop Surg 2016; 24:735-42. [PMID: 27579815 DOI: 10.5435/jaaos-d-16-00084] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Patient experience data are increasingly used to guide performance improvement and to determine physician and hospital reimbursement. We studied the relationship between emergency department (ED) admission and patient satisfaction with physicians' performance, and identified other associated predictors. METHODS We evaluated 6,524 inpatient Press Ganey patient experience surveys from two academic level I trauma centers over 5 years. We stratified patients by ED admission or other admission and compared the proportions of patients in each group who were satisfied with physician performance. We used logistic regression to control for demographic differences and characteristics of hospitalizations. RESULTS Among patients admitted through the ED, 85.18% were satisfied, compared with 89.44% of patients admitted through other pathways (P < 0.001). Admission through the ED predicted decreased satisfaction, with an odds ratio of 0.67 (P = 0.032) after controls were applied through logistic regression. CONCLUSIONS Admission through the ED is an independent risk factor for lower satisfaction with physician performance. Understanding the determinants of patient satisfaction will help improve physician-patient interactions and guide quality improvement and value-based reimbursement initiatives. LEVEL OF EVIDENCE This retrospective survey-based analysis of satisfaction does not fall clearly under any of the Journal's established categories of level of evidence. The most closely aligned choice would be Level III Prognostic.
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Cowen ME, Czerwinski J, Kabara J, Blumenthal DU, Kheder S, Simmons S. The risk-outcome-experience triad: Mortality risk and the hospital consumer assessment of healthcare providers and systems survey. J Hosp Med 2016; 11:628-35. [PMID: 27251217 DOI: 10.1002/jhm.2611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/11/2016] [Accepted: 03/15/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Studies have shown an association between the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) scores and clinical quality. The mortality risk on admission predicts adverse events. It is not known if this risk also portends a suboptimal patient experience. OBJECTIVE To determine if the admission mortality risk identifies an experience of care risk. DESIGN A retrospectively assembled cohort in which individual HCAHPS survey responses were linked to the admission risk of dying. SETTING Five community hospitals of various sizes in Michigan. PATIENTS There were 17,509 HCAHPS medical and surgical respondents; 2513 (14.4%) were at high risk of dying. MEASUREMENTS Odds ratio (OR) (high-risk patients to low-risk patients) for providing a top box score for HCAHPS dimensions, controlling for hospital and the standard HCAHPS patient mix adjustment factors. RESULTS High-risk respondents were less likely to provide the most favorable response (unadjusted) for all HCAHPS domains, although the difference was not significant (P = 0.09) for discharge information. Multivariable analyses indicated that high-risk patients were less likely to report a top box experience for doctor communication (OR: 0.85; 95% confidence interval [CI]: 0.77-0.94) and responsiveness of hospital staff (OR: 0.77; 95% CI: 0.69-0.85), but were more likely to have received adequate discharge information (OR: 1.30, 95% CI: 1.14-1.48). CONCLUSIONS Patients at high risk of dying who completed surveys were less likely to report favorable physician communication and staff responsiveness. Further understanding of these relationships may help design a care model to improve both outcomes and experience. Journal of Hospital Medicine 2016;11:628-635. © 2016 Society of Hospital Medicine.
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Affiliation(s)
- Mark E Cowen
- Department of Medicine, St. Joseph Mercy Hospital, Ann Arbor, Michigan.
- Quality Institute, St. Joseph Mercy Hospital, Ann Arbor, Michigan.
