Patient Satisfaction Stable Among Unstable Conditions

by Rick Blizzard, D.B.A.
Health and Healthcare Editor

First in a series of articles on Gallup's 2003 healthcare database

Anyone who has followed healthcare news in recent years is familiar with the cavalcade of problems that dogs the industry -- shortages of nurses and other licensed healthcare professionals, medical errors at unacceptable levels, crises in many hospital emergency departments, increased volume, long wait times for inpatient beds, and antiquated facilities.

None of these problems augur well for healthcare organizations seeking to increase their patient satisfaction scores. But an analysis of Gallup's healthcare database, which compiles hundreds of thousands of patient satisfaction interviews with more than 300 hospitals each year, suggests that hospitals aren't doing so badly considering the odds they are up against.

Patient Satisfaction Since 2000

Since 2000, Gallup has maintained a comprehensive database of satisfaction results for inpatient, emergency department, and outpatient surgery patients, and outpatient test and treatment patients. Results from the 2003 calendar year have just been released, and an analysis of the data from all four years shows that patient satisfaction in each of the areas has remained steady, at the very least.

Inpatient. Inpatient satisfaction scores dipped slightly between 2000 and 2001 (from a mean score of 3.51 in 2000 to 3.49 in 2001), and since 2001, there has been a slight improvement each year (3.50 in 2002 and 3.51 in 2003). While these changes appear quite small, the upward trend is noteworthy because of the extremely large number of cases in the database.

Despite the obstacles that today's hospitals face, they are experiencing incremental improvement when it comes to inpatient satisfaction. One might theorize that improved technology or other "process" issues have had a positive impact on scores, but Gallup research has shown that these factors are secondary to the impact of the quality of interactions between patients and hospital personnel. In fact, one process issue in particular -- staffing shortages -- is likely having a negative impact on patient satisfaction scores, slowing the rate of improvement. Any increase in inpatient satisfaction scores is more likely due to an increased focus on making patients feel they are valued and respected.

Emergency Department. Emergency department satisfaction remains the lowest-scoring of the four service areas examined, and has exhibited almost no change over the past four years. The mean satisfaction scores for the emergency department declined from 3.30 in 2000 to 3.29 in 2001, and have remained there ever since. In light of the challenges that today's emergency departments face, the static nature of these scores is not necessarily bad news. New emergency department programs, such as bedside registration and minor emergency patient tracks, have helped to maintain emergency department scores amid crisis conditions.

Outpatient Surgery. Outpatient surgery satisfaction continues to be the highest-rated area in terms of patient satisfaction. However, hospitals have been unable to leverage these scores into a consistent pattern of improvement. Mean scores have seesawed between 3.68 and 3.69 over the past four years.

Outpatient Test and Treatment. Outpatient test and treatment satisfaction scores are the second-highest after outpatient surgery, and have exhibited a small pattern of improvement since 2001 (increasing from 3.54 to 3.56). Outpatient test and treatment facilities serve the highest number of patients of the four areas, and often represent an opportunity for patients to sample the services of a particular hospital. Such facilities are therefore crucial for hospitals seeking to establish positive reputations in their communities.

Bottom Line

Of the four areas measured, outpatient surgery and outpatient test and treatment areas provide the largest volume of services to the greatest number of patients, and relatively high scores in these areas represent great potential for hospitals. On the other end of the spectrum, low emergency department scores are an ongoing concern.

Given the negative publicity surrounding the nation's healthcare system, one might expect to see a dip in patient satisfaction scores, but this has not happened. But while stable scores aren't necessarily negative, they are also not enough.

Future articles in this series will focus on what the best hospitals do differently, and how other hospitals can learn from them to achieve improvement.

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