Responsiveness Of Hospital Staff Research Articles

EVALUATION OF PATIENT SATISFACTION IN INPATIENT DEPARTMENT OF A SECONDARY LEVEL HOSPITAL OF SOUTH KASHMIR

INTRODUCTION: This study was undertaken to evaluate patient satisfaction in inpatient departments of a secondary level hospital in South Kashmir, J&K. The experience in the inpatient units in District Hospital Shopian and the able guidance and unstinted encouragement by the supervisory guide motivated the investigator to undertake this study. The review of related literature helped the investigator to get a clear concept about the research topic. METHODOLOGY: For this study the latest edition of HCAHPS Survey Questionnaire (Revised March 2022) was used as the research tool. The information from the patients on various aspects of patient’s satisfaction like communication with doctors and nurses, assistance and responsiveness of hospital staff, cleanliness and quietness of the hospital environment, communication about medicines, discharge information, overall rating of the hospital, willingness to recommend the hospital and biodata was obtained by interview with patients based on the HCAHPS questionnaire proforma. Data collection was done from the month of March 2022 to June 2022, analyzed and interpreted using descriptive and inferential statistics.The cleanliness of the toilets and hospital rooms was not optimal for the patients and needs to be improved. Although it may be done thrice a day and housekeeping staff is posted in all the wards round the clock in sufficient numbers to maintain the cleanliness of the wards/toilets, frequent and surprise checks by housekeeping executives and administrators will instill a sense of responsibility and alertness among housekeeping staff. The timing for activities like nursing, cleaning, ward rounds should be fixed, so that the patient is mentally prepared for the same and can take rest at other time and they should be regularly trained and sensitized about how to improve their image and behavior.The patients went home directly after surgery without going to a skilled nursing facility. Developing skilled nursing facilities as a transitional place between the hospital and patients’ homes could increase patient satisfaction and decrease the duration of stays at the hospital.In comparable settings, if care providers wish to improve the quality of health services from apatients’ perspective, they should give priority to provide the explanations and instructions in the discharge notes in writing about what symptoms or health problems to look out for after they left the hospital.Moreover, the patients should always be given clear explanations about the indications and side effects of the new medications.Sufficient number of nursing aids and other staff should be made available who would assist the patients in getting to the bathroom or in using a bedpan as soon as wanted by them.
 Since this study shows the satisfaction level above the average in the IPD of District Hospital Shopian, in future a study can be conducted on OPD to check the level of satisfaction and relate the satisfaction level with the IPD. Conclusion: Feedback of patients is one of the key parameters in assessing the quality of hospitals. Patient satisfaction is mainly achieved by a patient-centered approach that focuses on a proper understanding and involvement of the patient in the provided care.

Adaptation of a Lean Tool Across Surgical Units to Improve Patient Experience.

High reliability organizations (HROs) sustain consistently excellent outcomes over time. Health care systems need to eliminate major quality failures to become reliable. Practice variations, unstructured leader rounds, and unfavorable patient experience outcomes with Responsiveness of Hospital Staff prompted leaders to adopt Kamishibai cards (K-cards). Evidence-based practices (EBPs) such as timeliness of answering call lights, purposeful rounding, communication, and engaging patients were used to develop Responsiveness K-cards. Responsiveness K-cards established standard work for staff responsiveness and audited process compliance. Findings determined what areas needed improvement, and leaders engaged frontline staff in practice changes. Percentile rank for Responsiveness of Hospital Staff had a sustained increase. Four of 6 hospital units using Responsiveness K-cards achieved 80% rank or better in every patient experience domain for the entire fiscal year. K-cards use HRO principles to standardize practice and improve outcomes. They encourage continuous improvement, which supports the sustainability of EBPs.

Patient Satisfaction with a Tertiary Hospital in Egypt using a HCAHPS-Derived Survey.