| | | | - Jared Kabara
- Quality Institute, St. Joseph Mercy Hospital, Ann Arbor, Michigan
| | | | - Susan Kheder
- Department of Patient and Community Engagement, St. Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Stefanie Simmons
- Department of Emergency Medicine, St. Joseph Mercy Hospital, Ann Arbor, Michigan
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Maheshwari K, Cummings KC, Farag E, Makarova N, Turan A, Kurz A. A temporal analysis of opioid use, patient satisfaction, and pain scores in colorectal surgery patients. J Clin Anesth 2016; 34:661-7. [PMID: 27687467 DOI: 10.1016/j.jclinane.2016.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 06/22/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Recent health care policy changes promote objective measurements of patient satisfaction with care provided during hospitalization. Acute postsurgical pain is a significant medical problem and strongly impacts patient experience and patient satisfaction. Multimodal analgesic pathways are used for acute pain management, but opioid medications remain a mainstay of treatment. Opioid use is increasing in the outpatient setting, but opioid use trends in the inpatient postsurgical setting are not well known. We hypothesized that use of opioid medications has increased over time along with decrease in postoperative pain scores and increase in pain-related patient satisfaction. METHODS In this single-center study, we studied the trends and correlation in the average daily pain scores, opioid consumption, and patient satisfaction scores as measured by pain-related patient satisfaction questions in the Hospital Consumer Assessment of Healthcare Providers and System survey. Pain scores and opioid use data were obtained from electronic health records, vital signs monitoring, and medication databases. Adult patients who had nonemergent colorectal surgeries between January 2009 and December 2012 were included. RESULTS We found no significant trend in opioid use or pain-related patient satisfaction scores. There was an average annual increase of 0.3 (98.3% confidence interval, 0.2-0.4; P< .001) in average daily pain score from 2.8 ± 1.5 to 3.8 ± 1.5. The univariable associations between time-weighted pain score, average daily opioid dose, and pain-related patient satisfaction score were all highly significant. CONCLUSION In this retrospective cohort study, opioid use and pain-related patient satisfaction scores were stable over time. Pain-related patient satisfaction scores were negatively associated with both pain score and opioid dose. The associations we report should not be considered evidence of a causal relationship.
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Affiliation(s)
- Kamal Maheshwari
- Department of General Anesthesiology, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH.
| | - Kenneth C Cummings
- Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH
| | - Ehab Farag
- Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH
| | - Natalya Makarova
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH
| | - Alparslan Turan
- Department of General Anesthesiology, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH
| | - Andrea Kurz
- Department of General Anesthesiology, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH
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Cabrera-Barona P, Blaschke T, Kienberger S. Explaining Accessibility and Satisfaction Related to Healthcare: A Mixed-Methods Approach. SOCIAL INDICATORS RESEARCH 2016; 133:719-739. [PMID: 28890596 PMCID: PMC5569143 DOI: 10.1007/s11205-016-1371-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 05/09/2023]
Abstract
Accessibility and satisfaction related to healthcare services are conceived as multidimensional concepts. These concepts can be studied using objective and subjective measures. In this study, we created two indices: a composite healthcare accessibility index (CHCA) and a composite healthcare satisfaction index (CHCS). To calculate the CHCA index we used three indicators based on three components of multidimensional healthcare accessibility: availability, acceptability and accessibility. In the indicator based on the component of accessibility, we included an innovative perceived time-decay parameter. The three indicators of the CHCA index were weighted through the application of a principal components analysis. To calculate the CHCS index, we used three indicators: the waiting time after the patient arrives at the healthcare service, the quality of the healthcare, and the healthcare service supply. These three indicators making up the CHCA index were weighted by applying an analytical hierarchy process. Three kinds of regressions were subsequently applied in order to explain the CHCA and CHCS indices: namely the Linear Least Squares, Ordinal Logistic, and Random Forests regressions. In these regressions, we used different independent social and health-related variables. These variables represented the predisposing, enabling, and need factors of people´s behaviors related to healthcare. All the calculations were applied to a study area: the city of Quito, Ecuador. Results showed that there are health-related inequalities in regard to healthcare accessibility and healthcare satisfaction in our study area. We also identified specific social factors that explained the indices developed. The present work is a mixed-methods approach to evaluate multidimensional healthcare accessibility and healthcare satisfaction, incorporating a pluralistic perspective, as well as a multidisciplinary framework. The results obtained can also be considered as tools for healthcare and urban planners, for more integrative social analyses that can improve the quality of life in urban residents.
