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Giese A, Khanam R, Nghiem S, Rosemann T, Havranek MM. Patient-reported experience is associated with higher future revenue and lower costs of hospitals. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:1031-1039. [PMID: 38070018 DOI: 10.1007/s10198-023-01646-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/06/2023] [Indexed: 07/28/2024]
Abstract
BACKGROUND Despite the established positive association between patient experience and patient volume, the relationship between patient experience and the financial performance of hospitals has not been studied thoroughly. METHODS To investigate this relationship, we used longitudinal data from 132 Swiss acute-care hospitals from 2016 to 2019 to examine the associations between patient experience and the proportion of elective patients, revenue, costs, and profits of hospitals. To account for a potential time lag effect, we utilized annual patient experience data and employed multilevel mixed-effects regression modeling to investigate its association with the aforementioned financial performance indicators for the following year. RESULTS Data for private and public hospitals were analyzed both separately and in combination, to account for the different proportions of elective patients in these types of hospitals. The resulting mixed models, revealed that for each year studied, the previous year's patient experience was positively associated with the current year's proportion of elective patients (β = 0.09, p = 0.004, all hospitals) and revenue (β = 1789.83, p = 0.037, private hospitals only), and negatively associated with costs (β = - 1191.13, p = 0.017, all hospitals); but not significantly associated with future profits (β = 629.12, p = 0.240, all hospitals). CONCLUSIONS This analysis showed that better patient experience is associated with a higher proportion of elective patients, greater revenue, and lower costs. Our findings may assist hospital managers and regulators in identifying strategies to increase revenue and reduce costs.
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Affiliation(s)
- Alice Giese
- University of Southern Queensland, Toowoomba, Australia.
- Competence Center for Health Data Science, Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, Postfach, 6002, Lucerne, Switzerland.
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
| | | | - Son Nghiem
- Department of Health Economics, Wellbeing & Society, Australian National University, Canberra, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Michael M Havranek
- Competence Center for Health Data Science, Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, Postfach, 6002, Lucerne, Switzerland
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2
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Li J, Street RL. What Encourages Patients to Recommend Their Doctor After an Online Medical Consultation? The Influence of Patient-Centered Communication, Trust, and Negative Health Information Seeking Experiences. HEALTH COMMUNICATION 2024:1-12. [PMID: 39044550 DOI: 10.1080/10410236.2024.2383801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The doctor-patient relationship in China has become increasingly tense, with patients lacking trust in doctors. Meanwhile, online healthcare flourished, accelerated by the COVID-19 pandemic. This study utilized the direct and indirect pathway model of clinician-patient communication to health outcomes and online trust theory to examine the associations between online patient-centered communication (OPCC), benevolence and ability trust in doctors, negative online health information seeking experiences, and willingness to recommend doctors. The findings revealed that benevolence and ability trust mediated the relationship between OPCC and willingness to recommend doctors. Additionally, when participants had a high level of negative online health information seeking experiences, OPCC had a stronger effect on ability trust; meanwhile, the mediation effect of ability trust between the relationship of OPCC and willingness to recommend was stronger. This study also discussed theoretical and practical implications.
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Affiliation(s)
- Jinxu Li
- Department of Communication and Journalism, Texas A&M University
| | - Richard L Street
- Department of Communication and Journalism, Texas A&M University
- Department of Medicine, Baylor College of Medicine
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3
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Orewa GN, Feldman SS, Kennedy KC, Hall AG, Cheng YH, Malone AA, Grimes EO, Hearld KR. Improving Communication with Family Members during a Global Pandemic: Effect on Patient Experience. South Med J 2024; 117:182-186. [PMID: 38569604 DOI: 10.14423/smj.0000000000001670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Communication with patients and their families/caregivers to facilitate informed decision making is an integral part of patient/family-centered care. Due to the high coronavirus disease 2019 (COVID-19) infection rates and limited personal protective equipment, healthcare systems were forced to restrict patient visitors, limit patient-provider interactions, and implement other changes in treatment protocols that disturbed traditional communications and risked eroding patient/family-centered care and adversely affected patient satisfaction. This article focuses on changes in patient experience in two dedicated COVID-19 units of an academic medical center located in the US South as a result of the enhanced communication process implemented specifically during the COVID-19 pandemic. METHODS This retrospective quality improvement project used data from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, fielded between January 1, 2021 and August 31, 2021, to understand the role of a proactive communication initiative in patient satisfaction. RESULTS Our results show that HCAHPS scores for hospital unit hospital unit 4 (HSP4) in all categories increased over time, with the greatest improvements seen in the responsiveness of staff and care transition; however, HCAHPS scores for hospital unit HSP3 remained stable, with a small increase in responsiveness of staff. CONCLUSIONS Our findings suggest that communication is a critical factor in patient satisfaction, demonstrating the efficacy of a swift and innovative initiative to improve communication with family/caregivers, which may have been linked to better patient experiences. Developing communication strategies is crucial for enhancing patient satisfaction.
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Affiliation(s)
- Gregory N Orewa
- From the Department of Public Health, University of Texas at San Antonio, San Antonio
| | - Sue S Feldman
- Health Service Administration, University of Alabama at Birmingham, Birmingham
| | | | - Allyson G Hall
- Health Service Administration, University of Alabama at Birmingham, Birmingham
| | - Yu H Cheng
- UAB Hospital Medicine, University of Alabama at Birmingham, Birmingham
| | - Arnaz A Malone
- Stanford Medicine Children's Health, Stanford, California
| | | | - Kristine Ria Hearld
- Health Service Administration, University of Alabama at Birmingham, Birmingham
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4
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Yoon J, Ong MK, Vanneman ME, Zhang Y, Dizon MP, Phibbs CS. Hospital and Patient Factors Affecting Veterans' Hospital Choice. Med Care Res Rev 2024; 81:58-67. [PMID: 37679963 PMCID: PMC10842609 DOI: 10.1177/10775587231194681] [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] [Indexed: 09/09/2023]
Abstract
Veterans enrolled in the Veterans Affairs (VA) health care system gained greater access to non-VA care beginning in 2014. We examined hospital and Veteran characteristics associated with hospital choice. We conducted a longitudinal study of elective hospitalizations 2011 to 2017 in 11 states and modeled patients' choice of VA hospital, large non-VA hospital, or small non-VA hospital in conditional logit models. Patients had higher odds of choosing a hospital with an academic affiliation, better patient experience rating, location closer to them, and a more common hospital type. Patients who were male, racial/ethnic minorities, had higher VA enrollment priority, and had a mental health comorbidity were more likely than other patients to choose a VA hospital than a non-VA hospital. Our findings suggest that patients respond to certain hospital attributes. VA hospitals may need to maintain or achieve high levels of quality and patient experience to attract or retain patients in the future.
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Affiliation(s)
- Jean Yoon
- VA Palo Alto Health Care System, Menlo Park, CA, USA
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Michael K Ong
- VA Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California at Los Angeles, USA
| | - Megan E Vanneman
- VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yue Zhang
- VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Matthew P Dizon
- VA Palo Alto Health Care System, Menlo Park, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
| | - Ciaran S Phibbs
- VA Palo Alto Health Care System, Menlo Park, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
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Atsavapranee E, Heidenreich P, Smith-Bentley M, Vyas A, Shieh L. Care to Share? Patients in Private Rooms Are More Likely to Recommend a Hospital to Others. J Patient Exp 2023; 10:23743735231158250. [PMID: 36865380 PMCID: PMC9972040 DOI: 10.1177/23743735231158250] [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] [Indexed: 03/03/2023] Open
Abstract
A patient's likelihood to recommend a hospital is used to assess the quality of their experience. This study investigated whether room type influences patients' likelihood to recommend Stanford Health Care using Hospital Consumer Assessment of Healthcare Providers and Systems survey data from November 2018 to February 2021 (n = 10,703). The percentage of patients who gave the top response was calculated as a top box score, and the effects of room type, service line, and the COVID-19 pandemic were represented as odds ratios (ORs). Patients in private rooms were more likely to recommend than patients in semi-private rooms (aOR: 1.32; 95% CI: 1.16-1.51; 86% vs 79%, p < .001), and service lines with only private rooms had the greatest increases in odds of a top response. The new hospital had significantly higher top box scores than the original hospital (87% vs 84%, p < .001), indicating that room type and hospital environment impact patients' likelihood to recommend.
