Monday, April 22, 2013

Patient satisfaction does not mean care was good


I hear so many people gloss over offhand or bad medical care by saying, "The doctor was nice, though." Or: That hospital was great--the food was delicious."

Or--and I love this one--"It must have been OK because I lived."

More and more these days, patient satisfaction is being measured (Medicare reimbursement to docs and hospitals depends on it now). This is not bad in itself. I certainly welcome a chance to comment at every turn.

But Johns Hopkins recently looked into this and found the quality of what happened in the operating room did not correlate with what patients thought of their care.

On one Medicare survey--the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (catchier: HCAHPS)--patients commented on nursing care, cleanliness, pain management, explanation of new meds, and discharge followup.

Surgical care quality was measured separately on such standards as infection prevention, blood clot prevention, and timely removal of tubes.

No link between patient satisfaction and surgical are quality!

There was a link between how happy the staff was and how happy the patients were. That is human nature, I think. If you feel your place is good, your customer will share that.

But science? Back to the drawing boards.

Related to this is another thing I have noticed--sometimes big, sort of old and grungy hospitals may have the best trauma units--people may not want to go there, but should not resist.

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