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Affiliation(s)
- Pablo Cabrera-Barona
- Interfaculty Department of Geoinformatics - Z_GIS, University of Salzburg, Schillerstraße 30, 5020 Salzburg, Austria
| | - Thomas Blaschke
- Interfaculty Department of Geoinformatics - Z_GIS, University of Salzburg, Schillerstraße 30, 5020 Salzburg, Austria
| | - Stefan Kienberger
- Interfaculty Department of Geoinformatics - Z_GIS, University of Salzburg, Schillerstraße 30, 5020 Salzburg, Austria
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Li L, Lee NJ, Glicksberg BS, Radbill BD, Dudley JT. Data-Driven Identification of Risk Factors of Patient Satisfaction at a Large Urban Academic Medical Center. PLoS One 2016; 11:e0156076. [PMID: 27228056 PMCID: PMC4881910 DOI: 10.1371/journal.pone.0156076] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/09/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is the first publicly reported nationwide survey to evaluate and compare hospitals. Increasing patient satisfaction is an important goal as it aims to achieve a more effective and efficient healthcare delivery system. In this study, we develop and apply an integrative, data-driven approach to identify clinical risk factors that associate with patient satisfaction outcomes. METHODS We included 1,771 unique adult patients who completed the HCAHPS survey and were discharged from the inpatient Medicine service from 2010 to 2012. We collected 266 clinical features including patient demographics, lab measurements, medications, disease categories, and procedures. We developed and applied a data-driven approach to identify risk factors that associate with patient satisfaction outcomes. FINDINGS We identify 102 significant risk factors associating with 18 surveyed questions. The most significantly recurrent clinical risk factors were: self-evaluation of health, education level, Asian, White, treatment in BMT oncology division, being prescribed a new medication. Patients who were prescribed pregabalin were less satisfied particularly in relation to communication with nurses and pain management. Explanation of medication usage was associated with communication with nurses (q = 0.001); however, explanation of medication side effects was associated with communication with doctors (q = 0.003). Overall hospital rating was associated with hospital environment, communication with doctors, and communication about medicines. However, patient likelihood to recommend hospital was associated with hospital environment, communication about medicines, pain management, and communication with nurse. CONCLUSIONS Our study identified a number of putatively novel clinical risk factors for patient satisfaction that suggest new opportunities to better understand and manage patient satisfaction. Hospitals can use a data-driven approach to identify clinical risk factors for poor patient satisfaction to support development of specific interventions to improve patients' experience of care.
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Affiliation(s)
- Li Li
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 770 Lexington Ave., 15 floor, New York, NY 10065, United States of America
| | - Nathan J. Lee
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl, New York, NY 10029, United States of America
| | - Benjamin S. Glicksberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 770 Lexington Ave., 15 floor, New York, NY 10065, United States of America
| | - Brian D. Radbill
- Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl, New York, NY 10029, United States of America
| | - Joel T. Dudley
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 770 Lexington Ave., 15 floor, New York, NY 10065, United States of America
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States of America
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Goh ML, Ang ENK, Chan YH, He HG, Vehviläinen-Julkunen K. A descriptive quantitative study on multi-ethnic patient satisfaction with nursing care measured by the Revised Humane Caring Scale. Appl Nurs Res 2016; 31:126-31. [PMID: 27397830 DOI: 10.1016/j.apnr.2016.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/25/2015] [Accepted: 02/13/2016] [Indexed: 10/22/2022]
Abstract
AIM To determine patients' satisfaction with nursing care during hospitalization. BACKGROUND Limited studies reporting patients' satisfaction with quality of nursing care in Singapore. METHOD A descriptive study was conducted in a tertiary hospital in Singapore. RESULTS Data were collected from 270 adult patients using the Revised Humane Caring Scale. Patients were moderately satisfied with the nursing care. There were significant differences of patients' level of satisfaction between/among socio-demographic subgroups including ethnicity, gender, reasons for admission and disciplines. Chinese patients were least satisfied with nursing care. The patients were most satisfied with 'Respecting patient's feeling' (mean=82.29, SD=14.50) and least satisfied with 'Communication and participation' (mean=62.00, SD=16.46). CONCLUSION Our results reinforced the need to pay more attention to patient information provision and effective communication, which could improve patient satisfaction. The multi-ethnic patients valued respect as an influential attribute in quality nursing care.
