Cognitive interview techniques reveal specific behaviors and issues that could affect patient satisfaction relative to hospitalists

Binghamton University, East Binghamton, New York, USA.
Journal of Hospital Medicine (Impact Factor: 2.3). 11/2009; 4(9):E1-6. DOI: 10.1002/jhm.524
Source: PubMed


There is a trend toward patient-centered care as a means of improving patient satisfaction. The Centers for Medicare and Medicaid Services (CMS) have made this concept more significant with plans to link reimbursement to patient satisfaction measures such as the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS).
To generate hypotheses for reasons underlying diminished HCAHPS patient satisfaction survey ratings, with reference to hospitalists.
Observational study conducted using a cognitive interview (CI) technique in a 180-bed community hospital on adult medical, surgical, and critical care inpatients.
Mixed qualitative and quantitative study using both standard responses and open-ended responses. The standard responses were compiled into raw numbers and percentages and the qualitative responses were evaluated for common themes and other useful information.
Notable factors that may affect satisfaction of patients include ability to have all of their questions answered, incomplete discussion of medication side effects, and failure of physicians to listen and form personal connections with them. CONCLUSIO:: Cognitive interview techniques can be used to provide additional detail regarding patient satisfaction beyond that provided by standard surveys.

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    ABSTRACT: Background: Real-time feedback about patients' perceptions of the quality of the care they are receiving could provide physicians the opportunity to address concerns and improve these perceptions as they occur, but physicians rarely if ever receive feedback from patients in real time. Objective: To evaluate if real-time patient feedback to physicians improves patient experience. Design: Prospective, randomized, quality-improvement initiative. Setting: University-affiliated, public safety net hospital. Participants: Patients and hospitalist physicians on general internal medicine units. Intervention: Real-time daily patient feedback to providers along with provider coaching and revisits of patients not reporting optimal satisfaction with their care. Measurements: Patient experience scores on 3 provider-specific questions from daily surveys on all patients and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and percentiles on randomly selected patients. Results: Changes in HCAHPS percentile ranks were substantial (communication from doctors: 60th percentile versus 39th, courtesy and respect of doctors: 88th percentile versus 23rd, doctors listening carefully to patients: 95th percentile versus 57th, and overall hospital rating: 87th percentile versus 6th (P = 0.02 for overall differences in percentiles), but we found no statistically significant difference in the top box proportions for the daily surveys or the HCAHPS survey. The median [interquartile range] top box score for the overall hospital rating question on the HCAHPS survey was higher in the intervention group than in the control group (10 [9, 10] vs 9 [8, 10], P = 0.04). Conclusions: Real-time feedback, followed by coaching and patient revisits, seem to improve patient experience. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine.
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