Gotta Keep the (Healthcare) Customer Satisfied

Friday, October 31st, 2008
This post was written by Melanie Matthews

Rating the cleanliness of sleeping areas and bathrooms and nighttime noise levels may seem the stuff of hotel satisfaction surveys. In fact, hospital patients across the country are asked to evaluate these areas — along with pain management, communication and discharge processes — as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Consumers can access patient satisfaction reviews from this national, standardized survey of hospital patient experiences at the Hospital Compare Web site.

And if you believe that clinical excellence is the one true path to improved care delivery, think again. A new study of HCAHPS data has determined a direct link between patient satisfaction and the quality of care, suggesting that the aims of providing patient-centered care and ensuring high clinical standards can be met simultaneously.

In a study funded by The Commonwealth Fund and the Robert Wood Johnson Foundation, researchers from Harvard School of Public Health assessed the performance of 2,429 hospitals across multiple domains of patients’ experiences—including communication, quality of nursing services and pain management—comparing HCAHPS patient survey data from July 2006 to July 2007 with data from the Hospital Quality Alliance and the American Hospital Association.

They found that patients have moderately high levels of satisfaction with their care, and that the quality of clinical care and certain hospital characteristics, such as a higher ratio of nurses to patient-days, were associated with greater patient satisfaction.

Key areas for improvement: nursing care, communication about medications, pain control, and provision of clear discharge instructions.

Other key findings:

  • On average, 63 percent of patients responding to the HCAHPS survey gave their care a high overall rating (9 or 10, on a scale of 0 to 10); another 26 percent rated care as 7 or 8. Only 11 percent rated care as 6 or lower.
  • Sixty-seven percent of patients said they would definitely recommend the hospital in which they received care, and another 27 percent said they would probably recommend the hospital.
  • The ratio of nurses to patient-days was associated with patients’ satisfaction: a larger percentage of patients in hospitals placing in the top quartile of nurses-to-patient-days ratio gave their hospital a 9 or 10 rating, compared with patients in bottom-quartile hospitals (66% vs. 61%).
  • Fewer patients in for-profit hospitals gave a 9 or 10 rating than patients in either private or public nonprofit hospitals (59% vs. 65% and 65%, respectively).
  • Patients’ satisfaction with care was associated with quality of clinical care for four conditions: acute myocardial infarction, congestive heart failure, pneumonia, and prevention of surgical complications.
  • Patients’ satisfaction ranged widely across regions: 72 percent of patients in Birmingham, Ala., gave 9 or 10 ratings, compared with 50 percent of patients in East Long Island, N.Y.
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