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Affiliation(s)
- Mien Li Goh
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Finland; Evidence Based Nursing Unit, National University Hospital, Singapore.
| | - Emily N K Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National University Cancer Institute Singapore, National University Health System, Singapore
| | - Yiong-Huak Chan
- Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland; Kuopio University Hospital, Kuopio, Finland
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Más A, Parra P, Bermejo RM, Hidalgo MD, Calle JE. Improving quality in healthcare: What makes a satisfied patient? ACTA ACUST UNITED AC 2016; 31:196-203. [PMID: 26869298 DOI: 10.1016/j.cali.2015.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/17/2015] [Accepted: 11/26/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To update the metric properties of a perceived quality questionnaire for patients admitted to hospital medical departments, to determine the level of patient satisfaction achieved, and to identify the variables which predict satisfaction. METHODS Self-administered questionnaire completed at home following patient discharge, using a questionnaire prepared by the authors on a sample of 7207 users of medical departments in 9 public hospitals during the years 2006-2009. A principal component analysis with varimax rotation was performed. Reliability was assessed using internal consistency coefficient. An analysis was made of the compliance with each indicator reported by respondents. A logistic regression analysis was performed to determine the perceived quality dimensions which predicted overall patient satisfaction. RESULTS The results of the reliability analysis indicated good coefficients for interpersonal manner (0.94) and professional competence (0.85) dimensions, and moderate values for the other dimensions (comfort 0.55, information 0.38, and organisation 0.37). Factor analyses showed single factors in each of the perceived quality dimensions, with a percentage of explained variance greater than 35% for information, interpersonal manner, professional competence, and comfort, and less than 30% for organisation. The dimensions which predicted satisfaction were interpersonal manner of healthcare staff, professional competence, and information. CONCLUSIONS The metric properties of the questionnaire used have been updated, yielding a valid and reliable questionnaire for assessing patient satisfaction in quality management programmes, both for internal purposes and for conducting external comparisons. A positive relationship was obtained between the level of patient satisfaction and level of professional competence, interpersonal manner of healthcare staff, and information received.
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Affiliation(s)
- A Más
- Programa EMCA, Subdirección General de Planificación, Calidad e Investigación, Consejería de Sanidad, Región de Murcia, Spain.
| | - P Parra
- Programa EMCA, Subdirección General de Planificación, Calidad e Investigación, Consejería de Sanidad, Región de Murcia, Spain
| | | | | | - J E Calle
- Programa EMCA, Subdirección General de Planificación, Calidad e Investigación, Consejería de Sanidad, Región de Murcia, Spain
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Foran A, Millar E, Dorstyn D. Patient satisfaction with a hospital-based neuropsychology service. AUST HEALTH REV 2016; 40:447-452. [DOI: 10.1071/ah15054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/07/2015] [Indexed: 11/23/2022]
Abstract
Objective
The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process.
Methods
A focus group of out-patients (n = 15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α = 0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment.
Results
Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability.
Conclusions
The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale’s psychometric properties. Further research may also include a broader perspective on the consumers’ experience of neuropsychological services.
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Voutilainen A, Pitkäaho T, Kvist T, Vehviläinen-Julkunen K. How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs 2015; 72:946-57. [PMID: 26689434 DOI: 10.1111/jan.12875] [Citation(s) in RCA: 207] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 11/30/2022]
Abstract
AIMS To study the effects of scale type (visual analogue scale vs. Likert), item order (systematic vs. random), item non-response and patient-related characteristics (age, gender, subjective health, need for assistance with filling out the questionnaire and length of stay) on the results of patient satisfaction surveys. BACKGROUND Although patient satisfaction is one of the most intensely studied issues in the health sciences, research information about the effects of possible instrument-related confounding factors on patient satisfaction surveys is scant. DESIGN A quasi-experimental design was employed. A non-randomized sample of 150 surgical patients was gathered to minimize possible alterations in care quality. METHODS Data were collected in May-September 2014 from one tertiary hospital in Finland using the Revised Humane Caring Scale instrument. New versions of the instrument were created for the present purposes. In these versions, items were either in a visual analogue format or Likert-scaled, in systematic or random order. The data were analysed using an analysis of covariance and a paired samples t-test. RESULTS The visual analogue scale items were less vulnerable to bias from confounding factors than were the Likert-scaled items. The visual analogue scale also avoided the ceiling effect better than Likert and the time needed to complete the visual analogue scale questionnaire was 28% shorter than that needed to complete the Likert-scaled questionnaire. CONCLUSION The present results supported the use of visual analogue scale rather than Likert scaling in patient satisfaction surveys and stressed the need to account for as many potential confounding factors as possible.