Study DesignRetrograde cross-sectional study.ObjectiveTo assess patient satisfaction and outcomes in polytraumatized patients in EL-Demerdash hospital.BackgroundThis is the first study that assessed patient satisfaction with a tertiary hospital in Egypt. Ain Shams University Surgery Hospital, which is one of the largest hospitals in Egypt and serves millions of patients each year, was the site of the study.MethodsA version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to query 361 patients from November 2015 until July 2018 Survey questions were divided into the following categories: communication with doctors, responsiveness of hospital staff, cleanliness of the hospital environment, quietness of the hospital environment, pain management, communication about medicines, discharge information, overall rating of the hospital, and willingness to recommend the hospital.ResultsA total of 361 patients were interviewed. The results showed both positive and negative levels of satisfaction. The positive results included no delay in admission, friendly staff including nurses and doctors, better patient outcomes regarding pain management and adverse side effects, and the overall rating of the hospital was good, which reflected patient satisfaction. The negative findings were lack of proper communication between the medical staff and patients. Patients indicated they did not get a satisfactory explanation of their prescribed drug doses and drug adverse effects. In addition, they did not get enough instruction on what to do after being released from the hospital.ConclusionThe medical staff at Ain Shams University Surgery Hospital should focus more on the patient’s own preferences and communicate better with patients. We recommended that the hospital organize regular communication skills courses for medical students, physicians, and nurses. Patients should understand the discharge report and indications and side effects of the medications before leaving the hospital.

Disrupted and Restored Patient Experience With Transition to New Electronic Health Record System.

Transitioning from one electronic health record (EHR) system to another is of the most disruptive events in health care and research about its impact on patient experience for inpatient is limited. This study aimed to assess the impact of transitioning EHR on patient experience measured by the Hospital Consumer Assessment of Healthcare Providers and Systems composites and global items. An interrupted time series study was conducted to evaluate quarter-specific changes in patient experience following implementation of a new EHR at a Midwest health care system during 2017 to 2018. First quarter post-implementation was associated with statistically significant decreases in Communication with Nurses (−1.82; 95% CI, −3.22 to −0.43; P = .0101), Responsiveness of Hospital Staff (−2.73; 95% CI, −4.90 to −0.57; P = .0131), Care Transition (−2.01; 95% CI, −3.96 to −0.07; P = .0426), and Recommend the Hospital (−2.42; 95% CI, −4.36 to −0.49; P = .0142). No statistically significant changes were observed in the transition, second, or third quarters post-implementation. Patient experience scores returned to baseline level after two quarters and the impact from EHR transition appeared to be temporary.

Translation, adaptation and validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) for use in Japan: a multicentre cross-sectional study

ObjectivesThe Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a well-established and internationally recognised scale for measuring patients’ experience with hospital inpatient care. This study aimed to develop...

Pain Intensity: How Press Ganey Survey Domains Correlate in Total Knee Arthroplasty Patients.

Decreasing postoperative pain for total knee arthroplasty (TKA) patients has been an area of continued effort for healthcare providers. These efforts have been incentivized by legislative reform, which ties reimbursement for hospitals and providers to patient perception of care. Press Ganey (PG) surveys quantify patient satisfaction, and the "pain management" domain is thought to be the best metric for assessing pain intensity. Therefore, these responses are important, as they are used to guide further improvements in healthcare delivery. This study analyzes which PG survey domains are truly associated with pain intensity in the immediate postoperative period following TKA. We queried our PG database for all primary TKA patients between November 2012 and January 2015, yielding a total of 214 patients. Multivariate regression analysis was performed utilizing pain intensity as the dependent variable. Predictor variables included body mass index (BMI), Charlson's comorbidity index, opioid consumption, and PG survey domains. Patient ratings of "communication with doctors" (B = 58.147; p = 0.001), "responsiveness of hospital staff" (B = - 62.663; p = 0.041), "communication about medicines" (B= -45.037; p < 0.001), and "hospital environment" (B = 69.342; p = 0.017) were associated with patient pain intensity. We found survey domains, other than "pain management," were associated with pain intensity. Efforts to improve outcomes and satisfaction should focus on staff education and communication. The current method for measuring patient satisfaction and reimbursement should be critically assessed and redesigned to better reflect true patient experiences.