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Affiliation(s)
- Ella Atsavapranee
- Department of Medicine, Stanford
University School of Medicine, Stanford, CA, USA,Lisa Shieh, GME, Stanford University School
of Medicine, Department of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Paul Heidenreich
- Department of Medicine, Stanford
University School of Medicine, Stanford, CA, USA
| | | | - Alpa Vyas
- Stanford Health Care, Stanford, CA, USA
| | - Lisa Shieh
- Department of Medicine, Stanford
University School of Medicine, Stanford, CA, USA
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6
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Park HN, Park DJ, Han SY, Tae JY, Jung K, Bae EJ, Yoon JY. Effect of inpatient experiences on patient satisfaction and the willingness to recommend a hospital: The mediating role of patient satisfaction: A cross-sectional study. Health Sci Rep 2022; 5:e925. [PMID: 36320649 PMCID: PMC9617665 DOI: 10.1002/hsr2.925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS As high-quality health care encompasses patient-centered care, this study used the perceived quality-satisfaction-behavioral intention and structure-process-outcome models to (1) investigate the relationships among patient experience, patient satisfaction, and the willingness to recommend a hospital and (2) estimate the indirect effects of patient satisfaction on the relationship between patient experience and the willingness to recommend a hospital. METHODS A cross-sectional survey design was adopted to investigate data obtained from the Seoul National University Hospital Patient Experience survey administered in 2020. Responses were analyzed from 1555 patients, who had been admitted to the inpatient ward of a tertiary hospital for a period lasting more than 1 day. RESULTS The path model demonstrated a good fit to the relationships between patient experience, patient satisfaction, and the willingness to recommend the hospital. Patient experience directly influenced patient satisfaction (β = 0.659, p < 0.001) and the willingness to recommend the hospital (β = 0.168, p < 0.001), whereas patient satisfaction had an indirect effect (β = 0.418, p < 0.001) on the relationship between patient experience and the willingness to recommend the hospital. CONCLUSION Patient experience is a critical factor that health care systems need to consider for enhancing patient-centeredness, patient satisfaction, and the willingness to recommend a hospital.
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Affiliation(s)
- Hye Na Park
- Department of Medical InnovationSeoul National University HospitalSeoulRepublic of Korea,College of NursingSeoul National UniversitySeoulRepublic of Korea
| | - Do Joong Park
- Department of Medical InnovationSeoul National University HospitalSeoulRepublic of Korea,Department of SurgerySeoul National University HospitalSeoulRepublic of Korea
| | - Se Young Han
- Department of Medical InnovationSeoul National University HospitalSeoulRepublic of Korea
| | - Ji Yeon Tae
- Department of Medical InnovationSeoul National University HospitalSeoulRepublic of Korea
| | - Keun‐Hwa Jung
- Department of NeurologySeoul National UniversitySeoulRepublic of Korea
| | - Eun Jung Bae
- College of NursingSeoul National UniversitySeoulRepublic of Korea
| | - Ju Young Yoon
- College of NursingSeoul National UniversitySeoulRepublic of Korea,Research, Institute of Nursing ScienceSeoul National UniversitySeoulRepublic of Korea
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Soare T, Ianovici C, Gheorghe IR, Purcărea VL, Soare CM. A word-of-mouth perspective on consumers of family medicine services: a case study. J Med Life 2022; 15:655-660. [PMID: 35815082 PMCID: PMC9262271 DOI: 10.25122/jml-2022-0098] [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: 02/11/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
In an increasingly competitive health care market, family physicians have to elaborate and implement new strategies to attract potential patients. A useful and powerful method is word-of-mouth (WOM) because it shapes the consumers' attitudes and behaviours. Based on the recommendations of actual consumers, potential health care patients choose their family physicians. The aim of this study was to investigate the usefulness of WOM in family medicine and determine the key factors in recommending a certain family physician. The sample consisted of 338 patients under the supervision of a family physician, and the instrument for collecting data was a self-administered questionnaire. The findings revealed that the most important factors in spreading WOM are the communication skills and the expertise of the family physician. In addition, for patients between 27–33 years and 41–47 years, expertise is an absolute skill, whereas, for the health care consumers between 21 and 26 years, communication skills are essential in spreading WOM. Further, WOM becomes relevant in the family physician's activity as it may contribute to the delivery of value and in building sustainable physician-patient relationships.
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Affiliation(s)
- Traian Soare
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ciprian Ianovici
- Department of Oncological Surgery, Oncological Institute Prof. Dr. Al. Trestioreanu, Bucharest, Romania
| | - Iuliana-Raluca Gheorghe
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,Corresponding Author: Iuliana-Raluca Gheorghe, Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. E-mail:
| | - Victor Lorin Purcărea
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Cristina Maria Soare
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Eamranond A, Rodis JF, Richard KE, Safer A, Kunupakaphun S, Grey MR, Eamranond PP. Decade of Patient Experience Improvement at a Tertiary Care Urban Hospital. Qual Manag Health Care 2022; 31:53-58. [PMID: 34670956 DOI: 10.1097/qmh.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE The purpose of this quality management study was to demonstrate how one hospital made a journey from average patient experience to become a regional leader in the experience of patient care for nationally recognized quality and safety metrics. METHODS Saint Francis Hospital & Medical Center (SFHMC) located in Hartford, Connecticut, serves a diverse sociodemographic community as part of Trinity Health. "Recommend the Hospital" (RTH) has been the main marker of patient experience at SFHMC and Trinity Health across the United States as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). From 2010 to 2019, SFHMC implemented unit-based rounding hospital-wide, adopting charge nurse and executive leadership rounding as standard work. The intense support from senior leadership spurred the implementation of these changes across middle management and all frontline workers. The t test was used to determine differences between the mean RTH scores between SFHMC, Connecticut, and the United States. RESULTS Patient experience at SFHMC was regularly assessed by Press Ganey surveys and HCAHPS, which demonstrated higher scores than averages for the state of Connecticut and the United States between 2010 and 2019 (both Ps < .001). SFHMC was the top performer with an RTH score of 83%, with the state average being 71% and the national average being 72%. In the years following the implementation of a multipronged low-cost strategy, hospital RTH scores rose linearly from the state and national average. SFHMC observed gains in patient safety and quality scores as measured by national benchmarks, including Leapfrog patient safety scores of 7 A's and 1 B over a 4-year period. SFHMC was the only hospital in Connecticut to receive an A grade 4 years in a row. CONCLUSION A combination of nurse-led, unit-based rounding and executive team rounding with a consistent focus on patient experience resulted in significant improvement in RTH scores for a busy teaching urban hospital, with only a modest investment of resources. There was also improvement in quality and safety outcomes, which together with patient experience of care drove fiscal stability in an increasingly value-based health care environment.
