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Al‐Hammouri F, Hamdan KM, Haymour AM, Ibrahim MO, Malkawi A, Al‐Hiary SS, Albqoor MA, Shaheen AM. Quality of nursing care: Predictors of patient satisfaction in a national sample. Nurs Open 2024; 11:e2252. [PMID: 39166287 PMCID: PMC11336376 DOI: 10.1002/nop2.2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 08/22/2024] Open
Abstract
AIM To assess patients' satisfaction with the quality of nursing care and the relationship between patients' characteristics and their level of satisfaction. DESIGN A descriptive correlational cross-sectional design was used in this study. METHODS Convenient sampling was utilized to include 1014 inpatients from six hospitals in Jordan: three private hospitals; two governmental hospitals; and one university-affiliated hospital. The data collection process occurred from September 2022 to January 2023. The data were collected using the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire. The data were analysed using Pearson correlation, t-test, one-way ANOVA and multiple hierarchal regression. RESULTS The study included 1014 patients with an average age of 51.3 (SD = 18.6), and 59.9% were females. More than two thirds of the sample reported having health insurance, and 62.7% were unemployed. The mean total score of patients' satisfaction with nursing care quality (NCQ) was 68.2 (SD = 12.9), indicating high satisfaction. Higher-income levels (p < 0.001), higher education levels (p = 0.003), having health insurance (p < 0.001), being admitted to private hospitals (p < 0.001), being admitted to critical care units (p = 0.002), being in a single room (p = 0.001), excellent perceived health status (p < 0.001) and willingness to recommend the hospital to family and friends (p < 0.001) were significant predictors of patients' satisfaction with NCQ. CONCLUSIONS Patient and hospital environment characteristics affected patients' satisfaction with NCQ. Hospital management should consider these characteristics to improve patient satisfaction and outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Policymakers and hospital management should consider improving the physical environment of their facilities to improve patients' satisfaction. Continuous professional development should emphasize nurses' communication skills to enhance their abilities to deliver information to their patients. IMPACT This study examined levels and predictors of patients' satisfaction with the quality of nursing care. The results indicated that improving patients' satisfaction can be achieved by focusing on areas of nurses' communication skills and explaining information to patients. REPORTING METHOD The study adhered to STORBE guidelines for reporting observational studies. PATIENT OR PUBLIC CONTRIBUTION Hospitalized patients contributed to the data of this study. Hospital administrators facilitated its implementation.
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Affiliation(s)
| | | | | | | | | | | | | | - Abeer M. Shaheen
- Community Health Nursing Department, School of NursingThe University of JordanAmmanJordan
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Nakajima Y, Nagai S, Michikawa T, Hachiya K, Ito K, Takeda H, Kawabata S, Yoshioka A, Ikeda D, Kaneko S, Hachiya Y, Fujita N. Predictors of Patient Dissatisfaction after Lumbar Spinal Canal Stenosis Surgery: A Multicenter Retrospective Study. Spine Surg Relat Res 2024; 8:322-329. [PMID: 38868782 PMCID: PMC11165491 DOI: 10.22603/ssrr.2023-0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/25/2023] [Indexed: 06/14/2024] Open
Abstract
Introduction Recently, patient satisfaction has gained prominence as a crucial measure for ensuring patient-centered care. Furthermore, patient satisfaction after lumbar spinal canal stenosis (LCS) surgery is an important metric for physician's decision of surgical indication and informed consent to patient. This study aimed to elucidate how patient satisfaction changed after LCS surgery to identify factors that predict patient dissatisfaction. Methods We retrospectively reviewed time-course data of patients aged ≥40 years who underwent LCS surgery at multiple hospitals. The participants completed the Zurich Claudication Questionnaire (ZCQ) and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) before surgery and then 6 months and 1 year postsurgery. Patient satisfaction was categorized according to the postoperative score of the satisfaction domain of the ZCQ: satisfied, score ≤2.0; moderately satisfied, 2.0< score ≤2.5; and dissatisfied, score >2.5. Results The study enrolled 241 patients. Our data indicated a satisfaction rate of around 70% at 6 months and then again 1 year after LCS surgery. Among those who were dissatisfied 6 months after LCS surgery, 47.6% were more satisfied 1 year postsurgery. Furthermore, 86.2% of those who were satisfied 6 months after LCS surgery remained satisfied at 1 year. Multivariable analysis revealed that age (relative risk, 0.5; 95% confidence interval, 0.2-0.8) and preoperative score of psychological disorders on the JOABPEQ (relative risk, 0.2; 95% confidence interval, 0.03-0.08) were significantly associated with LCS surgery dissatisfaction. In addition, the receiver operating characteristic curve analysis revealed that the cutoff value for the preoperative score of psychological disorder of the JOABPEQ was estimated at 40 for LCS surgery dissatisfaction. Conclusions Age and psychological disorders were identified as significant predictors of dissatisfaction, with a JOABPEQ cutoff value providing potential clinical applicability.
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Affiliation(s)
- Yukio Nakajima
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Sota Nagai
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - Kurenai Hachiya
- Department of Orthopaedic Surgery, Hachiya Orthopaedic Hospital, Nagoya, Japan
| | - Kei Ito
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hiroki Takeda
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake, Japan
| | - Soya Kawabata
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Atsushi Yoshioka
- Department of Orthopaedic Surgery, Hachiya Orthopaedic Hospital, Nagoya, Japan
| | - Daiki Ikeda
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shinjiro Kaneko
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake, Japan
| | - Yudo Hachiya
- Department of Orthopaedic Surgery, Hachiya Orthopaedic Hospital, Nagoya, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan
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Yang E, Mummaneni PV, Chou D, Izima C, Fu KM, Bydon M, Bisson EF, Shaffrey CI, Gottfried ON, Asher AL, Coric D, Potts E, Foley KT, Wang MY, Virk MS, Knightly JJ, Meyer S, Park P, Upadhyaya C, Shaffrey ME, Uribe JS, Tumialán LM, Turner J, Haid RW, Chan AK. Is Upper Extremity or Lower Extremity Function More Important for Patient Satisfaction? An Analysis of 24-Month Outcomes from the QOD Cervical Spondylotic Myelopathy Cohort. Clin Spine Surg 2024; 37:188-197. [PMID: 38706113 DOI: 10.1097/bsd.0000000000001613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/28/2024] [Indexed: 05/07/2024]
Abstract
STUDY DESIGN Retrospective analysis of a prospective, multicenter registry. OBJECTIVE To assess whether upper or lower limb mJOA improvement more strongly associates with patient satisfaction after surgery for cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA The modified Japanese Orthopaedic Association (mJOA) is commonly used to assess functional status in patients with CSM. Patients present with upper and/or lower extremity dysfunction, and it is unclear whether improvement in one and/or both symptoms drives postoperative patient satisfaction. METHODS This study utilizes the prospective Quality Outcomes Database (QOD) CSM data set. Clinical outcomes included mJOA and North American Spine Society (NASS) satisfaction. The upper limb mJOA score was defined as upper motor plus sensory mJOA, and the lower limb mJOA as lower motor plus sensory mJOA. Ordered logistic regression was used to determine whether upper or lower limb mJOA was more closely associated with NASS satisfaction, adjusting for other covariates. RESULTS Overall, 1141 patients were enrolled in the QOD CSM cohort. In all, 780 had both preoperative and 24-month mJOA scores, met inclusion criteria, and were included for analysis. The baseline mJOA was 12.1±2.7, and postoperatively, 85.6% would undergo surgery again (NASS 1 or 2, satisfied). Patients exhibited mean improvement in both upper (baseline:3.9±1.4 vs. 24 mo:5.0±1.1, P<0.001) and lower limb mJOA (baseline:3.9±1.4 vs. 24 mon:4.5±1.5, P<0.001); however, the 24-month change in the upper limb mJOA was greater (upper:1.1±1.6 vs. lower:0.6±1.6, P<0.001). Across 24-month NASS satisfaction, the baseline upper and lower limb mJOA scores were similar (pupper=0.28, plower=0.092). However, as satisfaction decreased, the 24-month change in upper and lower limb mJOA decreased as well (pupper<0.001, plower<0.001). Patients with NASS scores of 4 (lowest satisfaction) did not demonstrate significant differences from baseline in upper or lower limb mJOA (P>0.05). In ordered logistic regression, NASS satisfaction was independently associated with upper limb mJOA improvement (OR=0.81; 95% CI: 0.68-0.97; P=0.019) but not lower limb mJOA improvement (OR=0.84; 95% CI: 0.70-1.0; P=0.054). CONCLUSIONS As the magnitude of upper and lower mJOA improvement decreased postoperatively, so too did patient satisfaction with surgical intervention. Upper limb mJOA improvement was a significant independent predictor of patient satisfaction, whereas lower limb mJOA improvement was not. These findings may aid preoperative counseling, stratified by patients' upper and lower extremity treatment expectations. LEVEL OF EVIDENCE Level-III.
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Affiliation(s)
- Eunice Yang
- Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, NY
| | | | - Dean Chou
- Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, NY
| | - Chiemela Izima
- Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, NY
| | - Kai-Ming Fu
- Department of Neurosurgery, Weill Cornell Medical Center, New York, NY
| | - Mohamad Bydon
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN
| | - Erica F Bisson
- Department of Neurosurgery, University of Utah, Salt Lake City, UT
| | | | | | - Anthony L Asher
- Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, NC
| | - Domagoj Coric
- Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, NC
| | - Eric Potts
- Goodman Campbell Brain and Spine, Indianapolis, IN
| | - Kevin T Foley
- Department of Neurosurgery, University of Tennessee; Semmes-Murphey Neurologic and Spine Institute, Memphis, TN
| | - Michael Y Wang
- Department of Neurosurgery, University of Miami, Miami, FL
| | - Michael S Virk
- Department of Neurosurgery, University of Miami, Miami, FL
| | | | - Scott Meyer
- Atlantic Neurosurgical Specialists, Morristown, NJ
| | - Paul Park
- Department of Neurosurgery, University of Tennessee; Semmes-Murphey Neurologic and Spine Institute, Memphis, TN
| | | | - Mark E Shaffrey
- Department of Neurosurgery, University of Virginia, Charlottesville, VA
| | | | | | - Jay Turner
- Barrow Neurological Institute, Phoenix, AZ
| | | | - Andrew K Chan
- Department of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons, The Och Spine Hospital at NewYork-Presbyterian, New York, NY
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Shah HA, O'Donnell DB, Galvez R, Reed ME, Ghosh D, Katz RR, Bedi AD, D'Amico RS. Digital health technology utilization is associated with enhanced patient perspectives of care. Clin Neurol Neurosurg 2024; 239:108218. [PMID: 38447481 DOI: 10.1016/j.clineuro.2024.108218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient experience and perspectives on care. Novel health information technologies facilitate communication between patients and healthcare teams. Playback Health is a health information technology that incorporates multimedia for providers to communicate health information to patients, their support network, and their healthcare teams. We hypothesized implementing Playback Health may enhance patient perspectives on care. METHODS HCAHPS scores were obtained retrospectively from a neurosurgical practice located in a metropolitan area between 2020 and 2022 for seven providers. Of these, four providers utilized Playback Health, and three did not. Individual providers' scores were compared between domains using two tailed t-tests at a significance level of p < 0.05. RESULTS Playback Health use was associated with higher HCAHPS scores across varying domains from 2020 through 2022 as well as overall scores. In 2020, the mean overall score of HCAHPS users was higher than non-users (89.65 vs. 87.28, p = 0.0095). In 2021, again higher mean overall scores were observed in users as compared to non-users (89.11 vs. 87.79, p 0.0266). In 2022, Playback Health users maintained higher scores across communication domains and overall scores (p < 0.00001). Comparisons within domains between Playback Health users and non-users revealed no domains in which non-users had a significantly higher score than users. CONCLUSION The addition of Playback Health multimedia health information technology was associated with improved patient satisfaction scores. When used as an adjunct to existing patient care, multimedia health information technologies may improve patient perceived care.