Inpatient Rehabilitation Quality of Care From the Patient’s Perspective: Effect of Data Collection Timing and Patient Characteristics

ObjectiveTo compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. DesignCohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. SettingTwo inpatient rehabilitation facilities (IRFs). ParticipantsPatients with neurologic conditions (N=391). InterventionsNot applicable. Main Outcome MeasuresWe calculated 18 quality measure scores using participants’ responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. ResultsOf the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. ConclusionPatients’ experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.

Does the Amount of Opioid Consumed Influence How Patients Rate Their Experience of Care After Total Knee Arthroplasty?

BackgroundWith legislative efforts aimed at optimizing value of care, surgeons performing total knee arthroplasty (TKA) are faced with increased responsibility of optimizing patient perception of care. However, pain after TKA may negatively influence patient perception of care, as measured by Press Ganey (PG) patient satisfaction surveys. While opioid-based medications are best suited for acute pain alleviation, awareness of a growing opioid epidemic has spurred efforts to reduce its administration. Therefore, this study assessed the correlation between postoperative opioid consumption and 7 PG question domains: (1) overall hospital rating; (2) communication with nurses; (3) response time of hospital staff; (4) communication with doctors; (5) hospital environment; (6) pain management and; (7) communication about medication. MethodsWe reviewed our institutional PG database for TKA patients from 2011 to 2014. A total of 406 patients were analyzed (mean age = 66, 73.4%). Opioid consumption was measured using a morphine milliequivalent conversion algorithm. Bivariate correlation analysis assessed the association between opioid consumption and PG domains. Spearman’s r was utilized to assess the strength of the association. ResultsNo association between total opioid consumption and overall hospital rating (r = 0.044), communication with doctors (r = 0.080), communication with nurses (r = 0.072), responsiveness of hospital staff (r = 0.084), pain management (r = 0.100), communication about medicines (r = 0.083), or hospital environment (r = 0.155) were found. DiscussionOur findings demonstrate that PG scores are not influenced by immediate postoperative opioid use. These results suggest opioid-based pain medications should be administered exclusively on the basis of clinical guidelines and patient needs without concern regarding satisfactions scores and reimbursement penalties.

Opioids Consumed in the Immediate Post-Operative Period Do Not Influence How Patients Rate Their Experience of Care After Total Hip Arthroplasty

BackgroundPatient perception of care, commonly measured with Press Ganey (PG) surveys, is an important metric used to determine hospital and provider reimbursement. However, post-operative pain following total hip arthroplasty (THA) may negatively affect patient satisfaction. As a result, over-administration of opioids may occur, even without marked evidence of pain. Therefore, this study evaluated whether opioid consumption in the immediate postoperative period bears any influence on satisfaction scores after THA. Specifically, this study assessed the correlation between post-operative opioid consumption and 7 PG domains: (1) Overall hospital rating; (2) Communication with nurses; (3) Responsiveness of hospital staff; (4) Communication with doctors; (5) Hospital environment; (6) Pain Management; and (7) Communication about medicines. MethodsOur institutional PG database was reviewed for patients who received THA from 2011 to 2014. A total of 322 patients (mean age = 65 years; 61% female) were analyzed. Patient’s opioid consumption was measured using a morphine milli-equivalent conversion algorithm. Bivariate correlation analysis assessed the association between opioid consumption and Press-Ganey survey elements. Pearson's r assessed the strength of the association. ResultsNo correlation was found between total opioid consumption and Overall hospital rating (r = 0.004; P = .710), Communication with nurses (r = 0.093; P = .425), Responsiveness of hospital staff (r = 0.104; P = .381), Communication with doctors (r = 0.009; P = .940), Hospital environment (r = 0.081; P = .485), and Pain management (r = 0.075; P = .536). However, there was a positive correlation between total opioid consumption and “Communication about medicines” (r = 0.262; P = .043). ConclusionsOur report demonstrates that PG patient satisfaction scores are not influenced by post-operative opioid use, with the exception of PG domain, “Communication about medications.” These results suggest that opioid medications should be administered based solely on patient requirements without concern about patient satisfaction survey results.