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Affiliation(s)
- Alyssa Eamranond
- Boston College, Boston, Massachusetts (Ms A. Eamranond); Arista Health, Farmington, Connecticut (Dr Rodis); Saint Francis Hospital & Medical Center, Hartford, Connecticut (Ms Richard and Dr Grey); Trinity Health of New England, Hartford, Connecticut (Ms Safer); Ever Medical Technologies, Boston, Massachusetts (Mr Kunupakaphun); and Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts (Dr P. P. Eamranond)
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9
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Xu J, Park S, Xu J, Hamadi H, Zhao M, Otani K. Factors Impacting Patients' Willingness to Recommend: A Structural Equation Modeling Approach. J Patient Exp 2022; 9:23743735221077538. [PMID: 35128045 PMCID: PMC8814971 DOI: 10.1177/23743735221077538] [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] [Indexed: 11/17/2022] Open
Abstract
Patient ratings of inpatient stay have been the focus of prior research since better patient satisfaction results in a financial benefit to hospitals and are associated with better patient health care outcomes. However, studies that simultaneously account for within- and between-hospital effects are uncommon. We constructed a multilevel structural equation model to identify predictors of patients’ willingness to recommend a hospital at both within-hospital and between-hospital levels. We used data from 60 U.S. general medical and surgical hospitals and 12,115 patients. Multilevel structural equation modeling reported that patient ratings on the overall quality of care significantly affect the willingness to recommend within hospitals. Also, patients’ perspectives on the hospital environment and nursing are the significant factors that predict the patient ratings on the overall quality of care. Overall patient satisfaction significantly predicts the willingness to recommend at the between-hospital level, whereas hospital size and location have marginal impacts.
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Affiliation(s)
- Jing Xu
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Sinyoung Park
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Jie Xu
- Clinical Science, Johnson & Johnson Vision, Jacksonville, FL, USA
| | - Hanadi Hamadi
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Mei Zhao
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Koichiro Otani
- Department of Public Policy, Purdue University Fort Wayne, IN, USA
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10
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Exploring characteristics of specialization as moderators of the link between specialization and patient experience of care. Health Care Manage Rev 2022; 47:297-307. [PMID: 35135990 DOI: 10.1097/hmr.0000000000000337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hospitals are increasingly pursuing specialization as a strategy to operate efficiently while delivering high-quality care. To date, however, evidence is lacking on whether hospital specialization has a consistent effect on patients' experience of care or whether different specialization characteristics influence how specialization works. PURPOSE This study investigates whether specialization characteristics, that is, the within-specialty concentration and the within-specialty urgency score, moderate the link between hospital specialization and patient experience of care. METHODOLOGY We use patient-reported and administrative data from German hospitals between 2014 and 2017, with orthopedic and trauma care as the research setting. Our sample consists of 157,458 patient observations nested within 483 hospitals. We apply random-intercept multilevel modeling. RESULTS Our results indicate that the effect of specialization on patient experience of care (a) decreases as the within-specialty concentration increases and (b) increases as the within-specialty urgency score increases. CONCLUSION This study provides novel insights into the specialization characteristics that make hospital specialization in orthopedic and trauma care particularly effective at improving patient experiences. PRACTICE IMPLICATIONS Although specialization is gaining popularity as a strategy for pooling scarce resources and facilitating high-quality health care, hospital managers and policymakers should consider that certain characteristics of specialization can influence the way that specialization works and how effective it is in improving patient experiences. Within the scope of orthopedic and trauma care, our study suggests that a low concentration of diagnoses within a service area and a high average level of medical urgency make specialization particularly effective at improving patient experiences.
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Belasen AR, Tracey MR, Belasen AT. Demographics matter: the potentially disproportionate effect of COVID-19 on hospital ratings. Int J Qual Health Care 2021; 33:6153811. [PMID: 33644795 PMCID: PMC7989431 DOI: 10.1093/intqhc/mzab036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/11/2021] [Accepted: 02/26/2021] [Indexed: 01/08/2023] Open
Abstract
Objective To identify how features of the community in which a hospital serves differentially relate to its patients' experiences based on the quality of that hospital. Design A Finite Mixture Model (FMM) is used to uncover a mix of two latent groups of hospitals that differ in quality. In the FMM, a multinomial logistic equation relates hospital-level factors to the odds of being in either group. A multiple linear regression relates the characteristics of communities served by hospitals to the patients' expected ratings of their experiences at hospitals in each group. Thus, this association potentially varies with hospital quality. The analysis was conducted via Stata. Setting Hospital ratings are measured by Hospital Compare using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, a patient satisfaction survey required by the Centers for Medicare and Medicaid Services for hospitals in the USA. Participants 2,816 Medicare-certified acute care hospitals across all US states. Intervention None. Main Outcome Measure Differences in the marginal impacts of key community demographics on patient experiences between the two groups of hospitals. Results We provide evidence that low-rated hospitals have much more variability in patient experience ratings than high-rated ones. Moreover, the experiences at low-rated hospitals are more sensitive to county demographic factors, which means exogenous shocks, like coronavirus disease-2019 (COVID-19), will likely affect these hospitals differently, as such shocks are known to disproportionately affect their communities. Conclusions Our results imply that low-rated hospitals with more variability in their HCAHPS responses are more likely to face adverse patient experiences due to COVID-19 than high-rated hospitals. Pandemics like COVID-19 create conditions that intensify the already high demands placed on hospitals and care providers and make it even more challenging to deliver quality care.
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Affiliation(s)
- Ariel R Belasen
- Department of Economics and Finance, Southern Illinois University Edwardsville, 3144 Alumni Hall, Edwardsville, IL 62026, USA
| | - Marlon R Tracey
- Department of Economics and Finance, Southern Illinois University Edwardsville, 3144 Alumni Hall, Edwardsville, IL 62026, USA
| | - Alan T Belasen
- MBA in Healthcare Leadership, SUNY Empire State College, 113 West Avenue, Saratoga Springs, NY 12866, USA
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Damen A, Murphy P, Fullam F, Mylod D, Shah RC, Fitchett G. Examining the Association Between Chaplain Care and Patient Experience. J Patient Exp 2021; 7:1174-1180. [PMID: 33457562 PMCID: PMC7786773 DOI: 10.1177/2374373520918723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A developing body of evidence indicates that chaplain care is associated with higher levels of patient/family satisfaction with their hospital care. We examined the association between chaplain care and patient experience among patients at Rush University Medical Center in Chicago who responded to Hospital Consumer Assessment of Healthcare Providers and Systems and Press Ganey survey items between 2011 and 2017. Information about chaplain care was taken from the inpatients’ electronic medical record. Our analyses included 11 741 patients, 26.5% of whom had received any chaplain care. Patients with lower self-rated health were more likely to have received chaplain care (P < .001). In bivariate analyses, chaplain care was associated with lower likelihood of reporting the highest score for 4 patient experience items (P < .001). In multi-variable models that adjusted for patient self-rated health and other factors, the association between chaplain care and the 4 patient experience items was nonsignificant. There was no effect modification for patient religious affiliation, self-rated health, or other demographic factors. The chaplain care-patient experience association may be more complex than has initially appeared, and further research is needed to help us better understand it.