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Affiliation(s)
- Harshal A Shah
- Department of Neurosurgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
| | - Devon B O'Donnell
- Department of Neurosurgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Rosivel Galvez
- Department of Neurosurgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Max E Reed
- Weill Cornell Medical College, New York, NY, USA
| | | | - Rebecca R Katz
- Department of Neurosurgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Anupama D Bedi
- Department of Neurosurgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Randy S D'Amico
- Department of Neurosurgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
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Huepenbecker SP, Iniesta MD, Wang XS, Cain KE, Zorrilla-Vaca A, Shen SE, Basabe MS, Suki T, Garcia Lopez JE, Mena GE, Lasala JD, Williams LA, Ramirez PT, Meyer LA. Longitudinal perioperative patient-reported outcomes in open compared with minimally invasive hysterectomy. Am J Obstet Gynecol 2024; 230:241.e1-241.e18. [PMID: 37827271 DOI: 10.1016/j.ajog.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND There are few prospective studies in the gynecologic surgical literature that compared patient-reported outcomes between open and minimally invasive hysterectomies within enhanced recovery after surgery pathways. OBJECTIVE This study aimed to compare prospectively collected perioperative patient-reported symptom burden and interference measures in open compared with minimally invasive hysterectomy cohorts within enhanced recovery after surgery pathways. STUDY DESIGN We compared patient-reported symptom burden and functional interference in 646 patients who underwent a hysterectomy (254 underwent open surgery and 392 underwent minimally invasive surgery) for benign and malignant indications under enhanced recovery after surgery protocols. Outcomes were prospectively measured using the validated MD Anderson Symptom Inventory, which was administered perioperatively up to 8 weeks after surgery. Cohorts were compared using Fisher exact and chi-squared tests, adjusted longitudinal generalized linear mixed modeling, and Kaplan Meier curves to model return to no or mild symptoms. RESULTS The open cohort had significantly worse preoperative physical functional interference (P=.001). At the time of hospital discharge postoperatively, the open cohort reported significantly higher mean symptom severity scores and more moderate or severe scores for overall (P<.001) and abdominal pain (P<.001), fatigue (P=.001), lack of appetite (P<.001), bloating (P=.041), and constipation (P<.001) when compared with the minimally invasive cohort. The open cohort also had significantly higher interference in physical functioning (score 5.0 vs 2.7; P<.001) than the minimally invasive cohort at the time of discharge with no differences in affective interference between the 2 groups. In mixed modeling analysis of the first 7 postoperative days, both cohorts reported improved symptom burden and functional interference over time with generally slower recovery in the open cohort. From 1 to 8 postoperative weeks, the open cohort had worse mean scores for all evaluated symptoms and interference measures except for pain with urination, although scores indicated mild symptomatic burden and interference in both cohorts. The time to return to no or mild symptoms was significantly longer in the open cohort for overall pain (14 vs 4 days; P<.001), fatigue (8 vs 4 days; P<.001), disturbed sleep (2 vs 2 days; P<.001), and appetite (1.5 vs 1 days; P<.001) but was significantly longer in the minimally invasive cohort for abdominal pain (42 vs 28 days; P<.001) and bloating (42 vs 8 days; P<.001). The median time to return to no or mild functional interference was longer in the open than in the minimally invasive hysterectomy cohort for physical functioning (36 vs 32 days; P<.001) with no difference in compositive affective functioning (5 vs 5 days; P=.07) between the groups. CONCLUSION Open hysterectomy was associated with increased symptom burden in the immediate postoperative period and longer time to return to no or mild symptom burden and interference with physical functioning. However, all patient-reported measures improved within days to weeks of both open and minimally invasive surgery and differences were not always clinically significant.
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Affiliation(s)
- Sarah P Huepenbecker
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maria D Iniesta
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Xin S Wang
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Katherine E Cain
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Andres Zorrilla-Vaca
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Shu-En Shen
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Sol Basabe
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tina Suki
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Juan E Garcia Lopez
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gabriel E Mena
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Javier D Lasala
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Loretta A Williams
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Pedro T Ramirez
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Keshtkar L, Madigan CD, Ward A, Ahmed S, Tanna V, Rahman I, Bostock J, Nockels K, Wang W, Gillies CL, Howick J. The Effect of Practitioner Empathy on Patient Satisfaction : A Systematic Review of Randomized Trials. Ann Intern Med 2024; 177:196-209. [PMID: 38285985 DOI: 10.7326/m23-2168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Practitioners who deliver enhanced empathy may improve patient satisfaction with care. Patient satisfaction is associated with positive patient outcomes ranging from medication adherence to survival. PURPOSE To evaluate the effect of health care practitioner empathy on patient satisfaction, using a systematic review of randomized trials. DATA SOURCES Ovid MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, and Scopus to 23 October 2023. STUDY SELECTION Randomized trials published in any language that evaluated the effect of empathy on improving patient satisfaction as measured on a validated patient satisfaction scale. DATA EXTRACTION Data extraction, risk-of-bias assessments, and strength-of-evidence assessments were done by 2 independent reviewers. Disagreements were resolved through consensus. DATA SYNTHESIS Fourteen eligible randomized trials (80 practitioners; 1986 patients) were included in the analysis. Five studies had high risk of bias, and 9 had some concerns about bias. The trials were heterogeneous in terms of geographic locations (North America, Europe, Asia, and Africa), settings (hospital and primary care), practitioner types (family and hospital physicians, anesthesiologists, nurses, psychologists, and caregivers), and type of randomization (individual patient or clustered by practitioner). Although all trials suggested a positive change in patient satisfaction, inadequate reporting hindered the ability to draw definitive conclusions about the overall effect size. LIMITATIONS Heterogeneity in the way that empathy was delivered and patient satisfaction was measured and incomplete reporting leading to concerns about the certainty of the underpinning evidence. CONCLUSION Various empathy interventions have been studied to improve patient satisfaction. Development, testing, and reporting of high-quality studies within well-defined contexts is needed to optimize empathy interventions that increase patient satisfaction. PRIMARY FUNDING SOURCE Stoneygate Trust. (PROSPERO: CRD42023412981).
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Affiliation(s)
- Leila Keshtkar
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| | - Claire D Madigan
- Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (C.D.M.)
| | - Andy Ward
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| | | | - Vinay Tanna
- Wythenshawe Hospital, Manchester Foundation Trust, Manchester, United Kingdom (V.T.)
| | - Ismail Rahman
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| | | | - Keith Nockels
- Library and Learning Services, University of Leicester, Leicester, United Kingdom (K.N.)
| | - Wen Wang
- School of Business, University of Leicester, Leicester, United Kingdom (W.W.)
| | - Clare L Gillies
- Leicester Real World Evidence Unit, University of Leicester, Leicester, United Kingdom (C.L.G.)
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
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Farid N, Sharifian S, Ghafouri R. Evaluation of the effect of reinforced education on the satisfaction of patients undergoing colonoscopy: A randomized controlled trial. PLoS One 2024; 19:e0296126. [PMID: 38180990 PMCID: PMC10769074 DOI: 10.1371/journal.pone.0296126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 12/02/2023] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION Fourteen million colonoscopies are performed annually in the United States, with the results dependent on bowel preparation before the procedure. However, suitable preparation is neglected in 20-25% of cases, resulting in increased loss of time, failure to diagnose, procedure repetition, and decreased patient satisfaction. Consequently, the current study was performed to evaluate the effect of reinforced education (RE) on the satisfaction of patients undergoing colonoscopy. METHODS This study employed an experimental research method. Participants included 83 patients referred to Ayatollah Taleghani Medical Educational Center for colonoscopy, who were divided into control and intervention groups. The control group received standard education, whereas the intervention group received instruction via media and virtually, and preparation was followed up on the day before the colonoscopy. The research tool was a demographic and satisfaction questionnaire developed by the researcher. Analyses were conducted using IBM SPSS software (v. 20). RESULTS Eighty-three patients, including 47 men and 36 women with an average age of 49.19 years, participated in the study. Mean (standard deviation) patient satisfaction was 11.78 (4.65) in the intervention group and 9.04 (2.95) in the control group; the independent t-test revealed a significant difference between the two groups (P<0.001). CONCLUSIONS The study suggests that reinforced education using media and virtual means is effective in the satisfaction of patients undergoing colonoscopy.
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Affiliation(s)
- Negin Farid
- Student Research Committee, Department of Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shakila Sharifian
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Raziyeh Ghafouri
- Department of Medical and Surgical, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kruk ME, Kapoor NR, Lewis TP, Arsenault C, Boutsikari EC, Breda J, Carai S, Croke K, Dayalu R, Fink G, Garcia PJ, Kassa M, Mohan S, Moshabela M, Nzinga J, Oh J, Okiro EA, Prabhakaran D, SteelFisher GK, Tarricone R, Garcia-Elorrio E. Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey. Lancet Glob Health 2024; 12:e100-e111. [PMID: 38096882 PMCID: PMC10716625 DOI: 10.1016/s2214-109x(23)00499-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 12/17/2023]
Abstract
Population confidence is essential to a well functioning health system. Using data from the People's Voice Survey-a novel population survey conducted in 15 low-income, middle-income, and high-income countries-we report health system confidence among the general population and analyse its associated factors. Across the 15 countries, fewer than half of respondents were health secure and reported being somewhat or very confident that they could get and afford good-quality care if very sick. Only a quarter of respondents endorsed their current health system, deeming it to work well with no need for major reform. The lowest support was in Peru, the UK, and Greece-countries experiencing substantial health system challenges. Wealthy, more educated, young, and female respondents were less likely to endorse the health system in many countries, portending future challenges for maintaining social solidarity for publicly financed health systems. In pooled analyses, the perceived quality of the public health system and government responsiveness to public input were strongly associated with all confidence measures. These results provide a post-COVID-19 pandemic baseline of public confidence in the health system. The survey should be repeated regularly to inform policy and improve health system accountability.
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Affiliation(s)
- Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Neena R Kapoor
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Todd P Lewis
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Catherine Arsenault
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Eleni C Boutsikari
- Division of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - João Breda
- Division of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Susanne Carai
- Division of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Kevin Croke
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rashmi Dayalu
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Patricia J Garcia
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Munir Kassa
- Minister's Office, Ministry of Health, Addis Ababa, Ethiopia
| | | | - Mosa Moshabela
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Jacinta Nzinga
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Juhwan Oh
- Seoul National University College of Medicine, Seoul, South Korea
| | - Emelda A Okiro
- Population and Health Impact Surveillance Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Gillian K SteelFisher
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rosanna Tarricone
- Department of Social and Political Science, Bocconi University, Milan, Italy
| | - Ezequiel Garcia-Elorrio
- School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru; Health Care Quality and Patient Safety, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
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Shrestha P, Karmacharya RM, Dhakal P, Bade S, Dahal S, Bhandari N, Bade S. Predicting factors of patient satisfaction after varicose vein surgery at a university hospital in Nepal. JOURNAL OF VASCULAR NURSING 2023; 41:180-185. [PMID: 38072570 DOI: 10.1016/j.jvn.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Varicose veins are a common vascular problem with a high prevalence, yet they are often neglected. The main objective of this study was to explore the patient satisfaction after varicose vein surgery, along with its predicting factors. To our knowledge, no similar study has been conducted in Nepal to date. METHODOLOGY This retrospective cross-sectional study included patients who underwent varicose vein surgery at Dhulikhel Hospital from September 2019 to February 2020. The satisfaction level after the surgery was assessed using a 10-point Likert scale questionnaire during a telephone interview with their verbal consent. Descriptive statistics and linear regression were performed to identify the predicting factors of patient satisfaction. RESULTS Among a total of 84 patients interviewed, 53.6% were male. The mean age of the participants was 43.13 ± 13.62 years. The mean patient satisfaction score was 42 ± 5.5, with nursing service, discharge teaching and hospital service being the highest scoring items in terms of patient satisfaction. Linear regression revealed age ≤40 years as a predictor of higher patient satisfaction (β=0.258, p=0.015) while early stage of varicose veins (β=-0.233, p=0.026) and duration of post-operative follow-up (β=-0.25, p=0.021) were negative predictors of patient satisfaction. This means that patients with C2-C3 venous disease and longer duration of postoperative follow-up tended to have lower satisfaction scores. CONCLUSION The overall patient satisfaction following varicose vein surgery was very good, and the major predictors of better satisfaction were age ≤40 years, C4-C6 clinical classification of venous disease and the shorter duration of follow-up after surgery.
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Affiliation(s)
- P Shrestha
- Department of Nursing and Midwifery, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Nepal.
| | - R M Karmacharya
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal.
| | - P Dhakal
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - S Bade
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - S Dahal
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - N Bhandari
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
| | - S Bade
- Department of Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavrepalanchowk, Dhulikhel, Bagmati Province, Nepal
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Boitano TKL, Gardner A, Chu DI, Leath CA, Straughn JM, Smith HJ. Use of a mobile health patient engagement technology improves perioperative outcomes in gynecologic oncology patients. Gynecol Oncol 2023; 178:23-26. [PMID: 37742507 PMCID: PMC10873082 DOI: 10.1016/j.ygyno.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/04/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE To evaluate the impact of a mobile health patient engagement technology (PET) on postoperative outcomes in gynecologic oncology patients. METHODS All gynecologic oncology patients undergoing laparotomy on an enhanced recovery program (ERP) were approached from July 2019 to May 2021 to enroll in a PET, which can be accessed by computer, tablet, or smart phone. This platform provides enhanced pre- and postoperative patient education and remote patient monitoring. Patients who elected to participate were provided with targeted education based on their age and comorbidities and were asked to complete daily health checks during the postoperative period. Participants in the PET were compared to patients who opted out as well as to a historical cohort from prior to PET implementation. Patient and procedure-level factors were recorded. The primary outcomes were length of stay (LOS) and 30-day readmission rate. Analysis was performed using SPSS v.26. RESULTS 682 women met inclusion criteria during the study time; 347 in the PET group and 335 in the control group. Demographic and other factors including race, BMI (kg/m2), Charlson Comorbidity Index (CCI), surgical complexity, and insurance status were not different between the PET and control group; however, patients in the PET cohort were slightly younger (55.0 yo vs. 57.2 yo; p = 0.04). Patients in the PET group had a significantly shorter LOS (2.9 days vs. 3.6 days; p < 0.01) and lower readmission rate (4.3% vs. 8.6%; p < 0.01) when compared with the control group. CONCLUSIONS Use of a PET in our gynecologic oncology patients decreased LOS by nearly one day despite an absence of differences in other demographic and surgical factors other than age. Furthermore, there was a 50% reduction in readmission rates in the PET group. The use of a PET allows for healthcare professionals to engage, evaluate, and treat patients in a way that improves perioperative care.