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Affiliation(s)
- Ari Voutilainen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Taina Pitkäaho
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Kuopio, Finland
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Voutilainen A, Pitkäaho T, Vehviläinen-Julkunen K, Sherwood PR. Meta-analysis: methodological confounders in measuring patient satisfaction. J Res Nurs 2015. [DOI: 10.1177/1744987115619209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study aimed to identify methodological confounding factors affecting patient satisfaction survey results. The data gathered from CINAHL and PubMed databases consisted of 355 surveys published from 2006 to 2012. Linear regression and Bayesian models, with seven potential survey-related confounders together with patient age and gender as explanatory variables, were constructed. According to the linear model, up to 12% of the original variation in patient satisfaction was explained by confounding variables, not by the actual variation in satisfaction. The presence of an interviewer resulted in lower satisfaction levels, and the satisfaction results correlated negatively with the number of items in the questionnaire. According to the Bayesian model, if patients were over 60 years old and the questionnaire consisted mainly of positively phrased items, the probability of rating their experiences as very satisfied was 75%. The Bayesian and linear models endorsed each other and revealed specifically that the surveys reporting high patient satisfaction could be predicted on the basis of confounding variables. The following recommendations are given for constructing a patient satisfaction survey: use neutral rather than negatively or positively phrased items, and use enough items to increase the likelihood that the least satisfactory care components are also included in order to better enable comparisons across sporadic surveys.
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Affiliation(s)
- Ari Voutilainen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Taina Pitkäaho
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Paula R Sherwood
- Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, USA
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Devlin AS, Andrade CC, Carvalho D. Qualities of Inpatient Hospital Rooms: Patients' Perspectives. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2015; 9:190-211. [PMID: 26666814 DOI: 10.1177/1937586715607052] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this qualitative study was to investigate what design features of hospital rooms are valued by inpatients. BACKGROUND Little research has explored how patients evaluate the physical environment of their hospital rooms. Most responses are captured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which includes only two questions about the physical environment. METHOD Two hundred thirty-six orthopedic patients (78 in the United States and 158 in Portugal) listed three features of their hospital room that influenced their level of satisfaction with their hospital stay, indicating whether the feature was positive or negative. RESULTS The comments were more positive (71.4%) than negative (28.6%). Using the framework of supportive design from Ulrich, over half the comments (64.31%) could be categorized in one of the three dimensions: 33.2% (positive distraction), 22.4% (perceived control), and 6.0% (social support). This total includes Internet (2.7%), which could be categorized as either social support or positive distraction. Comments called "other aspects" focused on overall environmental appraisals, cleanliness, and functionality and maintenance. CONCLUSIONS The majority of comments could be accommodated by Ulrich's theory, but it is noteworthy that other aspects emerge from patients' comments and affect their experience. Cross-cultural differences pointed to the greater role of light and sun for Portuguese patients and health status whiteboard for U.S. PATIENTS Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions.
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Affiliation(s)
| | - Cláudia Campos Andrade
- Centro de Investigação e Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
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82
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Hajj M, Gulgulian T, Haydar L, Saab A, Dirany F, Badr LK. The satisfaction of families in the care of their loved ones in CCUs in Lebanon. Nurs Crit Care 2015; 22:203-211. [PMID: 26256561 DOI: 10.1111/nicc.12195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/07/2015] [Accepted: 05/28/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care. AIMS To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction. METHODS A cross-sectional descriptive design was conducted using the Critical Care Family Satisfaction Survey (CCFSS). The participants were 123 adult relatives or significant others of patients cared for in both adult and paediatric intensive care units for at least 3 days. RESULTS The CCFSS showed acceptable internal reliability and construct validity in a Lebanese population. In general, families were satisfied with the care their loved ones received in the CCUs, and the least satisfaction was in the area of 'comfort' and the highest was in 'assurance'. Younger family members with more education were less satisfied with care and Christian families expressed less satisfaction with informational needs compared with Muslim families. Families of children in the paediatric CCU expressed least satisfaction with care. Gender, residency, relationship to patient, unit, prior experience in a CCU and diagnosis had no effect on satisfaction scores. CONCLUSIONS Assessment of family satisfaction in different cultures is important as each culture has specific needs that are essential to decipher. IMPLICATIONS FOR PRACTICE Patient satisfaction leads to improved quality of care; thus, it behoves nurses to meet the needs of families from different cultures to help them cope and increase their satisfaction, which leads to improve patient outcomes.
