Survey tracks trends in patient satisfaction
There’s some improvement and some backsliding
Patients think hospitals are doing better, but not in every area. A new Press, Ganey Associates Inc. survey of hospital services shows that facilities are doing better in areas such as visiting hours, room temperatures, noise levels, and visitor accommodation. But when it comes to starting IVs and drawing blood, there is plenty of room for improvement.
Using information from its database of 1,400 clients, the South Bend, IN, firm rated hospital care from 1993 to 1997 in three broad areas.
• Visitor services. This area showed the most improvement over the five years studied. In 1993, the mean score was 88.3, and by 1997, that increased to a mean of nearly 88.9. While the change, and others reported in the survey, may seem small, Press, Ganey’s report states that "when consistent, incremental changes in scores are observed . . . this is noteworthy. Such changes indicate something is changing in health care delivery or, at least, the patient’s perceptions and expectations of it."
In fact, the situation with visiting hours has improved so much that Press, Ganey no longer includes questions about visiting hours in its surveys. Perceptions about visitor accommodations also improved over time, with the mean score increasing from 83.3 to 83.4 during the five years studied.
• Venipuncture. This area shows a decline in scores. In 1993, IV starts received a mean score of 81.2. By 1997, that was down to less than 80.9. Blood draws declined from a mean score of about 84.1 in 1993 to 83 five years later. Part of the reason, Press, Ganey officials surmise, may be that patients expect painless treatment. Another reason may be the use of gloves by staff doing the venipuncture. Gloves cause decreased sense of touch and dexterity, which may make it more difficult to locate a vein and insert a needle. Another reason may be that specialists don’t take care of venipuncture any longer. Lastly, Press, Ganey suggests that staff may be rushed and thus more prone to make mistakes related to venipuncture.
• Patient rooms. Ratings of noise and temperature have improved marginally, but there is a seasonal pattern, with mean scores for temperature and noise decline in the winter months and increase in the summer months. The scores relate to the previous season, so the survey notes that the noise increase may be due to larger patient censuses in the colder seasons.
There was no meaningful change in other areas. For instance, patient ratings of time spent by physicians or of concern for their privacy barely changed at all. But the most startling change is the decline in scores regarding the likelihood that a patient would recommend a hospital. Press, Ganey charted the trend of this question over seven years, and while the mean score was 88.8 in 1993, it dropped to 87 by 1999. While the score is still relatively high, it is an important decline.
Press, Ganey notes in the survey that it might be that patients’ expectations are higher than they used to be, or perhaps they are making a statement about an overall decline in their satisfaction with health care in general, not just hospitals. But, the survey concludes, "regardless of the explanation, the patients’ willingness to recommend the hospital is slipping, and this should be troubling to hospitals. Quality improvement initiatives aimed at satisfying patients must become a focus of more of our nation’s hospitals."
[For more information about the survey, contact: Press, Ganey Associates Inc., South Bend, IN. Telephone: (800) 232-8032. Web site: www.pressganey.com.]
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