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Affiliation(s)
- Teresa K L Boitano
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham Birmingham, AL, USA.
| | - Austin Gardner
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel I Chu
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Charles A Leath
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham Birmingham, AL, USA
| | - J Michael Straughn
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham Birmingham, AL, USA
| | - Haller J Smith
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham Birmingham, AL, USA
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Marinova M, Sundaram A, Holtham K, Ebert JR, Wysocki D, Meyerkort D, Radic R. The role of a cryocompression device following total knee arthroplasty to assist in recovery: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2023; 31:4422-4429. [PMID: 37464101 PMCID: PMC10471706 DOI: 10.1007/s00167-023-07455-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 05/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE The study sought to investigate the effectiveness of a cryocompression Game Ready™ (GR) versus usual care protocol (UC) on early post-operative recovery following total knee arthroplasty. METHODS This study prospectively randomised 72 total knee arthroplasties to a 2-week (from day 0) intervention of GR treatment (n = 36, 63.9% females) or UC of ice with static compression (n = 36, 45.7% females). Knee flexion and extension range of motion (ROM), a visual analogue pain scale and limb circumference were documented at day 1, 2 and 14, as well as 6 weeks post-surgery. Medication usage and length of hospital stay were documented. Patient-reported outcome measures (PROMs) included the Knee Injury and Osteoarthritis Outcome Score and a Patient Satisfaction Questionnaire. Statistical analysis using linear mixed modelling and analysis of variance table with Satterthwaite's method were used along with two-tailed t-tests. RESULTS There were no significant group-by-time interactions regarding any of the outcomes. The GR group had 19% lost to follow-up at 2 weeks, while the UC group had 8%. The GR group demonstrated significantly better knee extension ROM at day 1 (p = 0.048) and day 14 (p = 0.007) compared with the UC group. There were no group differences (n.s.) observed in pain, flexion ROM, limb circumference, opioid use or PROMs. Overall, higher pain levels resulted in increased opioid intake (p = 0.002), older patients used significantly less opioids (p < 0.001) and males reported significantly less pain than females (p = 0.048). No adverse effects were observed due to either protocol. CONCLUSION Despite patients gaining significantly more knee extension during the initial two-week intervention period when using GR compared to UC, this effect was likely due to chance. No further significant differences were observed between the groups during or after cession of the intervention. LEVEL OF EVIDENCE Level 2.
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Affiliation(s)
- Mira Marinova
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia.
- Department of Orthopaedics, Royal Perth Hospital, Perth, WA, Australia.
| | - Abayasankar Sundaram
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
| | - Katie Holtham
- Sports Physiotherapist, Beatty Park Physiotherapy, North Perth, Australia
| | - Jay R Ebert
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, WA, Australia
| | - David Wysocki
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
| | - Daniel Meyerkort
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
| | - Ross Radic
- Perth Orthopaedic and Sports Medicine Research Institute, 31 Outram St, West Perth, WA, 6005, Australia
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram St, West Perth, WA, 6005, Australia
- Division of Surgery, School of Medicine, University of Western Australia, Crawley, WA, Australia
- Department of Orthopaedics, Royal Perth Hospital, Perth, WA, Australia
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12
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Kassymova G, Sydsjö G, Wodlin NB, Nilsson L, Kjølhede P. Effect of nurse-led telephone follow-up on postoperative symptoms and analgesics consumption after benign hysterectomy: a randomized, single-blinded, four-arm, controlled multicenter trial. Arch Gynecol Obstet 2023; 307:459-471. [PMID: 36050542 PMCID: PMC9918564 DOI: 10.1007/s00404-022-06722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/24/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The study aimed to determine if planned telephone follow-up, especially when adding structured, oriented coaching, reduces the intensity of postoperative symptoms and decreases analgesics consumption after benign hysterectomy. METHODS A randomized, single-blinded, four-armed, controlled multicenter trial of 525 women scheduled for hysterectomy was conducted in 5 hospitals in the southeast health region of Sweden. The women were allocated 1:1:1:1 into four follow-up models: (A) no telephone follow-up (control group); (B) one planned, structured, telephone follow-up the day after discharge; (C) as B but with additional telephone follow-up once weekly for 6 weeks; and (D) as C but with oriented coaching telephone follow-up on all occasions. Postoperative symptoms were assessed using the Swedish Postoperative Symptoms Questionnaire. Analgesic consumption was registered. Unplanned telephone contacts and visits were registered during the 6 weeks of follow-up. RESULTS In total, 487 women completed the study. Neither pain intensity, nor symptom sum score or analgesic consumption differed between the intervention groups. Altogether, 224 (46.0%) women had unplanned telephone contacts and 203 (41.7%) had unplanned visits. Independent of intervention, the women with unplanned telephone contacts had higher pain intensity and symptom sum scores, particularly if an unplanned telephone contact was followed by a visit, or an unplanned visit was preceded by an unplanned telephone contact. CONCLUSION Telephone follow-up did not seem to affect recovery regarding symptoms or analgesic consumption after benign hysterectomy in an enhanced recovery after surgery (ERAS) setting. Unplanned telephone contacts and visits were associated with more postoperative symptoms, especially pain. Trial registration The study is registered in ClinicalTrial.gov: NCT01526668 retrospectively from January 27; 2012. Date of enrolment of first patient: October 11; 2011.
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Affiliation(s)
- Gulnara Kassymova
- Department of Obstetrics and Gynecology in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, University Hospital, S-58245, Linköping, Sweden.
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, University Hospital, S-58245 Linköping, Sweden
| | - Ninnie Borendal Wodlin
- Department of Obstetrics and Gynecology in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, University Hospital, S-58245 Linköping, Sweden
| | - Lena Nilsson
- Department of Anesthesiology and Intensive Care in Linköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, University Hospital, S-58245 Linköping, Sweden
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13
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Mercier MR, Galivanche AR, McLean R, Kammien AJ, Toombs CS, Rubio DR, Varthi AG, Grauer JN. Correlation of Patient Reported Satisfaction With Adverse Events Following Elective Posterior Lumbar Fusion Surgery: A Single Institution Analysis. NORTH AMERICAN SPINE SOCIETY JOURNAL 2022; 12:100160. [PMID: 36118954 PMCID: PMC9478916 DOI: 10.1016/j.xnsj.2022.100160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/17/2022] [Accepted: 08/08/2022] [Indexed: 01/22/2023]
Abstract
Background With increasing emphasis on patient satisfaction metrics, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, hospital reputations and reimbursements are being affected by their results. The purpose of the current study is to determine if post-operative self-reported patient satisfaction differed among patients who experienced any adverse event (AAE) following elective posterior lumbar fusion (PLF) surgery compared to those who did not. Methods Patients who underwent elective PLF surgery performed at a single institution between February 2013 and May 2020 and returned an HCAHPS survey following discharge were included in the retrospective cohort analysis. Demographic, comorbidity, and HCAHPS survey data were compared between patients who did and did not experience any adverse event (AAE) in the 30-days postoperatively. Results Of 5,117 PLF patients, the HCAHPS survey was returned by 1,071 patients, of which 30-day AAE was experienced by 40 (3.73%). Of those that experienced AAE, the survey response rate was significantly lower (13.94% versus 21.35%, p=0.003). Those responding reported lower scores pertaining to if medication side-effects were adequately explained (22.22% versus 52.56%, p=0.002) and if post-discharge care was adequately explained (79.17% versus 93.76%, p=0.005), as well as overall top-box responses (67.62% versus 75.93% survey average, p<0.001). Conclusions Patients experiencing AAE after elective PLF surgery are less likely to respond to surveys about their hospital experience. For those who did respond, they report less satisfaction with multiple aspects of their hospital care measured by the HCAHPS survey. Understanding how postoperative adverse events impact patients' perception of healthcare quality provides insight into what patients value and has implications for optimizing their care.
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Affiliation(s)
| | | | | | | | | | | | | | - Jonathan N. Grauer
- Corresponding Author: Jonathan N. Grauer, MD, PO Box 208071, New Haven, CT 06520-8071, Tel: 203-737-7464, Fax: 203-785-7132.
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14
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Santoro AJ, Ford EA, Pontes M, Busconi BD, McMillan S. Patient-Specific E-mailed Discharge Instructions Improve Patient Satisfaction and Patient Understanding After Surgical Arthroscopy. Arthrosc Sports Med Rehabil 2022; 4:e1315-e1322. [PMID: 36033182 PMCID: PMC9402426 DOI: 10.1016/j.asmr.2022.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 03/13/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose The purpose of this study is to determine whether patient-specific e-mails after surgical arthroscopy improve patient satisfaction and patient understanding of their procedure compared to traditional, preprinted discharge instructions. Methods Sixty patients who underwent surgical arthroscopy were prospectively, randomized into two separate groups. One cohort received a detailed e-mail of their procedure, discharge instructions, and labeled intraoperative arthroscopic images, while the second cohort received the standard preprinted instructions, while their arthroscopic images were discussed at the time of follow-up. The procedures were performed by a single surgeon. All patients were seen at 1-week follow-up and given a 14-question survey specific to their postoperative course, discharge instructions, and overall satisfaction using a 5-point Likert Scale. Demographic information was collected and data points comparing overall patient satisfaction, ease of understanding instructions, quality of information, and the number of times referenced were analyzed using nonparametric tests between the two cohorts. Results Patients in the e-mail cohort were significantly more satisfied with their surgery than patients in the printed cohort (medians: 5 versus 4, Wilcoxon chi-square = 9.98; P =.002). Patients in the e-mail cohort indicated that their instructions more greatly enhanced their overall understanding of their surgery (medians: 5 vs 3, Wilcoxon chi-square = 10.84; P = .001) and were more helpful to their recovery (medians: 5 vs 3, Wilcoxon chi-square = 7.37; P = .007). E-mail patients were significantly more likely to recommend similar instructions be sent to a friend undergoing surgery (medians: 5 versus 3, Wilcoxon chi-square = 11.10; P < .001) and share their instructions with others 72% (18/25) versus 34.5% (10/29). There was no significant difference between the e-mail cohort and the print cohort for the number of times patients referred to their instructions (medians: 3 versus 3, Wilcoxon chi-square = 2.41; P =.121). Conclusions Patient-specific e-mailed discharge instructions improve patient satisfaction and overall understanding of the procedure compared with traditional printed discharge instructions after surgical arthroscopy. Level of Evidence Level II, prospective randomized trial.
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15
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Tucker K, Sullivan S, Deal AM, Allman K, Cuaboy L, McCabe SD, Gehrig PA. A prospective randomized trial of standard versus multimedia-supplemented counseling in patients undergoing endometrial cancer staging surgery. Gynecol Oncol 2022; 166:397-402. [PMID: 35863993 DOI: 10.1016/j.ygyno.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A patient's understanding of surgery is often limited, especially in the setting of complex oncologic procedures. The use of supplemental materials can improve patients' knowledge of their procedure and satisfaction with decision making. We sought to determine if a multimedia-supplemented approach in patients undergoing robotic endometrial cancer staging improves satisfaction with preoperative counseling. Secondary objectives were patient comprehension, physician satisfaction, and visit length. METHODS From 2018 to 2019, patients were randomized to standard physician education (SPE) or multimedia-based education (MBE), which included watching two novel videos followed by focused physician counseling. Basic demographic information was collected. Patient satisfaction was assessed using the Client Satisfaction Questionnaire-8 (CSQ-8, a validated satisfaction survey, scored 8-32) and a global satisfaction score (GGS, 10-point scale). Physician satisfaction was assessed using a GGS. Comprehension was assessed with a study-specific 9-question survey at three time points. t-tests and linear mixed models were used to compare groups. RESULTS Of the 75 patients included in the analysis, the majority were white (70%), 50-70 years old (72%), and had at least some college education (74%). The MBE group reported higher satisfaction on the CSQ-8 (31.69 vs 30.69, p < 0.01) and global satisfaction score (9.95 vs 9.74, p = 0.04). There was no difference in comprehension scores over time (p = 0.84) or between groups (p = 0.23). Visit lengths were significantly longer in the MBE group (90.36 vs 80.46 min, p = 0.04). CONCLUSIONS Patients had high satisfaction and comprehension with both SPE and MBE. Multimedia education may be implemented in preoperative counseling based on provider preference and consideration should be made for further study of satisfaction, both patient and physician, and visit length after the initial implementation period.