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Affiliation(s)
- Annelieke Damen
- PhD student Outcomes of Chaplaincy, University of Humanistic Studies, Utrecht, the Netherlands
| | - Patricia Murphy
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, IL, USA
| | - Francis Fullam
- Health Systems Management, Rush University Medical Center, Chicago, IL, USA
| | - Deirdre Mylod
- Institute for Innovation, SVP Research & Analytics, Press Ganey Associates, South Bend, IN, USA
| | - Raj C Shah
- Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - George Fitchett
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, IL, USA
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Min A, Kim YM, Yoon YS, Hong HC, Kang M, Scott LD. Effects of Work Environments and Occupational Fatigue on Care Left Undone in Rotating Shift Nurses. J Nurs Scholarsh 2020; 53:126-136. [PMID: 33205904 DOI: 10.1111/jnu.12604] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to examine the effects of work environments and occupational fatigue on care left undone in rotating shift nurses, and to identify the indirect (mediation) effect of work environments on care left undone through nurses' occupational fatigue in South Korean acute care hospitals. DESIGN This study employed a cross-sectional design using an online survey to collect data from 488 rotating shift nurses of acute care hospitals in Korea between November and December 2018. METHODS A mobile schedule management application for shift nurses was used to advertise the study and to send a link to the online survey. The survey included questions on the nurses' work environment characteristics, care left undone activities, and the Korean version of the Occupational Fatigue Exhaustion/Recovery scale. Poisson regression was used to explore the relationships among work environments, occupational fatigue, and care left undone. Hayes' Model 4 and a bootstrapping analysis were used to identify the mediating effect of occupational fatigue on the relationship between work environments and care left undone. FINDINGS The average number of tasks left undone was 3.45 (SD = 2.19). The higher the acute and chronic fatigue levels noted among nurses, the higher were the occurrences of care left undone. Conversely, the higher the intershift recovery level, the lower were the occurrences of care left undone. The results showed a positive relationship between care left undone and overtime hours and the number of patients per nurse. Moreover, nurses' occupational fatigue mediated the relationship between work environments and care left undone. Night shifts per month and the number of consecutive days off had an indirect effect on care left undone through occupational fatigue. CONCLUSIONS High levels of occupational fatigue and poor intershift recovery among nurses can lead to care left undone. Nurses' occupational fatigue mediates the effect of work environment on care left undone. CLINICAL RELEVANCE It is crucial for healthcare administrators and leaders to develop policies and mandatory regulations to facilitate better working conditions for nurses, consequently reducing their occupational fatigue and decreasing the occurrence of care left undone in acute care hospitals.
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Affiliation(s)
- Ari Min
- Assistant Professor, Department of of Nursing, Chung-Ang University, South Korea
| | - Young Man Kim
- Assistant Professor, College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, South Korea
| | - Yea Seul Yoon
- Doctoral Student, Department of Nursing, Graduate School, Yonsei University, South Korea
| | - Hye Chong Hong
- Assistant Professor, Department of Nursing, Chung-Ang University, South Korea
| | - Minkyung Kang
- Assistant Professor, College of Nursing, Keimyung University, South Korea
| | - Linda D Scott
- Dean and Professor, School of Nursing, University of Wisconsin, Madison, WI, USA
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Atukunda EC, Mugyenyi GR, Obua C, Musiimenta A, Agaba E, Najjuma JN, Ware NC, Matthews LT. Women's Choice to Deliver at Home: Understanding the Psychosocial and Cultural Factors Influencing Birthing Choices for Unskilled Home Delivery among Women in Southwestern Uganda. J Pregnancy 2020; 2020:6596394. [PMID: 32566299 PMCID: PMC7290878 DOI: 10.1155/2020/6596394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/11/2020] [Accepted: 04/30/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Utilization of perinatal services in Uganda remains low, with correspondingly high rates of unskilled home deliveries, which can be life-threatening. We explored psychosocial and cultural factors influencing birthing choices for unskilled home delivery among postpartum women in rural southwestern Uganda. METHODS We conducted in-depth qualitative face-to-face interviews with 30 purposively selected women between December 2018 and March 2019 to include adult women who delivered from their homes and health facility within the past three months. Women were recruited from 10 villages within 20 km from a referral hospital. Using the constructs of the Health Utilization Model (HUM), interview topics were developed. Interviews were conducted and digitally recorded in a private setting by a native speaker to elicit choices and experiences during pregnancy and childbirth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive categories using inductive content analytic approach. RESULTS Eighteen women (60%) preferred to deliver from home. Women's referent birth location was largely intentional. Overall, the data suggest women choose home delivery (1) because of their financial dependency and expectation for a "natural" and normal childbirth, affecting their ability and need to seek skilled facility delivery; (2) as a means of controlling their own birth processes; (3) out of dissatisfaction with facility-based care; (4) out of strong belief in fate regarding birth outcomes; (5) because they have access to alternative sources of birthing help within their communities, perceived as "affordable," "supportive," and "convenient"; and (6) as a result of existing gender and traditional norms that limit their ability and freedom to make family or health decisions as women. CONCLUSION Women's psychosocial and cultural understandings of pregnancy and child birth, their established traditions, birth expectations, and perceptions of control, need, and quality of maternity care at a particular birthing location influenced their past and future decisions to pursue home delivery. Interventions to address barriers to healthcare utilization through a multipronged approach could help to debunk misconceptions, increase perceived need, and motivate women to seek facility delivery.
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Affiliation(s)
| | | | - Celestino Obua
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Edgar Agaba
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Norma C. Ware
- Global Health and Social Medicine, Harvard Medical School, MA, USA
| | - Lynn T. Matthews
- Massachusetts General Hospital, Division of Infectious Diseases and Center for Global Health, Boston, Massachusetts, USA
- University of Alabama at Birmingham, Division of Infectious Disease, Birmingham, AL, USA
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15
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Atukunda EC, Mugyenyi GR, Obua C, Musiimenta A, Najjuma JN, Agaba E, Ware NC, Matthews LT. When Women Deliver at Home Without a Skilled Birth Attendant: A Qualitative Study on the Role of Health Care Systems in the Increasing Home Births Among Rural Women in Southwestern Uganda. Int J Womens Health 2020; 12:423-434. [PMID: 32547250 PMCID: PMC7266515 DOI: 10.2147/ijwh.s248240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Uganda’s maternal mortality remains unacceptably high, with thousands of women and newborns still dying of preventable deaths from pregnancy and childbirth-related complications. Globally, Antenatal care (ANC) attendance has been associated with improved rates of skilled births. However, despite the fact that over 95% of women in Uganda attend at least one ANC, over 30% of women still deliver at home alone, or in the presence of an unskilled birth attendant, with many choosing to come to hospital after experiencing a complication. We explored barriers to women’s decisions to deliver in a health care facility among postpartum women in rural southwestern Uganda, to ultimately inform interventions aimed at improving skilled facility births. Methods Between December 2018 and March 2019, we conducted in-depth qualitative face-to-face interviews with 30 post-partum women in rural southwestern Uganda. The purposeful sample was intended to represent women with differing experiences of pregnancy, delivery, and antenatal care. We included 15 adult women who had delivered from their homes and 15 who had delivered from a health facility in the previous 3 months. Women were recruited from 10 villages within 20 km of a regional referral hospital. Interviews were conducted and digitally recorded in a private setting by a trained native speaker to elicit experiences of pregnancy and birth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive descriptive categories using an inductive content analytic approach. Results Regardless of where they decided to give birth, women wished to deliver in a supportive, respectful, responsive and loving environment. The data revealed six key barriers to women’s decisions to deliver from a health care facility: 1) Fear of unresponsive care, fueling a fear of being neglected or abandoned while at the facility; 2) fear of embarrassment and mistreatment by health care providers; 3) low perception of risk associated with pregnancy and childbirth; 4) preferences for particular birthing positions and their outcome expectations; 5) perceived lack of privacy in public facilities; and 6) perceived poor clinical and interpersonal skills of health providers to adequately explain birthing procedures or support expectant or laboring women and their newborn. Conclusion Anticipation of unsupportive, unresponsive, disrespectful treatment, and a perceived lack of tolerance for simple, non-harmful traditions prevent women from delivering at health facilities. Building better interpersonal relationships between patients and providers within health systems could reinforce trust, improve patient–provider interaction, and facilitate useful information transfer during ANC and delivery visits. These expectations are important considerations in developing supportive health care systems that provide acceptable patient-friendly care. These findings are indicative of the vital need for midwives and other health care providers to have additional training in the role of communication and dignity in delivery of quality health care.
