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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    • "referred to as the " Blind spot of patient satisfaction. " Based on previous work, it seems that there is an unrecognized gap between the importance clinicians place on inquiring about patient expectations and satisfaction and their performance (Rozenblum et al., 2011; Rozenblum, Gianola, et al., 2015). This discrepancy appears to represent a " blind spot " in clinicians approach to patient expectations and satisfaction . "
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    ABSTRACT: Background: Addressing patient expectations is necessary to achieve high satisfaction. However, few data are available on nurses' perceptions and performance with respect to patient expectations and satisfaction. Objectives: This international multicenter study aimed to: (a) evaluate nurses' attitudes and performance with respect to patient satisfaction and expectations, and (b) identify predictors of nurses' inquiry of patients' satisfaction at the point of discharge. Methods: A questionnaire examining attitudes and performance toward patient satisfaction and expectations was developed and validated. Nurses at four academic hospitals in the United States, the United Kingdom, Israel, and Denmark were surveyed. Results: A total of 536 nurses participated in the study (response rate 85.3%). Nurses expressed positive attitudes toward activities related to patient satisfaction and expectations, endorsing the importance of talking with patients about their satisfaction status (91.6%) and their expectations (93.2%). More than half of the responders (51.8%) claimed to have responded to the status of patient satisfaction or dissatisfaction (Israel: 25%; United States: 54.9%; United Kingdom: 61.7%; Denmark: 69.9%; p < .001). However, only 12.1% stated that they routinely ask patients about their level of satisfaction, with nurses in the United States (18.3%) and Denmark (17.5%) more likely to ask compared to nurses in the United Kingdom (7.4%) and Israel (6.3%; p = .001). Adjusted logistic regression identified four significant predictors (p < .05) of nurses' inquiry about patients' satisfaction: "Responding to patient's satisfaction status" (OR: 3.1; 95% CI: 1.7-5.8); "Documenting patient's satisfaction status" (OR: 2.8; 95% CI: 1.6-5.1); "Asking routinely about expectations" (OR: 5.4; 95% CI: 3-9.7); and "Responded to expectations during the past month" (OR: 4.3; 95% CI: 1.9-9.4). Linking evidence to action: These findings warrant further investigation, potentially into the nurses' work environments or educational programs, to better understand why nurses' positive attitudes toward patient satisfaction and expectations do not result in actively asking patients about their satisfaction level and what should be done to improve nurses' performance. Healthcare organizations and policy makers should develop and support structured programs to address patient expectations and improve patient satisfaction during hospitalization.
    Full-text · Article · Feb 2016 · Worldviews on Evidence-Based Nursing
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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.
    Full-text · Article · Feb 2014
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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.
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