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Affiliation(s)
- Katherine Tucker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, United States of America.
| | - Stephanie Sullivan
- Division of Gynecologic Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Allison M Deal
- Senior Biostatistician, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America
| | - Kathryn Allman
- Nurse Practitioner, Palliative Care Program, University of North Carolina, Chapel Hill, NC, United States of America
| | - Luz Cuaboy
- Lead Study Coordinator, Office of Clinical & Translational Research, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States of America
| | - Sean D McCabe
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Paola A Gehrig
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, United States of America
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16
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Miller MB, Gabel SA, Gluf-Magar LC, Haan PS, Lin JC, Clarkson JHW. Virtual Reality Improves Patient Experience and Anxiety During In-office Carpal Tunnel Release. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4426. [PMID: 35919690 PMCID: PMC9278931 DOI: 10.1097/gox.0000000000004426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/04/2022] [Indexed: 04/21/2023]
Abstract
BACKGROUND This study examined how wide- awake local anesthesia no tourniquet (WALANT) surgery in the office versus the standard operating room (OR) impacts patient experience, and the effect wide awake virtual reality (WAVR) has in conjunction with WALANT on patient experience. METHODS This is a patient-reported outcome study of patients undergoing carpal tunnel release by a single surgeon between August 2017 and March 2021. Patients were classified by location; traditional OR versus WALANT in-office. In-office patients were further classified by whether they chose to use WAVR or not. Patients rated overall experience, enjoyability, and anxiety using a Likert scale (1-7). RESULTS The online survey had a 44.8% response rate. OR patients were twice as likely to report a neutral or negative experience (23% versus 11%, P = 0.03), significantly lower enjoyment scores (44% versus 20%, P = 0.0007)' and higher anxiety (42% versus 26%, P = 0.04) compared with office-based WALANT patients. With the addition of WAVR, office patients reported higher enjoyment than those who did not use WAVR (85% versus 73%, P = 0.05). Patients reporting an anxiety disorder were more likely to choose WAVR when compared with patients without anxiety disorder (73.8% versus 56.4%). When they chose WAVR, they had greater anxiolysis (79% versus 47%, P = 0.01)' and increased enjoyment (90% versus 59%, P = 0.005). CONCLUSIONS This study demonstrates improved patient experience in the office setting, further amplified by WAVR. Preexisting anxiety disorder is a positive predictive variable toward the patients' choice to use WAVR.
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Affiliation(s)
- McKenzie B. Miller
- From the Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Mich
| | - Shelley A. Gabel
- From the Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Mich
| | - Lindsay C. Gluf-Magar
- From the Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Mich
| | - Pam S. Haan
- From the Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Mich
| | - Judith C. Lin
- From the Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Mich
| | - James H. W. Clarkson
- From the Department of Surgery, Michigan State University College of Human Medicine, East Lansing, Mich
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Catalano MA, Hemli JM, Yu PJ, Scheinerman SJ, Hartman AR, Patel NC. Patient Satisfaction Scores After Cardiac Surgery: Should They Be Risk-Adjusted? Semin Thorac Cardiovasc Surg 2022; 35:696-704. [PMID: 35779848 DOI: 10.1053/j.semtcvs.2022.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/02/2022] [Indexed: 11/11/2022]
Abstract
The Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) is a survey tool that quantifies patient satisfaction after hospitalization. We sought to interrogate our HCAHPS results in order to identify any association between preoperative health, type of operation, and postoperative outcomes, with patient satisfaction after cardiac surgery. Of 12,572 patients who underwent cardiac surgery between December 2012 and December 2019, 2587 patients (20.6%) completed the HCAHPS survey. Patient satisfaction was quantified using HCAHPS responses, focused on 'top-box' rating in nursing care, physician care, hospital environment, and overall hospital rating, as primary endpoints. Multivariable logistic regression was used to identify those variables associated with top-box scores. Elevated patient risk, as measured by the Society of Thoracic Surgeons (STS) risk score in 2112 patients, was predictive of lower rates of top-box responses in nursing care (OR 0.963, P = 0.003), physician care (OR 0.96, P = 0.002), and overall hospital rating (OR 0.97, P = 0.007). Major postoperative complications were associated with lower patient satisfaction for nursing care (OR 0.67, P = 0.038), physician care (OR 0.59, P = 0.012), and overall hospital rating (OR 0.64, P = 0.035); length of stay ≥ 6 days was associated with increased patient satisfaction for nursing care (OR 1.45, P < 0.001). Increased preoperative risk and postoperative complications are associated with lower rates of top-box patient satisfaction scores after cardiac surgery. When assessing patient satisfaction after cardiac surgery, we suggest that a preoperative risk profile be considered.
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Affiliation(s)
- Michael A Catalano
- Department of Cardiovascular & Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, New York
| | - Jonathan M Hemli
- Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital / Northwell Health, New York, New York
| | - Pey-Jen Yu
- Department of Cardiovascular & Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, New York
| | - S Jacob Scheinerman
- Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital / Northwell Health, New York, New York
| | - Alan R Hartman
- Department of Cardiovascular & Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, New York
| | - Nirav C Patel
- Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital / Northwell Health, New York, New York..
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Kobo-Greenhut A, Frankenthal H, Darawsha A, Karasik A, Zohar Beja A, Ben Hur T, Ekstien D, Amir L, Shahaf D, Ben Shlomo I, Shichor I, Frey WH. A non-invasive direct nose to brain drug delivery platform vs. invasive brain delivery approach: patient-centered care impact analysis. Drug Deliv 2022; 29:1754-1763. [PMID: 35635357 PMCID: PMC9176683 DOI: 10.1080/10717544.2022.2080889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Current literature lacks structured methodologies for analyzing medical technologies' impact from the patient-centered care perspective. This study introduces, applies and validates 'Patient-Centered Care Impact Analysis' (PCIA) as a method for identifying patient-centered care associated demands and expectations for a particular technology and assessing its compliance with these demands. PCIA involves five stages: (1) demand identification, (2) ranking demands' impact magnitude, (3) scoring demand compliance (DC), (4) demand priority (DP) assignment based on impact magnitude and compliance, (5) generating a summative impact priority number (IPN). PCIA was performed as a comparative assessment of two central nervous system (CNS) drug-delivery platforms; SipNose, a novel noninvasive Direct-Nose-to-Brain (DNTB), vs. the standard-of-care invasive intrathecal/intracerebroventricular injection (Invasive I/I). Study participants included a ranking team (RT) without experience with the SipNose technology that based their scoring on experimental data; and a validation team (VT) experienced with the SipNose platform. All had experience with, or knowledge of, InvasiveI/I. Demand identification and impact magnitude were performed by one content and one assessment expert. Each participant assessed each technology's DC. DP scores, IPN's and IPN DNTB:InvasiveI/I ratios were generated for each technology, for each team, based on DC and summative DP scores, respectively. Both teams assigned DNTB higher DC scores, resulting in higher DNTB DP, IPN scores and DNTB:InvasiveI/I IPN ratios. Lack of difference between team assessments of DP and IPN ratio validate PCIA as an assessment tool capable of predicting patient-centered clinical care quality for a new technology. The significant differences between the platforms highlight SipNose's patient-care centered advantages as an effective CNS drug-delivery platform.
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Affiliation(s)
- Ayala Kobo-Greenhut
- Risk Management, Validation, Regulation, Haifa, Israel.,Zefat Academic College, Zefet, Israel
| | | | - Aziz Darawsha
- Emergency Department, Rambam Medical Center, Haifa, Israel
| | | | | | - Tamir Ben Hur
- Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Dana Ekstien
- Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Lisa Amir
- Department of Emergency Medicine, Schneider Medical Center, Petakh Tikva, Israel
| | | | | | | | - William H Frey
- Center for Memory & Aging, Center for Memory & Aging HealthPartners Neuroscience Center, St Paul, MN, USA
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Kahlenberg CA, Gibbons JAB, Mehta BY, Antao VC, Lai EY, Do HT, Russell LA, Sculco PK, Figgie MP, Goodman SM. Satisfaction With the Process vs Outcome of Care in Total Hip and Knee Arthroplasty. J Arthroplasty 2022; 37:419-424.e2. [PMID: 34774689 DOI: 10.1016/j.arth.2021.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/18/2021] [Accepted: 11/03/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Patient satisfaction, with both process of care and outcome of care, is critical for measuring the quality and value of elective procedures such as arthroplasty. The purpose of this study is to evaluate the correlation between early postoperative satisfaction with the process of care and 2-year satisfaction with the outcome of care after total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS We retrospectively analyzed data from institutional arthroplasty registries. Satisfaction with the outcome of care was measured on a scale of 0-100 by a previously validated questionnaire administered 2 years postoperatively. Patient satisfaction with the process of care was measured by the Press Ganey (PG) inpatient survey, also scored 0-100. We examined the correlation between these 2 measures of satisfaction in patients who underwent primary THA or TKA. RESULTS In total, 721 TKA patients and 760 THA patients underwent surgery and completed both the PG survey and 2-year satisfaction questionnaire. The mean age was 65.1 years with a mean body mass index of 28.8 and 56% were female. The mean PG survey score for the entire cohort was 95.6. The mean 2-year satisfaction score was 90.3. The Spearman correlation coefficient between the PG survey and the 2-year satisfaction survey was 0.23 for TKA patients (P < .001) and 0.13 for THA patients (P < .001). CONCLUSION We found a weak correlation between the measurement of satisfaction with the process of care surrounding hip and knee arthroplasty using the PG survey and measurement of satisfaction with the outcome of care after arthroplasty using a validated 2-year satisfaction instrument.
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Affiliation(s)
| | - J Alex B Gibbons
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY
| | - Bella Y Mehta
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY; Division of Rheumatology, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Vinicius C Antao
- Center for the Advancement of Value in Musculoskeletal Care, Hospital for Special Surgery, New York, NY
| | - Emily Y Lai
- Division of Research Administration, Hospital for Special Surgery, New York, NY
| | - Huong T Do
- Division of Research Administration, Hospital for Special Surgery, New York, NY
| | - Linda A Russell
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY; Division of Rheumatology, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Peter K Sculco
- Department of Orthopedics, Hospital for Special Surgery, New York, NY
| | - Mark P Figgie
- Department of Orthopedics, Hospital for Special Surgery, New York, NY
| | - Susan M Goodman
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY; Division of Rheumatology, Department of Medicine, Weill Cornell Medicine, New York, NY
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Revision Total Hip and Knee Arthroplasty are Associated With Lower Hospital Consumer Assessment of Healthcare Providers and Systems Patient Satisfaction Scores Compared With Primary Arthroplasty. J Am Acad Orthop Surg 2022; 30:e336-e346. [PMID: 34851861 DOI: 10.5435/jaaos-d-21-00839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/10/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION As rates of primary total joint arthroplasty continue to rise, so do rates of revision. Revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) are more frequently done at larger centers, are associated with higher morbidity, and may have different patient satisfaction outcomes. This study compares the survey results of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) between patients who underwent primary versus revision THA or TKA. METHODS All adult patients who underwent inpatient, elective, primary, and revision THA or TKA at a single institution were selected for retrospective analysis. Patient demographics, comorbidities, functional status, surgical variables, 30-day outcomes, and HCAHPS scores were assessed. Univariate and multivariate analyses were done to determine correlations between the aforementioned variables and top-box HCAHPS survey scores for primary versus revision THA and TKA. RESULTS Of 2,707 patients who met the inclusion criteria and had returned the HCAHPS survey, primary THA was documented in 1,075 patients (39.71%), revision THA in 75 (2.77%), primary TKA in 1,497 (55.30%), and revision TKA in 60 (2.22%). Revision THA patients were more functionally dependent, and TKA patients had higher American Society of Anesthesiologists score than their primary comparators. Revisions had longer hospital length of stay for both procedures. For THA, revision THA patients demonstrated lower total top-box rates compared withprimary THA patients (71.64% versus 75.67% top-box, P < 0.001) and lower scores on the care from doctors subsection (76.26% versus 85.34%, P < 0.001) of the HCAHPS survey. Similarly, for TKA, revision TKA patients demonstrated lower total top-box rates (76.13% versus 79.22%, P < 0.013) and lower scores on the care from doctors subsection (66.28% versus 83.65%, P < 0.001) of the HCAHPS survey. DISCUSSION For both THA and TKA, revision procedures were associated with lower total HCAHPS scores and rated care from doctors. This suggests that HCAHPS scores may be biased by factors outside the surgeon's control, such as the complexity associated with revision procedures. LEVEL OF EVIDENCE Level III.
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21
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Ramos-Vera C, Saintila J, Calizaya-Milla YE, Acosta Enríquez ME, Serpa Barrientos A. Relationship Between Satisfaction With Medical Care, Physical Health, and Emotional Well-Being in Adult Men: Mediating Role of Communication. J Prim Care Community Health 2022; 13:21501319221114850. [PMID: 35880499 PMCID: PMC9340312 DOI: 10.1177/21501319221114850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Non-communicable diseases and psychiatric pathologies are the health problems that most affect the population in the United States. OBJECTIVE This study aimed to examine the mediating role of patient-centered communication (PCC) in the relationship between satisfaction with medical care, physical health, and emotional well-being in American men. METHODS A cross-sectional - predictive study was carried out. The variables analyzed were satisfaction with medical care, physical health, and emotional well-being. Information from the Health Information National Trends Survey Data (HINTS) was used; HINTS 5, cycle 3 (collected between January and June 2019) and 4 (2020). Data from 3338 men were considered (mean age: M = 55.40, SD = 19.53). Data analyses were carried out using structural equation modeling (SEM) to represent the statistical mediation model with latent and observable variables. RESULTS Analyses showed that the variables were significantly related (P < .01). In the mediation model, there is evidence that satisfaction predicts communication (β = .764, P < .001) and this, in turn, is related to physical health (β = .079, P = .007) and emotional well-being (β = .145, P < .001). In addition, the standardized estimates of the structural multiple mediation model presented acceptable goodness-of-fit indices: χ2/gl = 2.24, CFI = 0.999, TLI = 0.999, RMSEA = 0.019 [90% CI: 0.013-0.022], SRMR = 0.018. CONCLUSION Patient-centered communication plays a significant dual mediating role in the relationship between satisfaction with medical care, physical health, and emotional well-being, respectively. Therefore, PCC is essential in healthcare for American men.
