Uncovering the blind spot of patient satisfaction: An international survey

Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, BS-3, Boston, MA 02120, USA.
BMJ quality & safety (Impact Factor: 3.99). 09/2011; 20(11):959-65. DOI: 10.1136/bmjqs-2011-000306
Source: PubMed


To achieve a high level of patient satisfaction, providers need to identify and address patients' expectations. However, providers' beliefs and attitudes regarding expectations, as well as how to manage them, are not well understood.
The authors developed a survey to assess clinicians' awareness, attitudes, competence and performance with respect to patient expectations. The authors surveyed clinicians in four academic hospitals located in Denmark, Israel, the UK and the USA.
The authors collected 1004 questionnaires (79.9% response rate) from four hospitals in four countries spanning three continents. Overall, 88.8% of respondents stated that clinician awareness regarding patient expectations was moderate to low, with significant differences between countries (p<0.001). Although 89.4% of clinicians believed it was important to ask patients about expectations, only 16.1% reported actually asking (p<0.0001). Nurses were more likely than physicians to ask patients about expectations (20.1% vs 11.5%, p<0.001). Only 19.6% of respondents felt they had adequate training to handle patients' expectations. In multivariate analyses, clinicians with greater awareness and adequate training were more likely to ask patients about their expectations.
While clinicians think it is important to ask patients about their expectations, they often fail to do so and consequently may not respond adequately. These results identify a 'blind spot' in clinicians' approach when attempting to address patient expectations and improve patient satisfaction, suggesting that healthcare organisations should take a more active role in increasing clinicians' awareness and initiating structured training programmes to cope with patient expectations.

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Available from: Ronen Rozenblum, Apr 18, 2015
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    • ") and clinicians lack both awareness and adequate training to address patients' expectations (Rozenblum et al., 2011). It is inherently problematic to link outcome and patient satisfaction. "
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    ABSTRACT: The level of patients’ satisfaction is one among the mechanisms used in assessing the quality of health care services. This cross sectional study was conducted in Hawassa University Teaching Hospital to assess level of satisfaction of patients with outpatient health services and factors associated with it. Multiple logistic regression was used to assess the relationship between patients’ satisfaction and possible predictors. Four-fifth (80.1%) of patients reported to be satisfied with the hospital’s outpatient services. Respondents who claimed to have had a long stay in the hospital were found to be more satisfied than those who claimed to have had a very long stay (adjusted odds ratio (AOR) = 4.54, 95% CI: 2.38, 8.65). Furthermore, there was negative association between patients’ satisfaction and not getting required services in the hospital (AOR = 0.78, 95% CI: 0.41, 0.96), lack of privacy (AOR = 0.52, 95% CI: 0.27, 0.78), and absence of good dialogue with outpatient service providers (AOR = 0.28, 95% CI: 0.12, 0.41). Health managers and service providers should devise innovative ways to reduce waiting time, have good dialogue with patients, and maintain privacy of patients in order to improve the level of satisfaction of patients.
    02/2014; 6(2):101-110. DOI:10.5897/JPHE2013
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    • "Q5. AU: The reference " Rozenblum et al., 2011 " is listed in the references list but is not cited in the text. Please either cite the reference or remove it from the references list. "
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    ABSTRACT: Measuring patient satisfaction is important in assessing healthcare outcomes due to the growing emphasis on greater partnership between providers and consumers. National Health Service (NHS) commissioning bodies in the United Kingdom increasingly expect patient satisfaction to be included as a service performance indicator as it is regarded as part of the definition of quality of care. The aim of this survey is to better understand levels of satisfaction with current gender identity clinic services (GICs) provision and to identify areas for improvement. A Patient Satisfaction Questionnaire (PSQ-GD) was developed specifically for use in GICs in the United Kingdom, which was given to all patients during one month. PSQ-GD covers clinical care, administrative and procedural issues as well as patient experience of local service provision from their General Practitioner, local psychiatric services and speech therapy. A total of 330 PSQ-GD were given with a response rate of 85%. Ninety-four percent would recommend the services if a friend or relative had a gender-related problem. Twenty percent were dissatisfied with the level of support for others close to the patient. Thirty-one percent were dissatisfied with local psychiatric services. Twenty-seven percent were dissatisfied with the wait for the first appointment. Administration scored high on satisfaction. A total of 222 positive and 131 negative comments were made. The PSQ-GD offers an opportunity to understand levels of satisfaction with current gender service provision and identifies areas for improvement, most notably the interface between GICs and local psychiatric services. Findings from this study put individual complaints in perspective and show that despite the challenges inherent in providing transgender care good satisfaction can be achieved. We encourage gender care providers to implement quality assurance and improvement procedures to give people with gender dysphoria the opportunity to provide feedback and have a voice in shaping their own health care.
    Sexual and Relationship Therapy 11/2013; 28(4). DOI:10.1080/14681994.2013.834321 · 0.51 Impact Factor
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    • "To do so, they are using a range of strategies that include redesigning and co-designing service delivery with patients, implementing patient rights charters and engaging patients as partners in improving care from the clinical level to the organizational one; i.e., “from exam room to boardroom”. Yet, many organizations continue to face barriers to transforming their culture from a provider focus to a patient-centric one, and the result is reflected in less than optimal scores on patient experience surveys [5,14,15]. "
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    ABSTRACT: 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.
    Israel Journal of Health Policy Research 09/2013; 2(1):35. DOI:10.1186/2045-4015-2-35
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