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Affiliation(s)
- Esther C Atukunda
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Godfrey R Mugyenyi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Angella Musiimenta
- Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Josephine N Najjuma
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edgar Agaba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Norma C Ware
- Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Lynn T Matthews
- Division of Infectious Diseases and Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.,Division of Infectious Disease, University of Alabama at Birmingham, Birmingham, AL, USA
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Leon S, Nakayama M. Exploring factors that influence positive WOM in the health insurance industry. Health Mark Q 2020; 37:176-192. [PMID: 32375013 DOI: 10.1080/07359683.2020.1756124] [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: 10/24/2022]
Abstract
Health insurance companies have an interest in understanding what factors may lead to positive word-of-mouth (WOM) from consumers. This research identifies factors that influence positive WOM about health insurance firms. Using data collected from 425 insurance policy holders, we find influential factors vary depending on the purchase source. Significant factors identified in the study that influence positive word-of-mouth include service quality, plan satisfaction, and plan type (individual vs. family). Further, claim count, preferred information source, and deductible levels also affect the spread of positive WOM differently among purchase sources. The study concludes with a discussion of implications and future research.
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Affiliation(s)
- Steven Leon
- Department of Marketing and SCM, Walker College of Business, Appalachian State University, Boone, NC, USA
| | - Makoto Nakayama
- College of Computing and Digital Media, School of Computing, DePaul University, Chicago, IL, USA
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17
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Quigley DD, Palimaru A, Lerner C, Hays RD. A Review of Best Practices for Monitoring and Improving Inpatient Pediatric Patient Experiences. Hosp Pediatr 2020; 10:277-285. [PMID: 32071119 PMCID: PMC11111154 DOI: 10.1542/hpeds.2019-0243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CONTEXT Achieving high-quality patient-centered care requires assessing patient and family experiences to identify opportunities for improvement. With the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, hospitals can assess performance and make national comparisons of inpatient pediatric experiences. However, using patient and family experience data to improve care remains a challenge. OBJECTIVE We reviewed the literature on best practices for monitoring performance and undertaking activities aimed at improving pediatric patient and family experiences of inpatient care. DATA SOURCES We searched PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO. STUDY SELECTION We included (1) English-language peer-reviewed articles published from January 2000 to April 2019; (2) articles based in the United States, United Kingdom, or Canada; (3) articles focused on pediatric inpatient care; (4) articles describing pediatric patient and family experiences; and (5) articles including content on activities aimed at improving patient and family experiences. Our review included 25 articles. DATA EXTRACTION Two researchers reviewed the full article and abstracted specific information: country, study aims, setting, design, methods, results, Quality Improvement (QI) initiatives performed, internal reporting description, best practices, lessons learned, barriers, facilitators and study implications for clinical practice, patient-experience data collection, and QI activities. We noted themes across samples and care settings. RESULTS We identified 10 themes of best practice. The 4 most common were (1) use evidence-based approaches, (2) maintain an internal system that communicates information and performance on patient and family experiences to staff and hospital leadership, (3) use experience survey data to initiate and/or evaluate QI interventions, and (4) identify optimal times (eg, discharge) and modes (eg, print) for obtaining patient and family feedback. These correspond to adult inpatient best practices. CONCLUSIONS Both pediatric and adult inpatient best practices rely on common principles of culture change (such as evidence-based clinical practice), collaborative learning, multidisciplinary teamwork, and building and/or supporting a QI infrastructure that requires time, money, collaboration, data tracking, and monitoring. QI best practices in both pediatric and adult inpatient settings commonly rely on identifying drivers of overall ratings of care, rewarding staff for successful implementation, and creating easy-to-use and easy-to-access planning and QI tools for staff.
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Affiliation(s)
| | | | - Carlos Lerner
- Division of General Internal Medicine and Health Services Research
- University of California, Los Angeles Mattel Children's Hospital, Los Angeles, California
| | - Ron D Hays
- RAND Corporation, Santa Monica, California
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and
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18
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Feng JY, Toomey SL, Elliott MN, Zaslavsky AM, Onorato SE, Schuster MA. Factors Associated With Family Experience in Pediatric Inpatient Care. Pediatrics 2020; 145:e20191264. [PMID: 32015139 PMCID: PMC7049938 DOI: 10.1542/peds.2019-1264] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hospitals are rapidly increasing efforts to improve the pediatric inpatient experience. However, hospitals often do not know what to target for improvement. To determine what matters most to families, we assessed which aspects of experience have the strongest relationships with parents' willingness to recommend a hospital. METHODS Cross-sectional study of 17 727 surveys completed from November 2012 to January 2014 by parents of children hospitalized at 69 hospitals in 34 states using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. Hierarchical logistic regressions predicted the "top box" for willingness to recommend from measures of specific care dimensions (nurse-parent communication, doctor-parent communication, communication about medicines, keeping parents informed about the child's care, privacy with providers, preparing to leave the hospital, mistakes and concerns, child comfort, cleanliness, and quietness), adjusting for parent-child characteristics. Relative importance was assessed by using partially standardized adjusted odds ratios (aORs). RESULTS Child comfort (aOR 1.50; 95% confidence interval 1.41-1.60) and nurse-parent communication (aOR 1.50; 95% confidence interval 1.42-1.58) showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. Privacy and quietness were not significantly associated with willingness to recommend in multivariate analysis. CONCLUSIONS Our study uncovered highly valued dimensions that are distinct to pediatric care. Hospitals that care for children should consider using dedicated pediatric instruments to measure and track their performance. Improvement efforts should focus on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.
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Affiliation(s)
- Jeremy Y Feng
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts;
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Medicine
| | - Sara L Toomey
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Departments of Pediatrics
| | | | | | - Sarah E Onorato
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Mark A Schuster
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Departments of Pediatrics
- Office of the Dean, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Otani K, Deng Y, Herrmann PA, Kurz RS. Patient Satisfaction, Quality Attributes, and Organizational Characteristics: A Hierarchical Linear Model Approach. J Patient Exp 2019; 7:801-806. [PMID: 33294618 PMCID: PMC7705829 DOI: 10.1177/2374373519892410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Patient satisfaction studies have gained more and more attention, and there are many patient satisfaction studies. These studies assume that patients were selected randomly and independently, but patient satisfaction surveys are described as a multistage or hierarchically structured sample. Thus, there is a need to conduct a hierarchical linear model (HLM) analysis with a large number of hospitals. This study utilized an HLM to investigate both the individual patient-level effect on the overall satisfaction rating and the effect of hospital characteristics on the combining process of patient’s overall satisfaction rating. This study used patient satisfaction data collected from 100 hospitals with the sample size of 85 766. The hospital-level characteristics include total expense per personnel, payroll expense per personnel, number of staffed beds per personnel, and number of admission per personnel. This study found that hospital characteristics influence overall rating of the hospital through the doctor, staff, and room attributes. When considering the complex nature of the overall patient rating process of hospitals, it makes more sense to analyze hospital characteristics that are interacting with attributes rather than treat hospital characteristics as independent of these factors.