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22
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Kinney AP, Sankaranarayanan B. Effects of Patient Portal Use on Patient Satisfaction: Survey and Partial Least Squares Analysis. J Med Internet Res 2021; 23:e19820. [PMID: 34448712 PMCID: PMC8433860 DOI: 10.2196/19820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/15/2020] [Accepted: 07/13/2021] [Indexed: 01/26/2023] Open
Abstract
Background With digital delivery of health care services gaining prominence, patient portals have become a mainstay of many health care organizations. Despite the importance of patient portals, inconclusive data exist regarding the effect of patient portal use on patient satisfaction. Objective The aim of this study is to understand the relationship between the postadoptive use of patient portals and patient satisfaction outcomes. Methods Postadoptive use of patient portals has a positive relationship with the 3 dimensions of patient satisfaction, mediated by gratification, health self-awareness, and health perceptions. A total of 504 valid patient portal user responses were collected, and partial least squares analysis was performed to analyze the data. Results Patient satisfaction was captured using three dimensions: care team interaction, atmosphere, and instruction effectiveness. The results show that postadoptive use of patient portals has a positive influence on all 3 dimensions of patient satisfaction through the mediating variables of gratification, health self-awareness, and health perceptions. Specifically, postadoptive use had significant positive influence on gratification, health self-awareness, and health perceptions. Each of the 3 patient perceptions had significant positive influence on all 3 dimensions of patient satisfaction: care team interaction, atmosphere, and instruction effectiveness. Specifically, our model explained 31.8% of the care team interaction, 40.6% of the atmosphere, and 39.1% of the instruction effectiveness. Conclusions Our model shows that patient portal use can influence patient satisfaction through the mediating effects of gratification, health self-awareness, and health perception. Patient satisfaction is an important outcome for health care organizations. Therefore, by promoting effective patient portal use and fostering patient perceptions, health care organizations can improve patient satisfaction.
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Affiliation(s)
- Aaron P Kinney
- Herma Heart Institute, Children's Wisconsin, Milwaukee, WI, United States
| | - Balaji Sankaranarayanan
- Department of Information Technology and Supply Chain Management, College of Business and Economics, University of Wisconsin - Whitewater, Whitewater, WI, United States
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Bernstein DN, Koolmees D, Hester J, Yedulla N, Makhni EC. Pain Is the Primary Factor Associated With Satisfaction With Symptoms for New Patients Presenting to the Orthopedic Clinic. Arthroscopy 2021; 37:2272-2278. [PMID: 33878419 DOI: 10.1016/j.arthro.2021.03.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of the current study was to (1) determine the percentage of new orthopedic patients reporting their symptoms to be acceptable at presentation, as measured by the Patient Acceptable Symptom State (PASS) question, and (2) evaluate whether patient-reported outcome measures (PROMs), including Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) or Upper Extremity, Pain Interference (PI), and Depression (D), or sociodemographic factors are associated with acceptable symptoms at presentation. METHODS Between February 7, 2020, and March 16, 2020, new orthopedic patients who completed PROMs were identified. Patient records were reviewed for those who also completed the PASS question, a yes/no question about whether a patient's current symptom state is satisfactory. Bivariate analysis was conducted to compare patient characteristics, such as area deprivation index (ADI), between those reporting acceptable symptoms and those who did not. Multivariable logistic regression models were used to determine factors associated with acceptable symptoms at presentation. RESULTS A total of 570 patients were included, with one-fourth (n = 143 [25%]) reporting acceptable symptoms at presentation. In multivariable regression analysis, only pain, as measured by the PROMIS PI, was associated with acceptable symptoms at presentation (non-upper extremity patient regression: PROMIS PI: odds ratio [OR], 0.84; 95% confidence interval [CI], 0.79-0.90, P < .01; upper extremity patient regression: PROMIS PI: OR, 0.91; 95% CI, 0.85-0.98, P < .01). In both multivariable regression analyses, insurance type (private, Medicare, Medicaid, other), visit subspecialty (sports, hand, joints, foot and ankle, spine, other), PROMIS PF, PROMIS D, and national ADI were not associated with acceptable symptoms at presentation (all P > .05). CONCLUSIONS One-fourth of new orthopedic patients reported their symptoms to be acceptable at presentation. Of those who considered their symptom state unsatisfactory, pain-not functional status, mental health, or sociodemographic factors-was the primary determinant. LEVEL OF EVIDENCE Level III, diagnostic.
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Affiliation(s)
- David N Bernstein
- Institute for Strategy and Competitiveness, Harvard Business School, Boston, Massachusetts, U.S.A
| | - Dylan Koolmees
- Department of Orthopaedic Surgery, Henry Ford Health System, West Bloomfield, Michigan, U.S.A
| | - Josh Hester
- Department of Orthopaedic Surgery, Henry Ford Health System, West Bloomfield, Michigan, U.S.A
| | - Nikhil Yedulla
- Department of Orthopaedic Surgery, Henry Ford Health System, West Bloomfield, Michigan, U.S.A
| | - Eric C Makhni
- Department of Orthopaedic Surgery, Henry Ford Health System, West Bloomfield, Michigan, U.S.A..
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Shang R, Wang D, Cai H, Chen J, Lv L, Huang C. Relationship between inpatient satisfaction and the quality of surgery. Gland Surg 2021; 10:1726-1735. [PMID: 34164316 DOI: 10.21037/gs-21-289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background This study sought to investigate the correlation between inpatient satisfaction and surgical quality evaluation indicators, and explore the factors affecting inpatient satisfaction. Methods A total of 5,000 inpatients who underwent surgery at 10 tertiary. A hospital in Chongqing were randomly selected and asked to complete an inpatient satisfaction questionnaire developed by our team in a previous study. A logistic regression was undertaken to analyze the factors affecting inpatient satisfaction, and the relationship between inpatient satisfaction and evaluation indicators of surgical quality. Results The overall satisfaction level of inpatients undergoing surgery was high. Specifically, the satisfaction level was 88.7%, and the dissatisfaction level was 11.3%. A univariate analysis showed that age, marital status, education level, monthly family income, the source of medical costs, the average length of the hospital stay, first hospitalization or not, doctor-patient communication, the quality of surgery, service attitude, 30-day postoperative mortality, major and minor complications, the rescue failure rate, readmission, and the incision infection rate affected the patient satisfaction, and the difference between satisfied and dissatisfied patients in each group was statistically significant (all P=0.000). The results of the logistic regression analysis showed that the factors related to the satisfaction of surgical quality indicators were postoperative 30-day mortality, major and minor complications, the rescue failure rate, the incision infection rate, and the average length of the hospital stay (all P<0.05), and the factors related to a decrease in inpatient satisfaction were increased postoperative 30-day mortality, a high incidence of major and minor complications, a high rescue failure rate, and a high incision infection rate. Conclusions There was a significant correlation between inpatient satisfaction and surgical quality evaluation indicators (i.e., 30-day mortality, major and minor complications, the rescue failure rate, the incision infection rate, and the average length of the hospital stay).
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Affiliation(s)
- Rongyu Shang
- Department of Medical Education, School of Basic Medicine, Army Medical University, Chongqing, China
| | - Duan Wang
- Department of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huifen Cai
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Jiafei Chen
- Department of Radiology, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Lin Lv
- Department of Infection Control, The First Affiliated Hospital of Army Medical University, Chongqing, China
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Shintani Smith S, Cheng BT, Kern RC, Cameron KA, Micco AG. Publicly Reported Patient Satisfaction Scores in Academic Otolaryngology Departments. Laryngoscope 2021; 131:2204-2210. [PMID: 33830507 DOI: 10.1002/lary.29557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Despite controversy regarding their impact and validity, there is a rising national focus on patient satisfaction scores (PSS). We describe the landscape of online PSS as posted by academic otolaryngology practices. STUDY DESIGN Retrospective cross-sectional study. METHODS Websites of academic otolaryngology programs were reviewed for PSS scores, provider type, and geographic location. Gender was determined by picture or profile pronouns. Years of experience were determined by year of initial American Board of Otolaryngology-Head and Neck Surgery certification. We defined PSS derived from Press-Ganey or Clinician and Group Consumer Assessment of Healthcare Providers and Systems surveys as "standardized PSS". We determined potential associations between provider characteristics and standardized PSS. RESULTS Out of 115 Otolaryngology-Head and Neck Surgery academic programs, 40 (35%) posted a total of 64,638 online PSS surveys (nonstandardized plus standardized) of 507 unique otolaryngology care providers. Standardized PSS were posted for 473 providers (370 [78%] male; 446 physicians; 27 advanced practice providers). Median overall standardized PSS was 4.8 (interquartile range 4.7-4.9; range 3.8-5.0). PSS were similar between gender, provider type, and years of experience. Male providers had more surveys than female providers (149 vs. 93; P < .01). There was a linear relationship between number of surveys and years of experience (P < .01), but no relationship between number of surveys and overall standardized PSS. CONCLUSIONS Patient satisfaction with otolaryngology providers at academic institutions is consistently high, as demonstrated by high online PSS with little variability. The limited variation in PSS may limit their usefulness in differentiating providers and quality of care. LEVEL OF EVIDENCE NA Laryngoscope, 2021.
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Affiliation(s)
- Stephanie Shintani Smith
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg, School of Medicine, Chicago, Illinois, U.S.A.,Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | - Brian T Cheng
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg, School of Medicine, Chicago, Illinois, U.S.A
| | - Robert C Kern
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg, School of Medicine, Chicago, Illinois, U.S.A
| | - Kenzie A Cameron
- Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | - Alan G Micco
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg, School of Medicine, Chicago, Illinois, U.S.A
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Commentary on "The Effects of a Novel Mindfulness-Based Intervention on Nurses' State Mindfulness and Patient Satisfaction in the Emergency Department". J Emerg Nurs 2021; 47:371-372. [PMID: 33814161 DOI: 10.1016/j.jen.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
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Vasiliadis HM, Gontijo Guerra S, Berbiche D, Pitrou IE. The Factors Associated with 3-Year Mortality Stratified by Physical and Mental Multimorbidity and Area of Residence Deprivation in Primary Care Community-Living Older Adults. J Aging Health 2021; 33:545-556. [PMID: 33779356 PMCID: PMC8236670 DOI: 10.1177/0898264321997715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: To examine the risk factors of mortality stratified by physical and mental multimorbidity (PMM) and area socioeconomic status. Methods: Cox regression analyses were used to study 3-year all-cause mortality in primary care older adults stratified by PMM status, and area of residence material and social deprivation. Results: There were socioeconomic differences in the associations between PMM and mortality. Continuity of care decreased mortality risk in moderately and most deprived areas. Satisfaction with medical consultations decreased mortality risk in moderately deprived areas. Current smoking increased mortality in those living in moderately and most deprived areas. Physical activity reduced mortality only in individuals without PMM. Higher cognition was associated with reduced mortality in individuals living in moderately deprived areas. Discussion: Public health policies should be further encouraged in primary care, aiming at increased continuity of care, quality of interactions with patients, and prevention strategies including smoking cessation programs and physical activity promotion.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.,Charles-Le Moyne Innovations in Health Research Center (CR-CSIS), Longueuil, QC, Canada
| | - Samantha Gontijo Guerra
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.,Charles-Le Moyne Innovations in Health Research Center (CR-CSIS), Longueuil, QC, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.,Charles-Le Moyne Innovations in Health Research Center (CR-CSIS), Longueuil, QC, Canada
| | - Isabelle E Pitrou
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.,Charles-Le Moyne Innovations in Health Research Center (CR-CSIS), Longueuil, QC, Canada
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Park J, Yu J, Hong JH, Hwang J, Kim Y. Head elevation and laryngeal mask airway Supreme insertion: A randomized controlled trial. Acta Anaesthesiol Scand 2021; 65:343-350. [PMID: 33174199 DOI: 10.1111/aas.13742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND A laryngeal mask airway (LMA) is usually inserted by conventional 7 cm head elevation. However, little is known about the association of head elevation degree and LMA insertion. We hypothesized that 14 cm head elevation would increase the first attempt success rate of LMA Supreme insertion compared with conventional 7 cm head elevation in patients undergoing transurethral resection of bladder tumour. METHODS Patients were randomly allocated to the high group (n = 55, 14 cm head elevation) or the control group (n = 55, conventional 7 cm head elevation). The primary outcome was the first attempt success rate of LMA Supreme insertion. RESULTS The first attempt success rate was significantly higher in the high group than in the control group (53 [96.4%] vs 40 [72.7%], P = .001, relative risk = 1.30, 95% confidence interval [CI] = 1.12-1.57, absolute risk reduction = 23.7%). Fibreoptic bronchoscope grade 4 (ie optimal position of the LMA) was significantly higher in the high group (35 [64.8%] vs 18 [36.7%], P = .004, relative risk = 1.76, 95% CI = 1.16-2.68, absolute risk reduction = 30.9%). CONCLUSIONS Head elevation of 14 cm height increased the first attempt success rate of LMA Supreme insertion and fibreoptic bronchoscopic grade in patients undergoing transurethral resection of bladder tumour. High head elevation can be an effective option for successful LMA Supreme insertion. Trial Registry Number: Clinicaltrials.gov (NCT04229862).