Factors Influencing Patients' Hospital Rating After Total Joint Arthroplasty.

Patient satisfaction assessments, such as the Press Ganey surveys, have been adopted by the Centers for Medicare & Medicaid Services to help determine reimbursements. It is uncertain what facets most affect survey scores among patients who have received total joint arthroplasty (TJA). This study explored which factors guide scores for TJA patients. Specifically, the authors assessed (1) which Press Ganey survey features affected the patients' overall hospital rating and (2) whether survey scores were disparate between patients who did and patient who did not have complications. The authors' institutional Press Ganey database was queried for lower-extremity TJAs that occurred between November 2009 and January 2015. This yielded 1454 patients with a mean age of 63 years (range, 15-92 years; 60% women and 40% men). The database contains information related to American Society of Anesthesiologists scores, Press Ganey question responses, and demographics. Multiple regression analysis was performed to assess the association (beta weight) between Press Ganey domains and overall hospital rating. The weighted mean for each domain was calculated. The authors' analysis revealed that overall hospital rating was significantly influenced by communication with nurses (beta weight=0.434, P<.001), responsiveness of hospital staff (beta weight=0.181, P=.001), communication with doctors (beta weight=0.115, P=.014), and hospital environment (beta weight=0.100, P=.039). No significant differences were found when comparing the Press Ganey scores of patients with and without complications. By recognizing these elements, physicians can direct measures appropriately, which may help avoid financial penalties and possibly increase patient satisfaction after TJA. [Orthopedics. 2017; 40(6):377-380.].

Does Patient Perception of Pain Influence How Patients Rate Their Experience after Total Knee Arthroplasty?

Press Ganey (PG) is an increasingly used measure to determine patient satisfaction. It has yet to be determined which factors influence the PG scores most amongst patients with inadequate pain control after total knee arthroplasty (TKA). Therefore, we assessed (1) which PG factors influence overall hospital rating (OHR) in patients who had poor pain control in comparison to those with good pain control and (2) whether pain control influences OHR during hospital admission following TKA. An institutional database search was performed between November 2009 and January 2015 for all TKA patient responders to the PG questionnaire. This yielded 148 patients (mean = 61 years; range, 24–92 years). Pain control was graded on a scale from 1(least satisfied) to 4 (most satisfied). Patients were separated into two cohorts: those who had poor pain control (score ≤ 2) and those who had good pain control (score &gt; 2). Multiple regression analysis assessed the weighted means (β) of all PG categories on OHR. To compare the demographics and survey responses between the two cohorts, χ 2 and t-tests were utilized. For patients with poor pain control, the responsiveness of hospital support staff had the highest influence on OHR (β = 2.103), followed by communication about medications (β = 1.230). For patients with good pain control, communication with nurses had the strongest effect on hospital rating (β = 0.233, p = 0.056), followed by communication about medications (β = 0.200, p = 0.049). The patients with good pain control had significantly higher OHR (6.0 vs. 9.1, p = ≤ 0.001) and scores in each category of PG. Communication about medications and responsiveness of hospital staff had a significant effect on OHR. Well-controlled patients were highly influenced by communication of medication and communication with nurses. Moreover, patients with good pain control had significantly higher scores in all areas of PG survey, signifying that patient perception of pain affects patient satisfaction with the hospital. Orthopaedists should be involved in direct efforts to improve pain control as well as address the aforementioned PG domains.

Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project," found on pages 306-313, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the unique nursing challenges that occur in caring for older adults in rural areas. Discuss the Improving Rural Geriatric Care through Education (iRuGCE) project, including the facilitators and challenges to its implementation. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Rural elders are the fastest growing segment of the U.S. population, with a projected increase of 32% in the next 20 years. Shortages in geriatric-prepared workers are particularly critical in rural areas. This article describes Improving Rural Geriatric Care through Education (iRuGCE), a feasible, scalable, and collaborative continuing education project. iRuGCE was designed to improve geriatric nursing practice. Project goals were to identify, mentor, and facilitate an RN geriatric site champion in critical access hospitals (CAHs) to complete national certification in gerontological nursing, and to design a continuing education program that met the specific needs of the CAHs via delivery of three continuing education sessions per year. Evaluation of the project is promising. Preliminary results suggest that iRuGCE has a positive effect on nurse-sensitive patient satisfaction scores, such as communication with nurses, responsiveness of hospital staff, pain management, communication about medicine, discharge information, and willingness to recommend the hospital. J Contin Educ Nurs. 2016;47(7):306-313.

The risk‐outcome‐experience triad: Mortality risk and the hospital consumer assessment of healthcare providers and systems survey

Studies have shown an association between the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) scores and clinical quality. The mortality risk on admission predicts adverse events. It is not known if this risk also portends a suboptimal patient experience. To determine if the admission mortality risk identifies an experience of care risk. A retrospectively assembled cohort in which individual HCAHPS survey responses were linked to the admission risk of dying. Five community hospitals of various sizes in Michigan. There were 17,509 HCAHPS medical and surgical respondents; 2513 (14.4%) were at high risk of dying. Odds ratio (OR) (high-risk patients to low-risk patients) for providing a top box score for HCAHPS dimensions, controlling for hospital and the standard HCAHPS patient mix adjustment factors. High-risk respondents were less likely to provide the most favorable response (unadjusted) for all HCAHPS domains, although the difference was not significant (P = 0.09) for discharge information. Multivariable analyses indicated that high-risk patients were less likely to report a top box experience for doctor communication (OR: 0.85; 95% confidence interval [CI]: 0.77-0.94) and responsiveness of hospital staff (OR: 0.77; 95% CI: 0.69-0.85), but were more likely to have received adequate discharge information (OR: 1.30, 95% CI: 1.14-1.48). Patients at high risk of dying who completed surveys were less likely to report favorable physician communication and staff responsiveness. Further understanding of these relationships may help design a care model to improve both outcomes and experience. Journal of Hospital Medicine 2016;11:628-635. © 2016 Society of Hospital Medicine.

Hospitalized Older Adults’ Patient Satisfaction

This article examines the extent to which older adult patients’ perceptions of inpatient dimensions of care experiences are associated with their overall satisfaction. A secondary objective is to determine if these specific care experiences differed between elderly female and male patients. Patient satisfaction data from 6,021 older patients (65 years of age and older) were collected by using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey through telephone interviews of older patients who were recently discharged. Multiple linear regression analyses with older patients’ HCAHPS dimensions (Communication With Nurses, Communication With Doctors, Responsiveness of Hospital Staff, Communication About Medicines, Cleanliness of the Hospital Environment, and Quietness of Hospital Environment) and gender were conducted while controlling for self-rated health status, age, race, and education. Multiple linear regression analysis showed that all of the HCAHPS dimensions were significantly associated with overall satisfaction. Older female patients reported substantially more positive global evaluations than their male counterparts. However, for older male patients, Communication With Doctors was more influential in their ratings of overall satisfaction than for older female patients. For older female patients, Communication With Nurses was more influential in their ratings of overall satisfaction than for older male patients.

