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Industry: Email Alert RSS FeedUsing public reports of patient satisfaction for hospital quality improvement
Health Services Research, June, 2006 by Judith K. Barr, Tierney E. Giannotti, Shoshanna Sofaer, Cathy E. Duquette, William J. Waters, Marcia K. Petrillo
A standardized patient satisfaction survey was administered by a single vendor, selected by a group consisting of hospitals and key stakeholders and approved by the Steering Committee (Barr et al. 2002). The satisfaction survey instrument, sampling methodology, and data collection procedures were uniform across all hospitals (except the psychiatric facility). The survey questionnaires were mailed shortly after discharge to adult patients with an overnight stay who received medical, surgical, or obstetrical services in general hospitals and the rehabilitation hospital; the instrument was handed to patients in the psychiatric hospital at discharge to protect confidentiality. The questionnaire asked patients about their satisfaction with hospital care in nine domains (total 56 items) of care: nursing care (n = 11); physician care (n = 8); treatment results (n = 5); patient education, including discharge instructions (n = 5); comfort/cleanliness (n = 5); admitting (n = 4); other staff courtesy (n = 9); food service (n = 6); and patient loyalty (n = 3). This last domain is a measure of general satisfaction that is composed of overall opinion, willingness to return, and likelihood of recommending the hospital. A summary domain, overall patient experience, was calculated as an average of the nine survey domains. The public report displayed each hospital's performance on the nine domains and the summary domain, expressed as ratings of above, below, or about the same as the average score of hospitals in the vendor's national database. These ratings were presented in a comparative format for hospitals in RI. The hospitals received detailed data (e.g., percentage scores) from the vendor on each survey item, as well as on the domains used for public reporting. For complete details on the survey instrument and methodology, see the Technical Report (Rhode Island Department of Health 2001b).
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Data Collection
This study relied on data from in-depth retrospective interviews conducted with key hospital staff. Using a semi-structured interview protocol with a preponderance of open-ended questions, we asked respondents to report on QI activities at the beginning of the public reporting process for patient satisfaction, following the initial pilot survey that was not publicly reported and, finally, after the release of the first public report in November 2001 (Rhode Island Department of Health 2001a; Barr et al. 2002). Specifically, we asked them to describe QI activities related to patient satisfaction that occurred in response to the pilot survey and the public report. Other questions focused on how the hospital was organized to identify, implement, and monitor QI activities. Two members of the research team conducted the interviews between September 2002 and January 2003, approximately 1 year after release of the public report on patient satisfaction in hospitals. This approach is consistent with studies of retrospective methods of assessing change through self-reports, which have shown that retrospective interviews may result in a more accurate picture than comparing self-reports before and after to measure change (Levinson, Gordon, and Skeff 1990).
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