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Affiliation(s)
- Jun‐Young Park
- Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea
| | - Jihion Yu
- Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea
| | - Jun Hyuk Hong
- Department of Urology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea
| | - Jai‐Hyun Hwang
- Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea
| | - Young‐Kug Kim
- Department of Anesthesiology and Pain Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea
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Chang M, Russo GS, Canseco JA, Nicholson K, Sharma R, Koomson J, Vaccaro AR. Variations in Patient Satisfaction Scores Between HCAHPS and a Novel Orthopedic Practice-Specific Survey. Am J Med Qual 2021; 36:103-109. [PMID: 32452696 DOI: 10.1177/1062860620926710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Performance on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey can affect up to 33% of a physician's reimbursement from the Centers for Medicare & Medicaid Services. At this pseudo-private orthopedic practice, the authors characterized how physicians often achieve drastically different scores between HCAHPS and an Internal Patient Satisfaction Questionnaire (IPSQ). Eighteen physicians were ranked separately according to percentage of top-box scores on HCAHPS and IPSQ. There was an inverse relationship between physician rank for the 2 surveys according to Spearman correlation coefficient (ρ = -0.36, P = .15). Qualitative subanalysis indicated that although "physician interaction" was the most common reason for negative comments on HCAHPS, "ancillary staff" and "workflow" concerns were common on IPSQ. The outpatient setting remains a critical component in achieving high-quality orthopedic care. Consequently, HCAHPS alone may not be a sufficient indicator of patient satisfaction for orthopedic and other subspecialty practices.
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Affiliation(s)
- Michael Chang
- Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA Quinnipiac University, Hamden, CT Drexel University, Philadelphia, PA
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Rabah NM, Khan HA, Levin JM, Winkelman RD, Mroz TE, Steinmetz MP. The association between patient rating of their spine surgeon and quality of postoperative outcome. J Neurosurg Spine 2021; 34:449-455. [PMID: 33339000 DOI: 10.3171/2020.7.spine20478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/13/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey was developed by the Centers for Medicare and Medicaid Services as a result of their value-based purchasing initiative. It allows patients to rate their experience with their provider in the outpatient setting. This presents a unique situation in healthcare in which the patient experience drives the marketplace, and since its creation, providers have sought to improve patient satisfaction. Within the spine surgery setting, however, the question remains whether improved patient satisfaction correlates with improved outcomes. METHODS All patients who had undergone lumbar spine surgery between 2009 and 2017 and who completed a CG-CAHPS survey after their procedure were studied. Demographic and surgical characteristics were then obtained. The primary outcomes of this study include patient-reported health outcomes measures such as the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) surveys for both mental health (PROMIS-GH-MH) and physical health (PROMIS-GH-PH), and the visual analog scale for back pain (VAS-BP). A multivariable linear regression analysis was used to assess whether patient satisfaction with their provider was associated with changes in each health status measure after adjusting for potential confounders. RESULTS The study population included 647 patients who had undergone lumbar spine surgery. Of these, 564 (87%) indicated that they were satisfied with the care they received. Demographic and surgical characteristics were largely similar between the two groups. Multivariable linear regression demonstrated that patient satisfaction with their provider was not a significant predictor of change in two of the three patient-reported outcomes (PROMIS-GH-MH and PROMIS-GH-PH) assessed at 1 year. However, top-box patient satisfaction with their provider was a significant predictor of improvement in VAS-BP scores at 1 year. CONCLUSIONS The authors found that after adjusting for patient-level covariates such as age, diagnosis of disc displacement, self-reported mental health, self-reported overall health, and preoperative patient-reported outcome measure status, a significant association was observed between top-box overall provider rating and 1-year improvement in VAS-BP, but no such association was observed for PROMIS-GH-PH and PROMIS-GH-MH. This suggests that pain-related outcome measures may serve as better predictors of patients' satisfaction with their spine surgeons. Furthermore, this suggests that the current method by which patient satisfaction is being assessed and publicly reported may not necessarily correlate with validated measures that are used within the spine surgery setting to assess surgical efficacy.
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Affiliation(s)
- Nicholas M Rabah
- 1Center for Spine Health, Cleveland Clinic
- 2Case Western Reserve University School of Medicine, Cleveland
- 3Department of Neurosurgery, Cleveland Clinic; and
- 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Hammad A Khan
- 1Center for Spine Health, Cleveland Clinic
- 2Case Western Reserve University School of Medicine, Cleveland
- 3Department of Neurosurgery, Cleveland Clinic; and
- 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Jay M Levin
- 1Center for Spine Health, Cleveland Clinic
- 2Case Western Reserve University School of Medicine, Cleveland
- 3Department of Neurosurgery, Cleveland Clinic; and
- 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Robert D Winkelman
- 1Center for Spine Health, Cleveland Clinic
- 2Case Western Reserve University School of Medicine, Cleveland
- 3Department of Neurosurgery, Cleveland Clinic; and
- 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Thomas E Mroz
- 1Center for Spine Health, Cleveland Clinic
- 3Department of Neurosurgery, Cleveland Clinic; and
- 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Michael P Steinmetz
- 1Center for Spine Health, Cleveland Clinic
- 3Department of Neurosurgery, Cleveland Clinic; and
- 4Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
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AL-Mohaithef M, Almezaal EM, Elsayed EH, Javed N, Chandramohan S. Chronic disease patients' satisfaction with primary health-care services provided by the second health cluster in Riyadh, Saudi Arabia. SAUDI JOURNAL FOR HEALTH SCIENCES 2021. [DOI: 10.4103/sjhs.sjhs_213_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lehrich BM, Goshtasbi K, Brown NJ, Shahrestani S, Lien BV, Ransom SC, Tafreshi AR, Ransom RC, Chan AY, Diaz-Aguilar LD, Sahyouni R, Pham MH, Osorio JA, Oh MY. Predictors of Patient Satisfaction in Spine Surgery: A Systematic Review. World Neurosurg 2020; 146:e1160-e1170. [PMID: 33253954 DOI: 10.1016/j.wneu.2020.11.125] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recently, there has been increased interest in patient satisfaction measures such as Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. In this systematic review, the spine surgery literature is analyzed to evaluate factors predictive of patient satisfaction as measured by these surveys. METHODS A thorough literature search was performed in PubMed/MEDLINE, Google Scholar, and Cochrane databases. All English-language articles from database inception to July 2020 were screened for study inclusion according to PRISMA guidelines. RESULTS Twenty-four of the 1899 published studies were included for qualitative analysis. There has been a statistically significant increase in the number of publications across years (P = 0.04). Overall, the studies evaluated the relationship between patient satisfaction and patient demographics (71%), preoperative and intraoperative clinical factors (21%), and postoperative factors (33%). Top positive predictors of patient satisfaction were patient and nursing/medical staff relationship (n = 4; 17%), physician-patient relationship (n = 4; 17%), managerial oversight of received care (n = 3; 13%), same sex/ethnicity between patient and physician (n = 2; 8%), and older age (n = 2; 8%). Top negative predictors of patient satisfaction were high Charlson Comorbidity Index/high disability/worse overall health functioning (n = 7; 29%), increased length of hospital stay (n = 4; 17%), high rating for pain/complications/readmissions (n = 4; 17%), and psychosocial factors (n = 3; 13%). CONCLUSIONS There is heterogeneity in terms of different factors, both clinical and nonclinically related, that affect patient satisfaction ratings. More research is warranted to investigate the role of hospital consumer surveys in the spine surgical patient population.
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Affiliation(s)
- Brandon M Lehrich
- Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
| | - Khodayar Goshtasbi
- School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Nolan J Brown
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
| | - Shane Shahrestani
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Department of Medical Engineering, California Institute of Technology, Pasadena, California, USA
| | - Brian V Lien
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
| | - Seth C Ransom
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ali R Tafreshi
- Department of Neurological Surgery, Geisinger Health System, Danville, Pennsylvania, USA
| | - Ryan C Ransom
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Alvin Y Chan
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
| | - Luis D Diaz-Aguilar
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Ronald Sahyouni
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Martin H Pham
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Joseph A Osorio
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Michael Y Oh
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
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Chiou SJ, Lee LH, Lee PC, Lin KC. Better Self-report Health Status and Provider-Patient Communication in Dental Service Can Improve the Patient Experience: A Cross-year Comparison from the NHI Survey. HEALTH COMMUNICATION 2020; 35:1569-1575. [PMID: 31423836 DOI: 10.1080/10410236.2019.1652390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Several factors, including healthcare outcomes and quality, influence patients' expectations of healthcare services. Currently, as patients have more understanding about dental care services, patient satisfaction is essential for continually improving the services being provided. The purpose of this study is to analyze the multiyear annual National Health Insurance (NHI) patient experience survey in Taiwan to explore the factors associated with the satisfaction rate from 2012-2016. This study used the annual NHI survey to explore patients' experiences of receiving medical service in dental care from 2012 to 2016. There were over 40 major items in the survey each year; however, we only selected suitable items that followed the Andersen model. We ran a logistics regression testing the relationship between the covariates and the items related to satisfaction in outcomes in different years. Patients who received health education from a provider in most time, self-reported better health status, felt that cost of care was not expensive, did not wait too long for counseling time and found it easy to make an appointment, had two to ten times greater satisfaction in outcomes compared with those who did not (OR: 1.83-10.06). Individuals working in the healthcare industry should implement communication strategies to improve patients' experience in the care process by including easy-to-understand explanations or sharing decision-making with patients. Furthermore, in patient experience surveys in dental care, less attention should be paid to whether patients can provide meaningful quality measures and more attention to ways in which patient experiences can be improved. This can be achieved by providing easy-to-understand explanations, giving patients an opportunity to express their concerns, and by sharing decision-making with patients.
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Affiliation(s)
- Shang-Jyh Chiou
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences
| | - Li-Hui Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang-Ming University
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Chen H, Wang B, Li Q, Zhou J, Li R, Zhang Y. Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study. BMC Anesthesiol 2020; 20:267. [PMID: 33092527 PMCID: PMC7583202 DOI: 10.1186/s12871-020-01189-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 10/16/2020] [Indexed: 12/17/2022] Open
Abstract
Background The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia. Methods This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p < 0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p < 0.001). No differences were detected in Steward score out of PACU (p = 0.213) and from the time of the end of operation to fully awake (p = 0.417). Conclusion Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia. Trial registration Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018.
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Affiliation(s)
- Hong Chen
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, Anhui Province, China
| | - Bin Wang
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, Anhui Province, China
| | - Qin Li
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, Anhui Province, China
| | - Juan Zhou
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, Anhui Province, China
| | - Rui Li
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, Anhui Province, China
| | - Ye Zhang
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, Anhui Province, China.
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Pitrou I, Berbiche D, Vasiliadis HM. Mental health and satisfaction with primary care services in older adults: a study from the patient perspective on four dimensions of care. Fam Pract 2020; 37:459-464. [PMID: 32201895 DOI: 10.1093/fampra/cmaa019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Few studies have examined the association between mental health and satisfaction with primary care services in community-dwelling older adults. OBJECTIVE To examine the association between mental health in older adults and low satisfaction with primary care services within four dimensions of care. METHODS This secondary data analysis included 1624 older adults participating in the 'Étude sur la Santé des Aînés Services' (ESA-Services study) and recruited in primary care practices between 2011 and 2013 in the province of Quebec. Patient satisfaction and experience with care were assessed during face-to-face interviews with questions adapted from the Primary Care Assessment Survey. Self-reported mental health indicators included depression, anxiety, suicidal ideation, psychological distress and cognition. We conducted four logistic regressions to examine the associations between mental health and low satisfaction in the following dimensions of care: continuity of care, provider-patient interactions, adequacy of care and physical environment. RESULTS Nearly half of participants (48.5%) reported low satisfaction in at least one dimension of care examined. High psychological distress was associated with low satisfaction with provider-patient interactions [odds ratio (OR) = 1.02; 95% confidence interval (CI) = 1.00-1.04] and adequacy of care (OR = 1.04; 95% CI = 1.01-1.06). The presence of an anxiety disorder was associated with low satisfaction in adequacy of care (OR = 1.64; 95% CI = 1.00-2.72). Worse cognitive functioning was associated with low satisfaction in continuity of care, provider-patient interaction and adequacy of care. CONCLUSIONS Mental health was consistently associated with low satisfaction within dimensions of care. Results support the need for increased attention when delivering care to older adults with mental health problems.
