Executive Health Administration

Patient Satisfaction: Surveys and Healthcare Quality Assurance

[fa icon="calendar'] Nov 17, 2016 7:30:00 AM / by Mary Kilgus

Fotolia_104995727_M.jpgPress Ganey, a leading consulting firm for hospitals, recently put out a white paper that discusses 10 ways healthcare executives and board members can focus on strategies to improve patient satisfaction.

Press Ganey partners with about 40% of U.S. hospitals to measure and improve patient care. By implementing report cards a healthcare board or executive can spearhead quality performance measures.

This translates to giving patients score cards for their care. Data collected from that may help the management and boards of hospitals compete on value, in addition to taking better care of patients. In conjunction with research on CEOs and other leaders in the organization the report card is intended to improve hospital quality. 

Surveys are sent to patients who have been treated asking them their impressions about the hospital or healthcare facility, its staff, doctors, and nurses. Press Ganey gathers the data, runs the numbers, and then gives the information back to the hospital or healthcare facility. That information is used to compare the facility to other, similar facilities, and to judge the quality of care given by its staff.

The hospitals may use the information about specific doctors or other staff for performance evaluations, compensation and benefit decisions, and training. Patient satisfaction has become a priority in hospitals and healthcare facilities. It is estimated that a high percentage of senior managers and board members are participating in such programs in the United States. However, patient surveys are viewed differently by leaders and frontline clinicians.

Some hospital doctors, nurses, and other healthcare professionals have a different perspective on value of patient surveys.

Clinicians note that there are drawbacks to concentrating on patient satisfaction. Many hospital administrators are being pressured by boards to improve patient satisfaction scores taken from Press Ganey’s lead.

Drawbacks in Press Ganey’s statistical information from the survey’s make the value of the surveys uncertain.  For instance, the sample size of Press Ganey’s surveys have high margins of error, but the hospital decision makers may be unaware of this fault.

Some problems may also appear when the actions of one department influence another department's scores. For example, when one doctor spends additional time with a critically ill patient that may make another department’s patient satisfaction scores better.

The biggest argument against such surveys is the fact that the survey of patients might not tell the whole story, making the information gained by the survey unreliable. 

Some healthcare providers say that patient surveys create a dilemma when physicians and nurses must choose between good patient satisfaction scores or giving time-consuming care to the sickest patients.

If an ER doctor takes in a critically ill patient, who needs care to be stabilized it can skew other patients' perceptions of care. This may occur when after an hour and a half of providing care to a critically ill patient, some other patients, who have had to wait, may give low scores on patient satisfaction surveys to the doctor. This happens even though the doctor is excellent and gives quality care to his/her patients.

Furthermore, some healthcare providers say that patient satisfaction surveys may not be reliable for other reasons. A patient asked whether a phlebotomist took their blood properly or asked to rate the skill and quality of doctors and nurses with whom the patient interacts may not have the knowledge to answer that question. In addition, patients who are unhappy about a long wait, or who did not receive requested narcotics may report low survey results.  

These incidents matter because in an online survey of doctors, set up by Emergency Physicians Monthly, 17% of 717 doctors surveyed reported that their employment was threatened based on patient satisfaction scores, and 27% of respondents said their compensation was tied in some way to patient satisfaction scores.

For these reasons, clinicians have requested that further research into the value of patient surveys be done.

Knowing the benefits and drawbacks of surveys, training leadership to properly evaluate them, and disseminating information to frontline clinicians may allay the fears of healthcare providers about the efficacy and appopriate use of surveys.


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Topics: Quality Assurance

Mary Kilgus

Written by Mary Kilgus

Mary Kilgus is a practicing attorney and currently enrolled in USC Price School's MPA program.

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