Purposeful and timely nursing rounds: a best practice implementation project

Purposeful and timely rounding is a best practice intervention to routinely meet patient care needs, ensure patient safety, decrease the occurrence of patient preventable events, and proactively address problems before they occur. The Institute for Healthcare Improvement (IHI) endorsed hourly rounding as the best way to reduce call lights and fall injuries, and increase both quality of care and patient satisfaction. Nurse knowledge regarding purposeful rounding and infrastructure supporting timeliness are essential components for consistency with this patient centred practice. The project aimed to improve patient satisfaction and safety through implementation of purposeful and timely nursing rounds. Goals for patient satisfaction scores and fall volume were set. Specific objectives were to determine current compliance with evidence-based criteria related to rounding times and protocols, improve best practice knowledge among staff nurses, and increase compliance with these criteria. For the objectives of this project the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool were used. Direct observation of staff nurses on a medical surgical unit in the United States was employed to assess timeliness and utilization of a protocol when rounding. Interventions were developed in response to baseline audit results. A follow-up audit was conducted to determine compliance with the same criteria. For the project aims, pre- and post-intervention unit-level data related to nursing-sensitive elements of patient satisfaction and safety were compared. Rounding frequency at specified intervals during awake and sleeping hours nearly doubled. Use of a rounding protocol increased substantially to 64% compliance from zero. Three elements of patient satisfaction had substantive rate increases but the hospital's goals were not reached. Nurse communication and pain management scores increased modestly (5% and 11%, respectively). Responsiveness of hospital staff increased moderately (15%) with a significant sub-element increase in toileting (41%). Patient falls decreased by 50%. Nurses have the ability to improve patient satisfaction and patient safety outcomes by utilizing nursing round interventions which serve to improve patient communication and staff responsiveness. Having a supportive infrastructure and an organized approach, encompassing all levels of staff, to meet patient needs during their hospital stay was a key factor for success. Hard-wiring of new practices related to workflow takes time as staff embrace change and understand how best practice interventions significantly improve patient outcomes.

Surgical Complications Impact Patient Perception of Hospital Care

Public reporting of the Hospital Consumer Assessment of Healthcare Providers and Systems survey is designed to produce data on patients' perceptions of the quality of hospital care. The aim of this study was to assess the impact of complications on patient responses to Hospital Consumer Assessment of Healthcare Providers and Systems "top-box" (most favorable) scores. All patients who underwent a colorectal procedure from October 2009 to June 2012 at a single center were included. Patient complications were categorized as major, minor, or no complications and "surgical technique" or "medical." Chi-square and Wilcoxon rank sum tests were used to compare binary and ordinal top-box scores, respectively. One thousand four hundred and nine surveys were collected for 1,233 patients (mean age 53 ± 15.7 years; 701 [52.2%] females) who underwent 955 (67.8%) major abdominal, 114 (8.1%) anorectal, and 340 (24.1%) stoma-related operations. There were 195 (13.8%) major and 396 (28.1%) minor complications. There were 159 (11.3%) technique complications and 411 (29.2%) medical complications. Patients without any complications were more likely to recommend the hospital than those with complications (p = 0.023) irrespective of type of complication (minor vs major; p = 0.72 or technique vs medical; p = 0.5). Responsiveness of hospital staff was also reported as higher for patients without complications (p = 0.0003) and the type of complication did not influence this assessment (minor vs major; p = 0.71 and technique vs medical; p = 0.95). The occurrence of any complication after colorectal surgery adversely impacts patients' self-reported perceptions of hospital care as measured by Hospital Consumer Assessment of Healthcare Providers and Systems. An instrument that more accurately reflects patients' assessment of quality in the context of variations in patient, disease, and surgical factors is required.