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Affiliation(s)
- Isabelle Pitrou
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada.,Department of Community Health Sciences, Charles-Le Moyne Innovations in Health Research Center CR-CSIS, University of Sherbrooke, Longueuil, Quebec, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada.,Department of Community Health Sciences, Charles-Le Moyne Innovations in Health Research Center CR-CSIS, University of Sherbrooke, Longueuil, Quebec, Canada
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada.,Department of Community Health Sciences, Charles-Le Moyne Innovations in Health Research Center CR-CSIS, University of Sherbrooke, Longueuil, Quebec, Canada
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Rabah NM, Levin JM, Winkelman RD, Mroz TE, Steinmetz MP. The Association Between Physicians' Communication and Patient-Reported Outcomes in Spine Surgery. Spine (Phila Pa 1976) 2020; 45:1073-1080. [PMID: 32675615 DOI: 10.1097/brs.0000000000003458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective cohort study using prospectively collected data. OBJECTIVE Determine the association between satisfaction with physician communication and patient-reported outcomes in the inpatient spine surgery setting. SUMMARY OF BACKGROUND DATA Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys measure the patient experience of care and influence reimbursement for hospital systems and providers in the United States. It is not known whether patient satisfaction with physician communication is associated with better outcomes after spine surgery. Therefore, we evaluated the association between patient satisfaction with physician communication on the HCAHPS survey and improvements in validated patient-reported outcomes measures in a spine surgery population. METHODS HCAHPS responses were obtained for patients undergoing elective cervical or lumbar spine surgery from 2013 to 2015. Patient-reported health status measures were the primary outcomes, including EuroQol Five Dimensions (EQ-5D), Pain Disability Questionnaire (PDQ), and Visual Analog Scores for Back and Neck Pain (VAS-BP/NP). The association between satisfaction with communication and preoperative to 1 year postoperative changes in each health status measure was evaluated utilizing multivariable linear regression models. RESULTS Our study included 648 patients, of which, 479 (74.4%) created our satisfied cohort. Demographically, our two cohorts were similar with regards to preoperative clinical measures; however, the satisfied cohort had a higher self-rating of their mental health (P < 0.01), and overall health (P < 0.01). After adjusting for clinically relevant confounders, our results demonstrated no significant association between satisfaction with physician communication and improvement in EQ-5D (P = 0.312), PDQ (P = 0.498), or VAS pain scores (P = 0.592). CONCLUSION Patient satisfaction with physician communication was not associated with 1-year postoperative improvement in EQ-5D, PDQ, and VAS-Pain after spine surgery. These findings do not diminish the importance of effective communication between doctor and patient, but instead suggest that within the spine surgery setting, using only patient experience data may not accurately reflect the true quality of care received during their inpatient stay. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Nicholas M Rabah
- Center for Spine Health, Cleveland Clinic, Cleveland, OH
- Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
| | - Jay M Levin
- Center for Spine Health, Cleveland Clinic, Cleveland, OH
- Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
| | - Robert D Winkelman
- Center for Spine Health, Cleveland Clinic, Cleveland, OH
- Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
| | - Thomas E Mroz
- Center for Spine Health, Cleveland Clinic, Cleveland, OH
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
| | - Michael P Steinmetz
- Center for Spine Health, Cleveland Clinic, Cleveland, OH
- Department of Neurosurgery, Cleveland Clinic, Cleveland, OH
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
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Harris AB, Kebaish F, Riley LH, Kebaish KM, Skolasky RL. The engaged patient: patient activation can predict satisfaction with surgical treatment of lumbar and cervical spine disorders. J Neurosurg Spine 2020; 32:914-920. [PMID: 32032962 DOI: 10.3171/2019.11.spine191159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/27/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Care satisfaction is an important metric to health systems and payers. Patient activation is a hierarchical construct following 4 stages: 1) having a belief that taking an active role in their care is important, 2) having knowledge and skills to manage their condition, 3) having the confidence to make necessary behavioral changes, and 4) having an ability to maintain those changes in times of stress. The authors hypothesized that patients with a high level of activation, measured using the Patient Activation Measure (PAM), will be more engaged in their care and, therefore, will be more likely to be satisfied with the results of their surgical treatment. METHODS Using a prospectively collected registry at a multiprovider university practice, the authors examined patients who underwent elective surgery (n = 257) for cervical or lumbar spinal disorders. Patients were assessed before and after surgery (6 weeks and 3, 6, and 12 months) using Patient-Reported Outcomes Measurement Information System (PROMIS) health domains and the PAM. Satisfaction was assessed using the Patient Satisfaction Index. Using repeated-measures logistic regression, the authors compared the likelihood of being satisfied across stages of patient activation after adjusting for baseline characteristics (i.e., age, sex, race, education, income, and marital status). RESULTS While a majority of patients endorsed the highest level of activation (56%), 51 (20%) endorsed the lower two stages (neither believing that taking an active role was important nor having the knowledge and skills to manage their condition). Preoperative patient activation was weakly correlated (r ≤ 0.2) with PROMIS health domains. The most activated patients were 3 times more likely to be satisfied with their treatment at 1 year (OR 3.23, 95% CI 1.8-5.8). Similarly, patients in the second-highest stage of activation also demonstrated significantly greater odds of being satisfied (OR 2.8, 95% CI 1.5-5.3). CONCLUSIONS Patients who are more engaged in their healthcare prior to elective spine surgery are significantly more likely to be satisfied with their postoperative outcome. Clinicians may want to implement previously proven techniques to increase patient activation in order to improve patient satisfaction following elective spine surgery.
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Affiliation(s)
| | | | | | | | - Richard L Skolasky
- Departments of1Orthopaedic Surgery and
- 2Physical Medicine and Rehabilitation, The Johns Hopkins University, Baltimore, Maryland
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Abstract
Background
Catheter-related bladder discomfort occurs because of involuntary contractions of the bladder smooth muscle after urinary catheterization. Magnesium is associated with smooth muscle relaxation. This study hypothesized that among patients having transurethral resection of bladder tumor, magnesium will reduce the incidence of postoperative moderate-to-severe catheter-related bladder discomfort.
Methods
In this double-blind, randomized study, patients were randomly allocated to the magnesium group (n = 60) or the control group (n = 60). In magnesium group, a 50 mg/kg loading dose of intravenous magnesium sulfate was administered for 15 min, followed by an intravenous infusion of 15 mg · kg−1 · h−1 during the intraoperative period. Patients in the control group similarly received normal saline. The primary outcome was the incidence of catheter-related bladder discomfort above a moderate grade at 0 h postoperatively. None, mild, moderate, and severe catheter-related bladder discomfort at 1, 2, and 6 h postoperatively, patient satisfaction, and magnesium-related adverse effects were also assessed.
Results
The incidence of catheter-related bladder discomfort above a moderate grade at 0 h postoperatively was significantly lower in the magnesium group than in the control group (13 [22%] vs. 46 [77%]; P < 0.001; relative risk = 0.283; 95% CI, 0.171 to 0.467; absolute risk reduction = 0.55; number needed to treat = 2); similar results were observed for catheter-related bladder discomfort above a moderate grade at 1 and 2 h postoperatively (5 [8%] vs. 17 [28%]; P = 0.005; relative risk = 0.294; 95% CI, 0.116 to 0.746; and 1 [2%] vs. 14 [23%]; P < 0.001; relative risk = 0.071; 95% CI, 0.010 to 0.526, respectively). Patient satisfaction on a scale from 1 to 7 was significantly higher in the magnesium group than in the control group (5.1 ± 0.8 vs. 3.5 ± 1.0; P < 0.001; 95% CI, 1.281 to 1.919). Magnesium-related adverse effects were not significantly different between groups.
Conclusions
Magnesium reduced the incidence of catheter-related bladder discomfort above a moderate grade and increased patient satisfaction among patients having transurethral resection of bladder tumor.
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
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Eftekhary N, Feng JE, Anoushiravani AA, Schwarzkopf R, Vigdorchik JM, Long WJ. Hospital Consumer Assessment of Healthcare Providers and Systems: Do Patient Demographics Affect Outcomes in Total Hip Arthroplasty? J Arthroplasty 2019; 34:2580-2585. [PMID: 31266690 DOI: 10.1016/j.arth.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/08/2019] [Accepted: 06/04/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's hospital experience. This study aims to assess whether HCAHPS scores vary by demographic or surgical factors in patients undergoing primary total hip arthroplasty. METHODS Patients who completed an HCAHPS survey after a primary total hip arthroplasty between October 2011 and November 2016 were included in this study. Patient demographics and surgical factors were evaluated for correlations with individual HCAHPS questions. RESULTS One thousand three hundred eighty-three HCAHPS questionnaires were reviewed for this study. Patients with a submitted HCAHPS response had an average age of 63.83 ± 10.17 years. Gender distribution was biased toward females at 57.27% (792 females) versus 42.73% (591 males). The average body mass index (BMI) was 28.68 ± 5.86 kg/m2. Race distribution was predominantly Caucasian at 81.49% (1127 patients), followed by "unknown" at 8.60% (119 patients) and African-American at 8.46% (117 patients). Home discharge occurred for 93.06% (1287 patients) versus 6.94% for facility discharge (96 patients). Mean length of stay was 2.41 ± 1.17 days. Each 1-year increase in age was positively correlated with a 0.16% increase in top-box response rate (β = 0.0016 ± 0.0008; P < .05). Male gender was correlated with a 4.61% increase in top-box response rate when compared to female gender (β = 0.0461 ± 0.0118; P < .01). BMI was found to be correlated with a 0.20% increase in HCAHPS response rates for each 1 kg/m2 increase (β = 0.0020 ± 0.0010; P < .05). For each day increase in length of stay, HCAHPS top-box response rates decrease by 3.41% (β = -0.0341 ± 0.0051; P < .0001). Race, marital status, smoking status, insurance type, and discharge disposition were not found to be significantly correlated with HCAHPS top-box response rate (P > .05). CONCLUSION The HCAHPS quality measurement metric affects physician reimbursement and may be biased by a number of variables including sex, length of stay, and BMI, rather than a true reflection of the quality of their hospital experience. Further research is warranted to determine whether HCAHPS scores are an appropriate measure of the quality of care received.
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Affiliation(s)
- Nima Eftekhary
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - James E Feng
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - Afshin A Anoushiravani
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY; Department of Orthopaedic Surgery, Albany Medical Center, Albany, NY
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - Jonathan M Vigdorchik
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY
| | - William J Long
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY; Insall Scott Kelly Institute, New York, NY
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Cultural and Organizational Adaptation of the QUOTE Breast Cancer Questionnaire for Italian Breast Units. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.91233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Trinh LN, Fortier MA, Kain ZN. Primer on adult patient satisfaction in perioperative settings. Perioper Med (Lond) 2019; 8:11. [PMID: 31548883 PMCID: PMC6751608 DOI: 10.1186/s13741-019-0122-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 08/19/2019] [Indexed: 02/08/2023] Open
Abstract
The topic of patient satisfaction has gained increasing importance over the past decade. Due to the impact of patient satisfaction on health care quality, understanding factors that predict satisfaction is vital. The purpose of this review is to examine the literature and identify factors related to patient perioperative satisfaction as well as predictive variables that, if modified, can enhance satisfaction scores of patients undergoing surgery. Our review reports that patient satisfaction scores are affected by modifiable factors such as clinician-patient communication, information provision to patients, and operational function of a hospital. Non-modifiable factors affecting patient satisfaction scores include patient demographics such as gender, age, and education. In order to enhance patient perioperative satisfaction, we suggest that anesthesiologists and surgeons focus their efforts on enhancing their communication skills and providing information that is appropriately tailored to the understanding of their patients.
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Affiliation(s)
- Lily N Trinh
- 1Center on Stress & Health, University of California School of Medicine, Irvine, USA
| | - Michelle A Fortier
- 1Center on Stress & Health, University of California School of Medicine, Irvine, USA.,2Sue & Bill Gross School of Nursing, University of California, Irvine, USA
| | - Zeev N Kain
- 1Center on Stress & Health, University of California School of Medicine, Irvine, USA.,3Department of Anesthesiology and Perioperative Care, University of California, Irvine, USA.,4Yale Child Study Center, Yale University, New Haven, CT USA.,5Health Policy Research Institution (HPRI), University of California, Irvine, USA
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Singer ES, Merritt RE, D'Souza DM, Moffatt-Bruce SD, Kneuertz PJ. Patient Satisfaction After Lung Cancer Surgery: Do Clinical Outcomes Affect Hospital Consumer Assessment of Health Care Providers and Systems Scores? Ann Thorac Surg 2019; 108:1656-1663. [PMID: 31430461 DOI: 10.1016/j.athoracsur.2019.06.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/13/2019] [Accepted: 06/20/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Little is known about patients' hospital experience and satisfaction after lung cancer surgery. We sought to determine how length of hospital stay (LOS) and postoperative complications affect hospital consumer assessment of health care providers and systems (HCAHPS) scores. METHODS Patients undergoing lung resection for cancer at a single academic cancer center between years 2014 and 2018 were analyzed. Clinical data were derived from The Society of Thoracic Surgeons institutional database and supplemented with HCAHPS survey data. Endpoints were "top-box" satisfaction scores and domain-specific scores for physicians and nurses communication. RESULTS In total, 181 of 478 patients (38%) who underwent pulmonary resection for lung cancer completed HCAHPS surveys. Median age was 65 years, and most patients underwent lobectomy (94%). The top-box rating for the overall hospital experience, physician communication, and nurse communication were 92%, 84%, and 69%, respectively. Overall and major complication rates were 43% and 3%, and were not associated with top-box HCAHPS scores. Increasing length of stay was associated with worse satisfaction with provider communication. Adjusted for patient factors, increasing length of stay was associated with worse patient satisfaction in the domains of communication with physicians and nurses. Patients with length of stay more than 6 days were less likely to endorse that doctors gave understandable explanations (odds ratio 0.15, 95% confidence interval, 0.04 to 0.56) and that nurses listened carefully (odds ratio 0.11, 95% confidence interval, 0.06 to 0.69). CONCLUSIONS Overall HCAHPS satisfaction scores after lung resection for cancer were high and were negatively associated with increasing length of stay. Patient satisfaction may be affected more by the perception of effective communication during prolonged hospitalizations than by complications.
