National Patient Experience Survey Research Articles

The road to patient experience of care measurement: lessons from the United States

Patient-centered care has become an increasing priority in the United States and plays a prominent role in recent healthcare reforms. One way the country has managed to advance patient-centered care is through establishment of a family of national patient experience surveys (the Consumer Assessment of Healthcare Providers and Systems Plans (CAHPS). CAHPS is publicly reported for several types of providers and was recently tied to hospital reimbursement. This is part of a trend over the last two decades that has shifted provider-patient relationships from a traditional paternal approach to customer service and then to clinical partnership. The health care system in Israel, however, is still struggling to overcome barriers to change in this area. While community based biannual patient experience surveys are conducted by the Myers-JDC-Brookdale Institute, there is no comprehensive national approach to measuring the patient experience across a broad range of settings. Only recently did the Israeli Ministry of Health take its first steps to include patient experience as a dimension of health care quality.In its current position, Israel should learn from the U.S. experience with policies promoting patient-centered care, and specifically the impact on clinical services of measuring the patient experience. Looking at what has happened in the United States, we suggest three main lessons. First, there is a need for a set of national patient experience surveys that would be publicly reported and eventually tied to provider reimbursement. Secondly, the national survey tools should be customized to the unique characteristics of Israeli society and draw from recent research on patient-centeredness to include new and important domains such as patient activation and shared decision-making. Finally, newer technological approaches should be explored with the aim of increasing response rates and the timeliness and usefulness of the surveys.

The Patient-Reported Incident in Hospital Instrument (PRIH-I): assessments of data quality, test–retest reliability and hospital-level reliability

BackgroundThe objective of this study was to test the data quality, test–retest reliability and hospital-level reliability of the Patient-Reported Incident in Hospital Instrument (PRIH-I).Methods13 incident questions were included in a...

Classification of patients based on their evaluation of hospital outcomes: cluster analysis following a national survey in Norway

BackgroundA general trend towards positive patient-reported evaluations of hospitals could be taken as a sign that most patients form a homogeneous, reasonably pleased group, and consequently that there is little need for quality improvement. The objective of this study was to explore this assumption by identifying and statistically validating clusters of patients based on their evaluation of outcomes related to overall satisfaction, malpractice and benefit of treatment.MethodsData were collected using a national patient-experience survey of 61 hospitals in the 4 health regions in Norway during spring 2011. Postal questionnaires were mailed to 23,420 patients after their discharge from hospital. Cluster analysis was performed to identify response clusters of patients, based on their responses to single items about overall patient satisfaction, benefit of treatment and perception of malpractice.ResultsCluster analysis identified six response groups, including one cluster with systematically poorer evaluation across outcomes (18.5% of patients) and one small outlier group (5.3%) with very poor scores across all outcomes. One-Way ANOVA with post-hoc tests showed that most differences between the six response groups on the three outcome items were significant. The response groups were significantly associated with nine patient-experience indicators (p < 0.001), and all groups were significantly different from each of the other groups on a majority of the patient-experience indicators. Clusters were significantly associated with age, education, self-perceived health, gender, and the degree to write open comments in the questionnaire.ConclusionsThe study identified five response clusters with distinct patient-reported outcome scores, in addition to a heterogeneous outlier group with very poor scores across all outcomes. The outlier group and the cluster with systematically poorer evaluation across outcomes comprised almost one-quarter of all patients, clearly demonstrating the need to tailor quality initiatives and improve patient-perceived quality in hospitals. More research on patient clustering in patient evaluation is needed, as well as standardization of methodology to increase comparability across studies.

Most practice nurses are aged over 50

Nurses specialising in lung cancer care are overstretched, with a ratio of only one nurse to every 122 patients in England, according to an expert review. A report by the United Kingdom Lung Cancer Coalition (UKLCC), made up of charities, senior NHS professionals and healthcare companies, points out more people die of the disease than any other type of cancer, yet lung cancer has the second lowest ratio of nurse specialists to patients. In comparison, it states there is one nurse specialist to every 79 breast cancer patients. The report contains 30 recommendations, including four that affect nurses directly: All lung cancer patients should be able to access nurse specialist support and advocacy. Lung cancer nurse specialists should be involved with pre-diagnosis care of suspected lung cancer patients. Lung cancer nurse specialists need to work closely with multidisciplinary team co-ordinators, trackers and audit staff to ensure they are not taking on unnecessary administrative roles. Despite the financial pressures facing the NHS, the role of the lung cancer nurse specialist must be protected. National Lung Cancer Forum for Nurses chair and nurse specialist John White said the report’s findings echo the results of a snapshot survey of forum members last year. This revealed that all believed their specialist role was under pressure. ‘Our members said they had been asked to work on the wards to relieve winter pressures,’ he added. ‘We are hoping that the UKLCC report will confirm to commissioners how vital we are.’ He added that the National Patient Experience Survey 2011/12 found that patients who had seen a cancer nurse specialist were more likely to report a good experience of care than those who had not. Macmillan Cancer Support head of policy Duleep Allirajah said the charity welcomed the report. ‘For too long lung cancer has been one of the most overlooked cancers, despite being the UK’s biggest cancer killer.’ To read the UKLCC report go to tiny.cc/Dream_MDT WORLD IN BRIEF

Overall patient satisfaction with hospitals: effects of patient-reported experiences and fulfilment of expectations

BackgroundPatient satisfaction and experiences are important parts of healthcare quality, but patient expectations are seldom included in quality assessments. The objective of this study was to estimate the effects of...

Patient satisfaction with preoperative assessment in a preoperative assessment testing clinic.

Preoperative Assessment Testing Clinics (PATCs) coordinate preoperative surgical, anesthesia, nursing, and laboratory care. Although such clinics have been noted to lead to efficiencies in perioperative care, patient experience and satisfaction with PATCs has not been evaluated. We distributed a one-page questionnaire consisting of satisfaction with clinical and nonclinical providers to patients presenting to our PATC over three different time periods. Eighteen different questions had five Likert scale options that ranged from excellent (5) to poor (1). We achieved a 71.4% collection rate. The average for the subscale that indicated overall satisfaction was 4.48 +/- 0.67 and the average for the total instrument was 4.46 +/- 0.55. Although the highest scores were given for subscales describing the anesthesia, nurse, and lab, only the anesthesia subscale improved with time (P = 0.007). The subscale that involved information and communication had the highest correlation with the overall satisfaction subscale (r = 0.76; P < 0.0001). The satisfaction with the total duration of the clinic visit (3.71 +/- 1.26) was significantly less (P < 0.0001) than the satisfaction to the other items. The authors conclude that the practitioner and functional aspects of the preoperative visit have a significant impact on patient satisfaction, with information and communication versus the total amount of time spent being the most positive and negative components, respectively. Patient satisfaction can serve as an important indicator of the quality of preoperative care delivered in Preoperative Assessment Testing Clinics (PATC). Information and communication, both from clinical and nonclinical service providers, remain the most important positive components, and the total duration of the clinic visit represents the most negative component, of patient satisfaction in a PATC.