433 DO US NEWS & WORLD REPORT TOP UROLOGY HOSPITALS ALSO PROVIDE A BETTER “PATIENT EXPERIENCE”?

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2013433 DO US NEWS & WORLD REPORT TOP UROLOGY HOSPITALS ALSO PROVIDE A BETTER “PATIENT EXPERIENCE”? Chandy Ellimoottil, Spencer Hart, Ahmer Farooq, and Marcus Quek Chandy EllimoottilChandy Ellimoottil Maywood, IL More articles by this author , Spencer HartSpencer Hart Maywood, IL More articles by this author , Ahmer FarooqAhmer Farooq Maywood, IL More articles by this author , and Marcus QuekMarcus Quek Maywood, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1823AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES U.S. News & World Report's annual “Best Hospitals” rankings are widely used by hospitals for marketing purposes. The methodology used for ranking takes into account multiple different elements of hospital structure, care delivery and outcomes. Currently, the methodology does not include a patient satisfaction instrument. In recent years, the Centers for Medicare and Medicaid services began collecting data on the “Patient Experience” and will soon tie these data to reimbursement. We compared ranked and unranked hospitals to identify whether ranked centers had a better “Patient Experience”. METHODS Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey database, we collected data on 10 domains related to the “Patient Experience”. We identified the 50 “Best Hospitals” for urology according to the 2012-2013 US News & World Report rankings. We then compared the scores between ranked and unranked hospitals. RESULTS There were 47 ranked hospitals and 4,558 unranked hospitals with data available for analysis. Compared to unranked hospitals, ranked hospitals had a higher mean percentage of patients reporting the highest score for survey questions relating to nurse communication (76.7 vs 64.7, p < 0.001), physician communication (79.06 vs 67.2, p < 0.001), responsiveness of hospital staff (60.3 vs 54.8 p < 0.001), pain management (68.9 vs 58.6 p < 0.001), communication about medicines (61.2 vs 51.9 p < 0.001), discharge information (76.7 vs 64.7 p < 0.001), cleanliness (66.8 vs 60.5 p < 0.001), and quietness (53.6 vs 49.8 p < 0.001). Ranked hospitals also had a higher percentage of patients reporting an overall 9 or 10 out of 10 rating (72.9 vs 57.5 p < 0.001) and recommending the hospital (78.2 vs 58.6 p < 0.001). CONCLUSIONS Our findings suggest that on average hospitals ranked by US News and World Report for urologic care tend to have higher Patient Experience scores as measured by the HCAHPS survey. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e176 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chandy Ellimoottil Maywood, IL More articles by this author Spencer Hart Maywood, IL More articles by this author Ahmer Farooq Maywood, IL More articles by this author Marcus Quek Maywood, IL More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

A trinity of engagement transforms care at UPMC Shadyside's 6 Main

AbstractAt 6 Main, part of the University of Pittsburgh Medical Center, the evolution from a struggling patient care unit to a high‐functioning patient care team was led by a thoughtful partnership involving the unit director, her staff, and an improvement specialist trained in the use of Transforming Care at the Bedside (TCAB) tools. Motivated to achieve total patient safety, they worked together to transform the culture of a nursing unit so that those closest to the patients are empowered to initiate and lead improvement efforts. The results of this transformation are reflected in higher patient satisfaction scores that stem from enhanced communication with nurses, greater responsiveness of hospital staff, and a safer and more pleasant hospital environment. © 2012 Wiley Periodicals, Inc.

Link Between Patients’ Perceptions of Their Acute Care Hospital Experience and Institutions’ Injurious Fall Rates

This exploratory study used 4 publicly available large data sets to determine whether significant correlations exist between patients' perceptions of their acute care hospital experience and hospital-acquired injurious fall rates at their hospitals in the states of California, Florida, and New York in 2007. The results showed that the higher the inpatient satisfaction levels with the responsiveness of hospital staff and cleanliness and quietness of the hospital environment, the lower were the injurious fall rates.

Managerial Challenges Toward Unequal Gender Treatment in South Africa

ABSTRACT Worldwide changes in medical health care have raised a number of challenges for health care organisations. In addition to building and maintaining massive networks of patient information, cost analysis, managed care and physicians, they must also maintain responsiveness to the dynamic market conditions (Johns, 1997). According to Casebeer and Hannah (1998), the efforts of government to adjust the responsiveness and efficiency of their health care systems are evident across the globe. This paper focuses on the quality element of the managerial service system dimension with specific reference to the satisfaction (congruence between expectations and perceptions of performance) of patients and the service responsiveness of hospital staff towards patients in public hospitals in South Africa. Real quality can only be achieved if all patients have access to and receive the same levels of service regardless of gender or race. doi:10.1300/J156v08n01_04served.]