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Affiliation(s)
- Madeleine Hajj
- Department of Nursing, Keserwan Medical Center, Jounieh, Lebanon
| | - Taline Gulgulian
- School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Lili Haydar
- PICU, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amali Saab
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatima Dirany
- American University of Beirut Medical Center, Beirut, Lebanon
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83
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Russell RS, Johnson DM, White SW. Patient perceptions of quality: analyzing patient satisfaction surveys. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2015. [DOI: 10.1108/ijopm-02-2014-0074] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view.
Design/methodology/approach
– This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality.
Findings
– Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type.
Originality/value
– This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.
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84
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Kemp KA, Chan N, McCormack B, Douglas-England K. Drivers of Inpatient Hospital Experience Using the HCAHPS Survey in a Canadian Setting. Health Serv Res 2015; 50:982-97. [PMID: 25483921 PMCID: PMC4545343 DOI: 10.1111/1475-6773.12271] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify factors associated with patients' overall rating of inpatient hospital care. DATA SOURCES Two years of patient interview data (April 1, 2011 to March 31, 2013), linked to inpatient administrative records. STUDY DESIGN Patients rated their overall health on a scale of 0 (worst care) to 10 (best care) using the HCAHPS instrument administered via telephone, up to 42 days postdischarge. Logistic regression was used to generate odds ratios for each independent predictor. DATA EXTRACTION HCAHPS data were linked to inpatient records based on health care numbers and dates of service. The outcome (overall health experience) was collapsed into two groups (10 vs. 0-9). PRINCIPAL FINDINGS Overall hospital experience of 0-9 was associated with younger age, male gender, higher level of education, being born in Canada, urgent admission, not having a family practitioner as the most responsible provider service, and not being discharged home. A length of stay of less than 3 days was protective. The c-statistic for the multivariate model was 0.635. CONCLUSIONS Our results are novel in the Canadian population. Several questions for future research have been generated, in addition to opportunities for quality improvement within our own organization.
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Affiliation(s)
- Kyle A Kemp
- Nancy Chan, B.Sc., Brandi McCormack, M.Sc., and Kathleen Douglas-England, M.Sc., are with the Survey and Evaluation Services, Alberta Health Services, Calgary, Alberta, Canada
| | - Nancy Chan
- Nancy Chan, B.Sc., Brandi McCormack, M.Sc., and Kathleen Douglas-England, M.Sc., are with the Survey and Evaluation Services, Alberta Health Services, Calgary, Alberta, Canada
| | - Brandi McCormack
- Nancy Chan, B.Sc., Brandi McCormack, M.Sc., and Kathleen Douglas-England, M.Sc., are with the Survey and Evaluation Services, Alberta Health Services, Calgary, Alberta, Canada
| | - Kathleen Douglas-England
- Nancy Chan, B.Sc., Brandi McCormack, M.Sc., and Kathleen Douglas-England, M.Sc., are with the Survey and Evaluation Services, Alberta Health Services, Calgary, Alberta, Canada
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85
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Ballou S, Taft T, Keefer L. Disease-specific self-efficacy in the eosinophilic gastrointestinal disorders. J Health Psychol 2015; 20:1027-36. [PMID: 24157935 PMCID: PMC8454211 DOI: 10.1177/1359105313506028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Eosinophilic gastrointestinal disorders (EGIDs) are chronic inflammatory conditions with increasing global prevalence. Self-efficacy is important for patients' ability to manage chronic disease. We sought to evaluate disease-specific self-efficacy in the EGIDs via a modified version of the Inflammatory Bowel Disease Self-Efficacy Scale (IBD-SES). Ninety-one Participants reported demographic, clinical, and psychosocial variables. The IBD-SES demonstrated excellent reliability and validity in this population. Self-efficacy was higher in men, patients with less severe disease, and those who had consulted a dietitian. The IBD-SES is a useful measure of disease-specific self-efficacy in the EGIDs. Further research is necessary to understand the role of self-efficacy in the management of these illnesses.