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Affiliation(s)
- Koichiro Otani
- Department of Public Policy, Purdue University Fort Wayne, Fort Wayne, IN, USA
| | - Yihao Deng
- Department of Mathematical Sciences, Purdue University Fort Wayne, Fort Wayne, IN, USA
| | | | - Richard S Kurz
- School of Public Health, University of North Texas, Fort Worth, TX, USA
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20
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Martin S, Greiling D, Danninger B. Patient recommendations as determining factor for the choice of physiotherapists. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1681154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sebastian Martin
- Faculty for Medical Engineering and Applied Social Sciences, University of Applied Sciences Upper Austria, Linz, Austria
| | - Dorothea Greiling
- Institut for Management Accounting, Johannes Kepler University Linz, Linz, Austria
| | - Bettina Danninger
- Faculty for Medical Engineering and Applied Social Sciences, University of Applied Sciences Upper Austria, Linz, Austria
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21
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Sillero-Sillero A, Zabalegui A. Safety and satisfaction of patients with nurse's care in the perioperative. Rev Lat Am Enfermagem 2019; 27:e3142. [PMID: 31038636 PMCID: PMC6528624 DOI: 10.1590/1518-8345.2646.3142] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 01/27/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE to investigate the safety and satisfaction of patients and their relationship with nurse's care in the perioperative period. METHOD cross-sectional, multi-level, correlational study with 105 nurses in the surgical area and 150 patients operated in a Spanish tertiary hospital. For the nurses the sociodemographic variables, the perception of the work environment, the professional burnout and the satisfaction in the work were collected. For patients, the safety of adverse events and level of satisfaction, through the application of questionnaires. Univariate and multivariate analysis were used. RESULTS job satisfaction, professional commitment, and participation in hospital issues were negative predictors for adverse events related to the patient, while postoperative nurse care was a positive predictor. CONCLUSION there is an increase in adverse events when nurses are dissatisfied at work, less professional commitment and low availability to participate in the subjects of their unit. On the other hand, adverse events decrease when nurses perform the care in the postoperative period. Satisfaction was good and there was no association with the characteristics of nurses' attention. It is recommended to improve these predictors to increase the safety of surgical patients.
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Peca E, Sandberg J. Modeling the relationship between women's perceptions and future intention to use institutional maternity care in the Western Highlands of Guatemala. Reprod Health 2018; 15:9. [PMID: 29325572 PMCID: PMC5765672 DOI: 10.1186/s12978-017-0448-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 12/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background Despite global gains, women in hard-to-reach areas are at a relatively higher risk of death and disability related to childbirth. Traditional methods of measuring satisfaction may mask negative experiences (such as disrespect and abuse) that can drive down demand for institutional care. Better measurement of women’s perceptions of care quality, especially among marginalized populations with historically low utilization of institutional care, are needed to inform how to improve services and foster greater utilization of (potentially life-saving) clinical care. Methods A population-based household survey was conducted in 15 purposively selected villages in the rural Western Highlands of Guatemala among women who gave birth to a child within the last 5 years. Demographic and health information including experiences and perceptions of maternity care were collected. Two sets of nested multivariate logistic regression models were estimated to identify factors associated with future intention to give birth in a health facility, separately among women who gave birth to their last child at home and women who gave birth to their last child in a facility. The independent variables of interest were access to care, perceived need for maternity care, and two measures of perceived quality: satisfaction with last birth and disrespect and abuse (perceived or experienced). Thematic analysis was performed on open-ended responses. Results Perceived need for facility-based childbirth services and satisfaction with last childbirth experience, either at home or in a facility, emerged as the key factors influencing intention to give birth in a health institution in the future. Among the facility birth group, reporting disrespect and abuse is a deterrent to seeking facility-based care in the future. However, select perceptions of disrespect and abuse did not have an association with future intention (among the home birth group). Conclusions Women’s perceptions of care quality influence care-seeking. Women who feel they were mistreated in health facilities are more likely to avoid or delay seeking care in the future. Health systems need to reinforce trust and positive perceptions of respectful care. Developing better measures of women’s perceptions of maternity care experiences among indigenous populations in Guatemala can inform improvements in care provision.
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Affiliation(s)
- Emily Peca
- University Research Co., LLC, 5404 Wisconsin Avenue, Suite 800, Chevy Chase, MD, 20815-3594, USA.
| | - John Sandberg
- Milken Institute School of Public Health, Department of Global Health, The George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20052, USA
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Martin S, Greiling D, Leibetseder N. Effects of word-of-mouth on the behavior of Austrian blood donors: a case study of the Red Cross Blood Donation Service. Health Promot Int 2017; 34:429-439. [DOI: 10.1093/heapro/dax086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Summary
The procurement of blood is an essential challenge of today’s health care. Current studies emphasize the influence of word-of-mouth (WOM) on health care behavior, including blood donation. Still, there exists no study which systematically investigates how WOM affects the behavior of blood donors. Therefore, this paper aims to contribute to this lack of research by focusing on Austrian blood donors as possible receivers and senders of WOM. A survey was distributed to 300 donors of the Austrian Red Cross with a return of 245 surveys. The results highlight the strong influence of WOM on the awareness of the blood service and the willingness to donate blood. Further, structured and organized procedures, friendly employees and respectful interaction were found to be important factors determining willingness to recommend blood donation. Family members as well as friends are the preferred WOM-receivers and the personal face-to-face contact is the favored channel of communication. The results also show that WOM-behavior is strongly influenced by factors such as age, gender and donation frequency. By helping blood bank managers to better understand how WOM affects donation intention and behavior, this study provides a new approach to attract blood donors.
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Affiliation(s)
- Sebastian Martin
- Faculty for Health and Social Sciences, University of Applied Sciences Upper Austria, Garnisonstrasse 21, 4020 Linz, Austria
| | - Dorothea Greiling
- Institut for Management Accounting, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Nina Leibetseder
- Brothers of Saint John of God – Hospital Linz, Seilerstätte 2, 4021 Linz, Austria
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24
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A Hospital Recommendation System Based on Patient Satisfaction Survey. APPLIED SCIENCES-BASEL 2017. [DOI: 10.3390/app7100966] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Toomey SL, Elliott MN, Zaslavsky AM, Klein DJ, Ndon S, Hardy S, Wu M, Schuster MA. Variation in Family Experience of Pediatric Inpatient Care As Measured by Child HCAHPS. Pediatrics 2017; 139:peds.2016-3372. [PMID: 28330970 PMCID: PMC5369678 DOI: 10.1542/peds.2016-3372] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey to address this gap. Using Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, we measured performance of hospitals in a national field test. METHODS We analyzed 17 727 surveys completed from December 2012 to February 2014 by parents of children (<18 years) hospitalized at 69 hospitals in 34 states. For each of 18 survey measures, we calculated a case-mix-adjusted hospital "top-box" score (ie, percentage of respondents selecting the most positive response option). We quantified variation across hospitals by estimating hospital-level SDs for each item with a hierarchical linear probability model. We examined associations of family experience with patient, parent, and hospital characteristics. We compared aggregate performance on each measure across participating hospitals. RESULTS Mean hospital top-box scores ranged from 55% ("Preventing mistakes and helping you report concerns") to 84% ("Keeping you informed about your child's care in the emergency department"). The mean for overall rating of hospital stay was 73% (SD 7%). "Quietness of hospital room" scores varied most across hospitals (SD 8%). Overall top-box scores were higher for freestanding children's hospitals (74%) and children's hospitals within a hospital (73%) than for pediatric wards within hospitals (68%, P = .007). CONCLUSIONS Family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
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Affiliation(s)
- Sara L. Toomey
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts;,Pediatrics, Harvard Medical School, Boston, Massachusetts; and
| | | | | | - David J. Klein
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Sifon Ndon
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Shannon Hardy
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Melody Wu
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Mark A. Schuster
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts;,Pediatrics, Harvard Medical School, Boston, Massachusetts; and
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Janisse T, Tallman K. Can All Doctors Be Like This? Seven Stories of Communication Transformation Told by Physicians Rated Highest by Patients. Perm J 2017; 21:16-097. [PMID: 28333605 DOI: 10.7812/tpp/16-097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The top predictors of patient satisfaction with clinical visits are the quality of the physician-patient relationship and the communications contributing to their relationship. How do physicians improve their communication, and what effect does it have on them? This article presents the verbatim stories of seven high-performing physicians describing their transformative change in the areas of communication, connection, and well-being. METHODS Data for this study are based on interviews from a previous study in which a 6-question set was posed, in semistructured 60-minute interviews, to 77 of the highest-performing Permanente Medical Group physicians in 4 Regions on the "Art of Medicine" patient survey. Transformation stories emerged spontaneously during the interviews, and so it was an incidental finding when some physicians identified that they were not always high performing in their communication with patients. RESULTS Seven different modes of transformation in communication were described by these physicians: a listening tool, an awareness course, finding new meaning in clinical practice, a technologic tool, a sudden insight, a mentor observation, and a physician-as-patient experience. DISCUSSION These stories illustrate how communication skills can be learned through various activities and experiences that transform physicians into those who are highly successful communicators. All modes result in a change of state-a new way of seeing, of being-and are not just a new tool or a new practice, but a change in state of mind. This state resulted in a marked change of behavior, and a substantial improvement of communication and relationship.