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Affiliation(s)
- Emily S Singer
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Robert E Merritt
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Desmond M D'Souza
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Susan D Moffatt-Bruce
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Peter J Kneuertz
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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Eftekhary N, Feng JE, Anoushiravani AA, Schwarzkopf R, Vigdorchik JM, Long WJ. Hospital Consumer Assessment of Healthcare Providers and Systems: Do Patient Demographics Affect Outcomes in Total Knee Arthroplasty? J Arthroplasty 2019; 34:1570-1574. [PMID: 31053469 DOI: 10.1016/j.arth.2019.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/03/2019] [Accepted: 04/05/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a nationally standardized tool to assess patient experience between hospitals. The HCAHPS survey can affect hospital reimbursement. This study aims to determine if HCAHPS scores vary by a number of demographic variables in patients undergoing primary total knee arthroplasty (TKA). METHODS Patients who underwent primary TKA and returned a completed HCAHPS survey were included in this study. HCAHPS surveys were collected from our institution's Center for Quality and Patient Safety department, which was cross-referenced with our hospital's electronic data warehouse. Patient demographics, surgical factors, and quality outcomes were queried, and multivariable linear regression was performed. RESULTS In total, 1028 HCAHPS questionnaires after primary TKA were evaluated. The average age of patients was 65.9 ± 9.0 years and 67.9% (698 patients) were female. Average body mass index was 32.5 ± 6.9 kg/m2. Sixty-nine percent of the patients (1287 patients) were discharged home versus 10.3% (106 patients) to another facility. Mean length of stay was 2.9 ± 1.4 days. Age was correlated with a 0.3% decrease in top-box response rate (P < .01) for each 1-year increase in age. Compared to Caucasian race, African American race was correlated with a 5.6% increased rate for top-box response (P < .01), while Asian race (P = .42) and unknown race (P = 1.00) demonstrated no significant difference. Marital status demonstrated that divorced/separated status resulted in a significant 5.4% decrease in top-box response rates (P < .05). Similarly, single (P = .12) and widowed (P = .09) statuses also demonstrated a trend toward lower top-box response rates when compared to married or partnered patients. For each day increase in length of stay, HCAHPS top-box response rates decrease by 1.6% (P < .01). Gender, body mass index, smoking status, insurance type, and discharge disposition were not found to be significantly correlated with HCHAPS top-box response rate (P > .05). CONCLUSION HCAHPS scores in patients undergoing primary TKA are influenced not just by hospital and surgeon factors such as length of stay but by demographic variables such as age, race, and marital status. As surgeons become more involved with the burden of improving patient experience, they should be aware that static demographic variables can have a significant effect on HCAHPS scores.
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Affiliation(s)
- Nima Eftekhary
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - James E Feng
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - Afshin A Anoushiravani
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY; Department of Orthopaedic Surgery, Albany Medical Center, Albany, NY
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| | - Jonathan M Vigdorchik
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY
| | - William J Long
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY; Insall Scott Kelly Institute for Orthopaedics and Sports Medicines, New York, NY
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Pike CW, Zillioux J, Rapp D. Online Ratings of Urologists: Comprehensive Analysis. J Med Internet Res 2019; 21:e12436. [PMID: 31267982 PMCID: PMC6632102 DOI: 10.2196/12436] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 03/23/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022] Open
Abstract
Background Physician-rating websites are being increasingly used by patients to help guide physician choice. As such, an understanding of these websites and factors that influence ratings is valuable to physicians. Objective We sought to perform a comprehensive analysis of online urology ratings information, with a specific focus on the relationship between number of ratings or comments and overall physician rating. Methods We analyzed urologist ratings on the Healthgrades website. The data retrieval focused on physician and staff ratings information. Our analysis included descriptive statistics of physician and staff ratings and correlation analysis between physician or staff performance and overall physician rating. Finally, we performed a best-fit analysis to assess for an association between number of physician ratings and overall rating. Results From a total of 9921 urology profiles analyzed, there were 99,959 ratings and 23,492 comments. Most ratings were either 5 (“excellent”) (67.53%, 67,505/99,959) or 1 (“poor”) (24.22%, 24,218/99,959). All physician and staff performance ratings demonstrated a positive and statistically significant correlation with overall physician rating (P<.001 for all analyses). Best-fit analysis demonstrated a negative relationship between number of ratings or comments and overall rating until physicians achieved 21 ratings or 6 comments. Thereafter, a positive relationship was seen. Conclusions In our study, a dichotomous rating distribution was seen with more than 90% of ratings being either excellent or poor. A negative relationship between number of ratings or comments and overall rating was initially seen, after which a positive relationship was demonstrated. Combined, these data suggest that physicians can benefit from understanding online ratings and that proactive steps to encourage patient rating submissions may help optimize overall rating.
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Affiliation(s)
- C William Pike
- Georgetown University School of Medicine, Washington, DC, United States
| | - Jacqueline Zillioux
- Department of Urology, University of Virginia Medical Center, Charlottesville, VA, United States
| | - David Rapp
- Department of Urology, University of Virginia Medical Center, Charlottesville, VA, United States
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Eftekhary N, Feng JE, Anoushiravani AA, Schwarzkopf R, Vigdorchik JM, Long WJ. Revision Versus Primary Hospital Consumer Assessment of Healthcare Providers and Systems Scores in Total Joint Arthroplasty. J Arthroplasty 2019; 34:S84-S90. [PMID: 30545652 DOI: 10.1016/j.arth.2018.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/23/2018] [Accepted: 11/10/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's inpatient experience. This study aims to assess whether HCAHPS scores differ between patients undergoing primary total joint arthroplasty (TJA) and patients undergoing revision TJA. METHODS Patients who underwent primary or revision total hip or total knee arthroplasty (THA or TKA) and returned a completed HCAHPS survey were included in this study. HCAHPS scores were collected from our institution's Center for Quality and Patient Safety department, which was cross-referenced with our hospital's electronic data warehouse. Patient demographics, surgical factors, and quality outcomes were queried. Appropriate statistical analyses were performed using MatLab 2017a and P-values less than .05 were deemed significant. RESULTS In total, 523 primary and 59 revision THA recipients completed HCAHPS surveys at our institution between October 2011 and November 2016. During this same period, 507 primary TKA recipients and 40 revision TKA recipients completed HCAHPS surveys. Compared to revision THA, primary THA patients had a significantly higher top box for overall hospital ratings (58.46% vs 41.38%), felt that nurses listened to them carefully (84.3% vs 72.88%), and felt that they clearly understood the role of each medication (69.48% vs 56.90%). Moreover, 18 of 20 HCAHPS question responses favored primary THA despite not reaching significance for the majority of HCAHPS questions. Patients with revision TKA demonstrated a significantly higher incidence of "top box" choices for quieter rooms and a trend favoring better HCAHPS scores in revision TKA in a further 12 of 20 HCAHPS responses. CONCLUSION Patients undergoing primary THA report higher HCAHPS scores than those undergoing revision THA, while revision TKA demonstrated a general trend toward higher scores when compared to primary TKA patients. This publicly reported quality measurement metric which factors into physician reimbursement may be biased by the patient's health status, the complexity of the surgical procedure, and length of stay in hospital rather than a true reflection of the quality of their hospital experience.
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Affiliation(s)
- Nima Eftekhary
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - James E Feng
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - Afshin A Anoushiravani
- Department of Orthopedic Surgery, Albany Medical Center, Albany Medical College, Albany, NY
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - Jonathan M Vigdorchik
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY
| | - William J Long
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY
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Zikos D, Massaria K, Graziano M, DeLellis N. Multifactorial analysis to examine drivers of CMS summary star ratings in home health agencies. Home Health Care Serv Q 2019; 38:43-60. [PMID: 31010406 DOI: 10.1080/01621424.2019.1604459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This cross-sectional study examines factors associated with the CMS Summary Star Ratings in Home Health Agencies (HHA). Using Home Health Compare, medical claims, and census data, negative binomial regression analysis was conducted at the HHA level. Positive associations were found between Summary Star Ratings and beneficiary age, the number of claims, the proportion for specific diagnoses, the agency being hospital based, HHA age since establishment, patient retainment, improved walking/moving/bathing, and homeownership. Negative associations were found for specific ICD diagnosis proportions, HHAs serving special populations, the rate of non-white patients, patients transferred to different HHAs, income, and marital status in the coverage area. These findings are relevant to both practitioners and policymakers, in that they highlight major non-service factors associated with perceived quality of care.
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Affiliation(s)
- Dimitrios Zikos
- a College of Health Sciences , Central Michigan University , Mount Pleasant , USA
| | - Katelyn Massaria
- a College of Health Sciences , Central Michigan University , Mount Pleasant , USA
| | - Marcello Graziano
- b College of Science and Engineering & Institute for Great Lakes Research , Central Michigan University , Mount Pleasant , USA
| | - Nailya DeLellis
- a College of Health Sciences , Central Michigan University , Mount Pleasant , USA
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Impact of a Resident-Guided Rounding Initiative on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey Scores in Orthopaedic Surgery Inpatients. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2019; 3:e041. [PMID: 31334476 PMCID: PMC6510459 DOI: 10.5435/jaaosglobal-d-18-00041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Patient-centered medicine is becoming the main focus of many healthcare systems, and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a tool used to track patient satisfaction. In this study, we evaluate the HCAHPS scores in orthopaedic surgery inpatients before and after implementation of a resident-guided rounding protocol. Analyses of the HCAHPS surveys for 154 orthopaedic surgical inpatients at one community hospital were compared 6 months before and after implementation of a resident-guided rounding initiative. Specific questions of the HCAHPS survey were analyzed using the top box, mean, and positive scores. Implementation of the rounding initiative resulted in an increase in the top box, mean, and positive scores for all questions evaluated; however, no significance was noted in the results, with the exception of the positive score for a staff cohesiveness question (P = 0.046). Physician and hospital recommendation questions showed a 5-point increase (91st to 96th percentile) compared with 42-point increase (21st to 63rd percentile) by publicly reported national data. Implementation of the rounding initiative resulted in increases in HCAHPS scores across multiple questions and domains; however, these were not significant. These results suggest that simple interventions can help increase the overall patient satisfaction and promote future investigations.
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Brachmann M, Kikull K, Kill C, Betz S. Economic and operational impact of an improved pathway using rapid molecular diagnostic testing for patients with influenza-like illness in a German emergency department. J Clin Monit Comput 2019; 33:1129-1138. [PMID: 30610515 PMCID: PMC6823314 DOI: 10.1007/s10877-018-00243-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 12/22/2018] [Indexed: 11/27/2022]
Abstract
To evaluate the economic and operational effects of implementing a shorted diagnostic pathway during influenza epidemics. This retrospective study used emergency department (ED) data from the 2014/2015 influenza season. Alere i influenza A & B rapid molecular diagnostic test (RDT) was compared with the polymerase chain reaction (PCR) pathway. Differences in room occupancy time in the ED and inpatient ward and cost differences were calculated for the 14-week influenza season. The process flow was more streamlined with the RDT pathway, and the necessary isolation time in the ED was 9 h lower than for PCR. The difference in the ED examination room occupancy time was 2.9 h per patient on a weekday and 4 h per patient on a weekend day, and the difference in the inpatient room occupancy time was 2 h per patient on a weekday and 3 h per patient on a weekend day. Extrapolated time differences across the influenza season were projected to be 2733 h in the ED examination room occupancy and 1440 h in inpatient room occupancy. In patients with a negative diagnosis, the RDT was also estimated to reduce the total diagnostic costs by 41.52 € per patient compared with PCR. The total cost difference was projected to be 31,892 € across a 14-week influenza season. The improved process and earlier diagnosis with the RDT pathway compared with conventional PCR resulted in considerable savings in ED, inpatient room occupancy time and cost across the influenza season.
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Affiliation(s)
- Matthias Brachmann
- bcmed GmbH, Neue Strasse 76, 89073, Ulm, Germany
- Witten/Herdecke University, 58448, Witten, Germany
| | - Katja Kikull
- Ategris hospitals, CEO's Office, 45468, Muelheim, Germany
| | - Clemens Kill
- Center for Emergency Medicine, Essen University Hospital, 45147, Essen, Germany.
| | - Susanne Betz
- Department of Emergency Medicine, University Hospital Marburg, 35033, Marburg, Germany
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Health literacy and quality of physician-trauma patient communication: Opportunity for improvement. J Trauma Acute Care Surg 2018; 85:193-197. [DOI: 10.1097/ta.0000000000001934] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Evolution and Use of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Surveys and Their Application for Spinal Surgery Patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1097/01.css.0000532432.98702.73] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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