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Affiliation(s)
- Sarah Ballou
- Northwestern University Feinberg School of Medicine, USA
| | - Tiffany Taft
- Northwestern University Feinberg School of Medicine, USA
| | - Laurie Keefer
- Northwestern University Feinberg School of Medicine, USA
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86
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Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors? Med Care 2015; 53:446-54. [PMID: 25856567 DOI: 10.1097/mlr.0000000000000350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND An important aspect of medical care is clear and effective communication, which can be particularly challenging for individuals based on race/ethnicity. Quality of communication is measured systematically in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and analyzed frequently such as in the National Healthcare Disparities Report. Caution is needed to discern differences in communication quality from racial/ethnic differences in perceptions about concepts or expectations about their fulfillment. OBJECTIVES To examine assumptions about the degree of commonality across racial/ethnic groups in their perceptions and expectations, and to investigate the validity of conclusions regarding racial/ethnic differences in communication quality. METHODS We used 2007 HCAHPS data from the National CAHPS Benchmarking Database to construct racial/ethnic samples that controlled for other patient characteristics (828 per group). Using multiple-groups confirmatory factor analyses, we tested whether the factor structure and model parameters (ie, factor loadings, intercepts) differed across groups. RESULTS We identified support for basic tests of equivalence across 7 racial/ethnic groups in terms of equivalent factor structure and loadings. Even stronger support was found for Communication with Doctors and Nurses. However, potentially important nonequivalence was found for Communication about Medicines, including instances of statistically significant differences between non-Hispanic whites and non-Hispanic blacks, Asians, and Native Hawaiian/other Pacific Islanders. CONCLUSIONS Our results provide strongest support for racial/ethnic comparisons on Communication with Nurses and Doctors, and reason to caution against comparisons on Communication about Medicines due to significant differences in model parameters across groups; that is, a lack of invariance in the intercept.
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Elliott MN, Cohea CW, Lehrman WG, Goldstein EH, Cleary PD, Giordano LA, Beckett MK, Zaslavsky AM. Accelerating Improvement and Narrowing Gaps: Trends in Patients' Experiences with Hospital Care Reflected in HCAHPS Public Reporting. Health Serv Res 2015; 50:1850-67. [PMID: 25854292 DOI: 10.1111/1475-6773.12305] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Measure HCAHPS improvement in hospitals participating in the second and fifth years of HCAHPS public reporting; determine whether change is greater for some hospital types. DATA Surveys from 4,822,960 adult inpatients discharged July 2007-June 2008 or July 2010-June 2011 from 3,541 U.S. hospitals. STUDY DESIGN Linear mixed-effect regression models with fixed effects for time, patient mix, and hospital characteristics (bedsize, ownership, Census division, teaching status, Critical Access status); random effects for hospitals and hospital-time interactions; fixed-effect interactions of hospital characteristics and patient characteristics (gender, health, education) with time predicted HCAHPS measures correcting for regression-to-the-mean biases. DATA COLLECTION METHODS National probability sample of adult inpatients in any of four approved survey modes. PRINCIPAL FINDINGS HCAHPS scores increased by 2.8 percentage points from 2008 to 2011 in the most positive response category. Among the middle 95 percent of hospitals, changes ranged from a 5.1 percent decrease to a 10.2 percent gain overall. The greatest improvement was in for-profit and larger (200 or more beds) hospitals. CONCLUSIONS Five years after HCAHPS public reporting began, meaningful improvement of patients' hospital care experiences continues, especially among initially low-scoring hospitals, reducing some gaps among hospitals.
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Affiliation(s)
| | - Christopher W Cohea
- Surveys, Research & Analysis Division, Health Services Advisory Group, Phoenix, AZ
| | - William G Lehrman
- Center for Beneficiary Choices Department, Centers for Medicare and Medicaid Services, Baltimore, MD
| | - Elizabeth H Goldstein
- Center for Beneficiary Choices Department, Centers for Medicare and Medicaid Services, Baltimore, MD
| | - Paul D Cleary
- School of Public Health, Yale University, New Haven, CT
| | - Laura A Giordano
- Surveys, Research & Analysis Division, Health Services Advisory Group, Phoenix, AZ
| | | | - Alan M Zaslavsky
- Harvard Medical School, Department of Health Care Policy, Boston, MA
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Abstract
Healthcare information technology (HIT) has been examined and shown to be a tool to improve patient healthcare quality. This study seeks to define the relationship between HIT applications such as computerized physician order entry, clinical decision support systems, and handheld device use and select Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures (doctor and nurse communication, discharge instructions, and whether the patient would highly recommend the hospital). Several control variables were used that represent the hospital level and contextual hospital service area level. The analysis had mixed results: the aforementioned HIT applications may add and support certain HCAHPS measures (Always Given Discharge Information), whereas there were no significant findings for the more interpersonal quality measures (nurse and doctor communication, recommendation). These results show that although patients may not score doctors and nurses significantly higher for their communication in hospitals that use HIT, they did receive discharge instructions significantly at a higher rate than the non-HIT hospitals.