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Affiliation(s)
- Tom Janisse
- Editor-in-Chief of The Permanente Journal and Publisher of The Permanente Press.
| | - Karen Tallman
- Research Consultant for the Center for Care Experience, Care Management Institute and The Permanente Federation in Oakland, CA.
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Liu W, Shi L, Pong RW, Chen Y. How patients think about social responsibility of public hospitals in China? BMC Health Serv Res 2016; 16:371. [PMID: 27515063 PMCID: PMC4982228 DOI: 10.1186/s12913-016-1621-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 08/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospital social responsibility is receiving increasing attention, especially in China where major changes to the healthcare system have taken place. This study examines how patients viewed hospital social responsibility in China and explore the factors that influenced patients' perception of hospital social responsibility. METHODS A cross-sectional survey was conducted, using a structured questionnaire, on a sample of 5385 patients from 48 public hospitals in three regions of China: Shanghai, Hainan, and Shaanxi. A multilevel regression model was employed to examine factors influencing patients' assessments of hospital social responsibility. Intra-class correlation coefficients (ICCs) were calculated to estimate the proportion of variance in the dependent variables determined at the hospital level. RESULTS The scores for service quality, appropriateness, accessibility and professional ethics were positively associated with patients' assessments of hospital social responsibility. Older outpatients tended to give lower assessments, while inpatients in larger hospitals scored higher. After adjusted for the independent variables, the ICC rose from 0.182 to 0.313 for inpatients and from 0.162 to 0.263 for outpatients. The variance at the patient level was reduced by 51.5 and 48.6 %, respectively, for inpatients and outpatients. And the variance at the hospital level was reduced by 16.7 % for both groups. CONCLUSIONS Some hospital and patient characteristics and their perceptions of service quality, appropriateness, accessibility and professional ethics were associated with their assessments of public hospital social responsibility. The differences were mainly determined at the patient level. More attention to law-abiding behaviors, cost-effective health services, and charitable works could improve perceptions of hospitals' adherence to social responsibility.
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Affiliation(s)
- Wenbin Liu
- School of Public Health, Key Lab of Health Technology Assessment (Ministry of Health), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 197 Mailbox, 138 Yixueyuan Road, Xuhui District, Shanghai, 200032 China
| | - Lizheng Shi
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112 USA
| | - Raymond W. Pong
- Centre for Rural and Northern Health Research and Northern Ontario School of Medicine, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - Yingyao Chen
- School of Public Health, Key Lab of Health Technology Assessment (Ministry of Health), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 197 Mailbox, 138 Yixueyuan Road, Xuhui District, Shanghai, 200032 China
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Slater JK, Braverman MT, Meath T. Patient satisfaction with a hospital’s arts-enhanced environment as a predictor of the likelihood of recommending the hospital. Arts Health 2016. [DOI: 10.1080/17533015.2016.1185448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yavas U, Babakus E, Westbrook KW, Grant CC, Deitz GD, Rafalski E. An Investigation of Service Quality—Willingness to Recommend Relationship across Patient and Hospital Characteristics. JOURNAL OF HEALTH MANAGEMENT 2016. [DOI: 10.1177/0972063415625508] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigates onto which dimensions of service quality have more impact on patients’ overall quality perceptions of a hospital and seeks to determine the nature of relationship between service quality and patients’ willingness to recommend a hospital to their friends and family. The study also uncovers if the levels of service quality and recommendation behaviours and the relationship between service quality and recommendation behaviour exhibit similar patterns among male versus female, black versus white patients and small/medium versus large hospitals. Data gathered via mail questionnaires and phone interviews from a large sample of the patients of a hospital system in the Southern United States serve as the study setting. Results are presented and their implications are discussed. Avenues for future research are offered.
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Affiliation(s)
- Ugur Yavas
- Professor of Marketing and Advisory Board Faculty Fellow, Department of Management and Marketing, East Tennessee State University, Johnson City, TN, United States
| | - Emin Babakus
- Professor of Marketing and George Johnson Research Fellow, Department of Marketing & Supply Chain Management, The University of Memphis, Memphis, TN, United States
| | - Kevin W. Westbrook
- Professor of Marketing, McAfee School of Business Administration, Union University, Germantown, TN, United States
| | | | - George D. Deitz
- Associate Professor of Marketing, Department of Marketing & Supply Chain Management, The University of Memphis, Memphis, TN, United States
| | - Ed Rafalski
- Affiliate Research Professor, School of Public Health, University of Memphis, Memphis, TN, United States
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Goh ML, Ang ENK, Chan YH, He HG, Vehviläinen-Julkunen K. A descriptive quantitative study on multi-ethnic patient satisfaction with nursing care measured by the Revised Humane Caring Scale. Appl Nurs Res 2016; 31:126-31. [PMID: 27397830 DOI: 10.1016/j.apnr.2016.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/25/2015] [Accepted: 02/13/2016] [Indexed: 10/22/2022]
Abstract
AIM To determine patients' satisfaction with nursing care during hospitalization. BACKGROUND Limited studies reporting patients' satisfaction with quality of nursing care in Singapore. METHOD A descriptive study was conducted in a tertiary hospital in Singapore. RESULTS Data were collected from 270 adult patients using the Revised Humane Caring Scale. Patients were moderately satisfied with the nursing care. There were significant differences of patients' level of satisfaction between/among socio-demographic subgroups including ethnicity, gender, reasons for admission and disciplines. Chinese patients were least satisfied with nursing care. The patients were most satisfied with 'Respecting patient's feeling' (mean=82.29, SD=14.50) and least satisfied with 'Communication and participation' (mean=62.00, SD=16.46). CONCLUSION Our results reinforced the need to pay more attention to patient information provision and effective communication, which could improve patient satisfaction. The multi-ethnic patients valued respect as an influential attribute in quality nursing care.
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Affiliation(s)
- Mien Li Goh
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Finland; Evidence Based Nursing Unit, National University Hospital, Singapore.
| | - Emily N K Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National University Cancer Institute Singapore, National University Health System, Singapore
| | - Yiong-Huak Chan
- Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland; Kuopio University Hospital, Kuopio, Finland
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Women's Satisfaction of Maternity Care in Nepal and Its Correlation with Intended Future Utilization. Int J Reprod Med 2015; 2015:783050. [PMID: 26640814 PMCID: PMC4657080 DOI: 10.1155/2015/783050] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/14/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022] Open
Abstract
The impact of rapid increase in institutional birth rate in Nepal on women's satisfaction and planned future utilization of services is less well known. This study aimed to measure women's satisfaction with maternity care and its correlation with intended future utilisation. Data came from a nationally representative facility-based survey conducted across 13 districts in Nepal and included client exit interviews with 447 women who had either recently delivered or had experienced complications. An eight-item quality of care instrument was used to measure client satisfaction. Multivariate probit model was used to assess the attribution of different elements of client satisfaction with intended future utilization of services. Respondents were most likely to suggest maintaining clean/hygienic health facilities (42%), increased bed provision (26%), free services (24%), more helpful behaviour by health workers (18%), and better privacy (9%). Satisfaction with the information received showed a strong correlation with the politeness of staff, involvement in decision making, and overall satisfaction with the care received. Satisfaction with waiting time (p = 0.035), information received (p = 0.02), and overall care in the maternity care (<0.001) showed strong associations with willingness to return to facility. The findings suggest improving physical environment and interpersonal communication skills of service providers and reducing waiting time for improving client satisfaction and intention to return to the health facility.
