Patient satisfaction - BMJ article

The patient satisfaction chasm: the gap between hospital management and frontline clinicians 
BMJ Quality & Safty 2013;22:3 242-250 Published Online First: 23 November 2012  (f/t via Athens)

Abstract

Background Achieving high levels of patient satisfaction requires hospital management to be proactive in patient-centred care improvement initiatives and to engage frontline clinicians in this process.

Method We developed a survey to assess the attitudes of clinicians towards hospital management activities with respect to improving patient satisfaction and surveyed clinicians in four academic hospitals located in Denmark, Israel, the UK and the USA.

Results We collected 1004 questionnaires (79.9% response rate) from four hospitals in four countries on three continents. Overall, 90.4% of clinicians believed that improving patient satisfaction during hospitalisation was achievable, but only 9.2% of clinicians thought their department had a structured plan to do so, with significant differences between the countries. Among responders, only 38% remembered targeted actions to improve patient satisfaction and just 34% stated having received feedback from hospital management regarding patient satisfaction status in their department during the past year. In multivariate analyses, clinicians who received feedback from hospital management and remembered targeted actions to improve patient satisfaction were more likely to state that their department had a structured plan to improve patient satisfaction.

Conclusions This portrait of clinicians’ attitudes highlights a chasm between hospital management and frontline clinicians with respect to improving patient satisfaction. It appears that while hospital management asserts that patient-centred care is important and invests in patient satisfaction and patient experience surveys, our findings suggest that the majority do not have a structured plan for promoting improvement of patient satisfaction and engaging clinicians in the process.

Mind your manners

An assistant professor of psychiatry at Harvard Medical School said that medical education and postgraduate training should place more emphasis on teaching doctors good behavior that would enhance their relationship with patients. He said when dcotors deal with patients in a polite manner, patients have a satisfying experience.

Source:"Etiquette-Based Medicine" New England J of Medicine, 2008, 358(19):1988-1989 ( free f/t)

Coaching can help patients ask right questions

A new Cochrane review of 33 randomised controlled trials involving more than 8000 patients from 6 countries and in a range of settings and diagnosis found that question checklists and patient coaching were the most common interventions used to help patients address their information needs, coaching produced a smaller increase in consultation length and a larger increase in patient satisfaction.


The review concluded that interventions immediately before consultations led to a small and statistically significant increase in consultation length, whereas those implemented some time before the consultation had no effect. Only interventions immediately before the consultation led to small and statistically significant increases in patient satisfaction. Read more...


"Interventions before consultations for helping patients address their information needs" - Kinnersley et al. Cochrane Library 2007, Issue 3 ( Athens password required for full text article via the HILO website )