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89
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Kouatly IA, Hassan MMA, Yazbik-Doumit N, Soubra M, Malak S, Badr LK. Psychometric Testing of a Comprehensive Patient Satisfaction Survey in Arabic. J Nurs Meas 2015; 23:204-23. [DOI: 10.1891/1061-3749.23.2.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Although patient satisfaction is an important indicator of the quality of care received in hospitals, no reliable and valid Arabic comprehensive inpatient satisfaction survey has been published. The purpose of this study was to evaluate the psychometric properties of an Arabic patient satisfaction survey. Methods: A cross-sectional design was used where 1,339 randomly selected patients were interviewed by phone. The questionnaire was adopted and from the Hospital Consumer Assessment of Healthcare Providers and Systems survey, refined and tested over a 4-year period. Results: Item–item correlations for the 22 items on the survey ranged from .52 to .92, and the Cronbach’s alpha coefficient was .87. Construct and predictive validity were also adequate. Conclusion: The survey is recommended for use in hospitals in Lebanon and other Middle Eastern countries to facilitate benchmarking and quality improvement.
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90
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Day MS, Hutzler LH, Karia R, Vangsness K, Setia N, Bosco JA. Hospital-Acquired Conditions After Orthopedic Surgery Do Not Affect Patient Satisfaction Scores. J Healthc Qual 2014; 36:33-40. [DOI: 10.1111/jhq.12031] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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91
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Saunders CL, Abel GA, Lyratzopoulos G. Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey. Eur J Cancer Care (Engl) 2014; 24:85-98. [PMID: 25327713 PMCID: PMC4309492 DOI: 10.1111/ecc.12267] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 11/30/2022]
Abstract
Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69,086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P < 0.0001). There were also inequalities in experience among patients with cancers treated by the same specialty for five of nine services (P < 0.0001). Specifically, patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience.
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Affiliation(s)
- C L Saunders
- Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK
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Ersek M, Smith D, Cannuscio C, Richardson DM, Moore D. A nationwide study comparing end-of-life care for men and women veterans. J Palliat Med 2013; 16:734-40. [PMID: 23676096 DOI: 10.1089/jpm.2012.0537] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The quality of end-of-life (EOL) care at Veterans Affairs Medical Centers (VAMC) has improved. To date, however, the quality and outcomes of end-of-life care delivered to women veterans have not been examined. OBJECTIVE The goal of this study was to evaluate gender differences in the quality of EOL care received by patients in VAMCs nationwide. DESIGN The study was conducted via retrospective medical chart review and telephone survey with next of kin of recently deceased inpatients. SETTING/SUBJECTS The chart review included records for all patients who died in acute and long-term care units in 145 VAMCs nationwide (n=36,618). For the survey, the documented next of kin were invited to respond on behalf of the deceased veteran; a total of 25,638 next of kin completed the survey. MEASUREMENTS Chart review measures included five indicators of optimal end-of-life care. Bereaved family survey items included one global and nine specific items (e.g., bereavement care, pain management) describing care in the last month of life. RESULTS Receipt of optimal end-of-life care did not differ significantly between women and men with respect to frequency of discussion of treatment goals with a family member, receipt of palliative consult, bereavement contact, and chaplain contact with a family member. Family members of women were more likely than those of men to report that the overall care provided to the veteran had been "excellent" (adjusted proportions: 63% versus 56%; odds ratio (OR)=1.33; 95% confidence interval (CI) 1.10-1.61; p=0.003). CONCLUSIONS In this nationwide study of all inpatient deaths in VAMCs, women received comparable and on some metrics better quality EOL care than that received by male patients.
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Affiliation(s)
- Mary Ersek
- PROMISE Center, Center for Health Equity Research and Promotion, Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA.
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