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Lake ET, Germack HD, Viscardi MK. Missed nursing care is linked to patient satisfaction: a cross-sectional study of US hospitals. BMJ Qual Saf 2015; 25:535-43. [PMID: 26376673 DOI: 10.1136/bmjqs-2015-003961] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/25/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND As nurses are the principal care provider in the hospital setting, the completion or omission of nursing care is likely to have a sizable impact on the patient care experience. However, this relationship has not been explored empirically. AIM To describe the prevalence and patterns of missed nursing care and explore their relationship to the patient care experience. METHODS This cross-sectional study used secondary nurse and patient survey data from 409 adult non-federal acute care US hospitals in four states. Descriptive statistics were calculated and linear regression models were conducted at the hospital level. Regression models included controls for hospital structural characteristics. RESULTS In an average hospital, nurses missed 2.7 of 12 required care activities per shift. Three-fourths (73.4%) of nurses reported missing at least one activity on their last shift. This percentage ranged from 25 to 100 across hospitals. Nurses most commonly reported not being able to comfort or talk with patients (47.6%) and plan care (38.5%). 6 out of 10 patients rated hospitals highly. This proportion ranged from 33% to 90% across hospitals. At hospitals where nurses missed more care (1 SD higher=0.74 items), 2.2% fewer patients rated the hospital highly (p<0.001); a coefficient equivalent to a one-quarter SD change. CONCLUSIONS Missed nursing care is common in US hospitals and varies widely. Most patients rate their hospital care experience highly, but this also varies widely across hospitals. Patients have poorer care experiences in hospitals where more nurses miss required nursing care. Supporting nurses' ability to complete required care may optimise the patient care experience. As hospitals face changing reimbursement landscapes, ensuring adequate nursing resources should be a top priority.
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Affiliation(s)
- Eileen T Lake
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hayley D Germack
- Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Abstract
Professionalism is a core competency of physicians. Clinical knowledge and skills (and their maintenance and improvement), good communication skills, and sound understanding of ethics constitute the foundation of professionalism. Rising from this foundation are behaviors and attributes of professionalism: accountability, altruism, excellence, and humanism, the capstone of which is professionalism. Patients, medical societies, and accrediting organizations expect physicians to be professional. Furthermore, professionalism is associated with better clinical outcomes. Hence, medical learners and practicing physicians should be taught and assessed for professionalism. A number of methods can be used to teach professionalism (e.g. didactic lectures, web-based modules, role modeling, reflection, interactive methods, etc.). Because of the nature of professionalism, no single tool for assessing it among medical learners and practicing physicians exists. Instead, multiple assessment tools must be used (e.g. multi-source feedback using 360-degree reviews, patient feedback, critical incident reports, etc.). Data should be gathered continuously throughout an individual's career. For the individual learner or practicing physician, data generated by these tools can be used to create a "professionalism portfolio," the totality of which represents a picture of the individual's professionalism. This portfolio in turn can be used for formative and summative feedback. Data from professionalism assessments can also be used for developing professionalism curricula and generating research hypotheses. Health care leaders should support teaching and assessing professionalism at all levels of learning and practice and promote learning environments and institutional cultures that are consistent with professionalism precepts.
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Affiliation(s)
- Paul S. Mueller
- Consultant, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Professor of Medicine and Professor of Biomedical Ethics at the Mayo Clinic College of Medicine, Rochester, MN, USA; Associate Editor of NEJM Journal Watch General Medicine
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Harris N, Badr LK, Saab R, Khalidi A. Caregivers' perception of drug administration safety for pediatric oncology patients. J Pediatr Oncol Nurs 2014; 31:95-103. [PMID: 24569227 DOI: 10.1177/1043454213517749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Medication errors (MEs) are reported to be between 1.5% and 90% depending on many factors, such as type of the institution where data were collected and the method to identify the errors. More significantly, the risk for errors with potential for harm is 3 times higher for children, especially those receiving chemotherapy. Few studies have been published on averting such errors with children and none on how caregivers perceive their role in preventing such errors. The purpose of this study was to evaluate pediatric oncology patient's caregivers' perception of drug administration safety and their willingness to be involved in averting such errors. A cross-sectional design was used to study a nonrandomized sample of 100 caregivers of pediatric oncology patients. Ninety-six of the caregivers surveyed were well informed about the medications their children receive and were ready to participate in error prevention strategies. However, an underestimation of potential errors uncovered a high level of "trust" for the staff. Caregivers echoed their apprehension for being responsible for potential errors. Caregivers are a valuable resource to intercept medication errors. However, caregivers may be hesitant to actively communicate their fears with health professionals. Interventions that aim at encouraging caregivers to engage in the safety of their children are recommended.
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Koné Péfoyo AJ, Wodchis WP. Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis. BMC Res Notes 2013; 6:509. [PMID: 24304888 PMCID: PMC3867627 DOI: 10.1186/1756-0500-6-509] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient satisfaction in health care constitutes an important component of organizational performance in the hospital setting. Satisfaction measures have been developed and used to evaluate and improve hospital performance, quality of care and physician practice. In order to direct improvement strategies, it is necessary to evaluate both individual and organizational factors that can impact patients' perception of care. The study aims were to determine the dimensions of patient satisfaction, and to analyze the individual and organizational determinants of satisfaction dimensions in hospitals. METHODS We used patient and hospital survey data as well as administrative data collected for a 2008 public hospital report in Ontario, Canada. We evaluated the clustering of patient survey items with exploratory factor analysis and derived plausible dimensions of satisfaction. A two-level multivariate model was fitted to analyze the determinants of satisfaction. RESULTS We found eight satisfaction factors, with acceptable to good level of loadings and good reliability. More than 95% of variation in patient satisfaction scores was attributable to patient-level variation, with less than 5% attributable to hospital-level variation. The hierarchical models explain 5 to 17% of variation at the patient level and up to 52% of variation between hospitals. Individual patient characteristics had the strongest association with all dimensions of satisfaction. Few organizational performance indicators are associated with patient satisfaction and significant determinants differ according to the satisfaction dimension. CONCLUSIONS The research findings highlight the importance of adjusting for both patient-level and organization-level characteristics when evaluating patient satisfaction. Better understanding and measurement of organization-level activities and processes associated with patient satisfaction could contribute to improved satisfaction ratings and care quality.
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Affiliation(s)
- Anna J Koné Péfoyo
- Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, 155 College St, 4th floor, Toronto, ON M5T 3 M6, Canada.
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Ford EW, Huerta TR, Diana ML, Kazley AS, Menachemi N. Patient satisfaction scores and their relationship to hospital website quality measures. Health Mark Q 2013; 30:334-348. [PMID: 24308412 DOI: 10.1080/07359683.2013.844041] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Hospitals and health systems are using web-based and social media tools to market themselves to consumers with increasingly sophisticated strategies. These efforts are designed to shape the consumers' expectations, influence their purchase decisions, and build a positive reputation in the marketplace. Little is known about how these web-based marketing efforts are taking form and if they have any relationship to consumers' satisfaction with the services they receive. The purpose of this study is to assess if a relationship exists between the quality of hospitals' public websites and their aggregated patient satisfaction ratings. Based on analyses of 1,952 U.S. hospitals, our results show that website quality is significantly and positively related to patients' overall rating of the hospital and their intention to recommend the facility to others. The potential for web-based information sources to influence consumer behavior has important implications for policymakers, third-party payers, health care providers, and consumers.
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Affiliation(s)
- Eric W Ford
- a University of North Carolina Greensboro , Greensboro , North Carolina
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