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PURPOSE The process and outcomes of delivering medical care for chronic low back pain might affect patient satisfaction. We aimed to determine the associations of process and outcomes with patient satisfaction. METHODS We conducted a cross-sectional study of patient satisfaction among adult participants with chronic low back pain in a national pain research registry using self-reported measures of physician communication, physician empathy, current physician opioid prescribing for low back pain, and outcomes pertaining to pain intensity, physical function, and health-related quality of life. We used simple and multiple linear regression models to measure factors associated with patient satisfaction, including a subgroup of participants having both chronic low back pain and the same treating physician for >5 years. RESULTS Among 1,352 participants, only physician empathy (standardized [beta], 0.638; 95% CI, 0.588-0.688; t = 25.14; P < .001) and physician communication (standardized [beta], 0.182; 95% CI, 0.133-0.232; t = 7.22; P < .001) were associated with patient satisfaction in the multivariable analysis that controlled for potential confounders. Similarly, in the subgroup of 355 participants, physician empathy (standardized [beta], 0.633; 95% CI, 0.529-0.737; t= 11.95; P < .001) and physician communication (standardized [beta], 0.208; 95% CI, 0.105-0.311; t = 3.96; P < .001) remained associated with patient satisfaction in the multivariable analysis. CONCLUSIONS Process measures, notably physician empathy and physician communication, were strongly associated with patient satisfaction with medical care for chronic low back pain. Our findings support the view that patients with chronic pain highly value physicians who are empathic and who make efforts to more clearly communicate treatment plans and expectations. Key words: patient satisfaction; chronic low back pain; physician communication; physician empathy; opioid prescribing https://doi.org/10.1370/afm.2949, INTRODUCTION Donabedian proposed the triad model of quality-of-care assessment on the basis of structure, process, and outcomes more than 3 decades ago. (1) The model remains relevant today, with the [...]

PURPOSE Most patients are escorted to exam rooms (escorted rooming) although patients directing themselves to their exam room (self-rooming) saves patient and staff time while increasing patient satisfaction. This study assesses patient and staff perceptions after pragmatic implementation of self-rooming. METHODS In October-December 2020, we surveyed patients and staff in 25 primary care clinics after our institution expanded self-rooming from 4 specially built clinics during the COVID-19 pandemic. Semi-structured surveys asked about rooming process used, rooming process preferred, and perceptions of self-rooming compared with escorted rooming. RESULTS Most patients (n = 1,561) preferred self-rooming (86%), especially among patients aged Over one-half of staff (n = 241; 180 clinical, 61 nonclinical) preferred self- rooming (59%) and thought most patients liked self-rooming (65.8%), especially among clinical staff and in early adopter clinics ([less than or equal to] 2016). Few staff reported worse waiting times for patients (12.4%), medical assistants (MAs) (15.9%), and clinicians (16.4%) or worse crowding in waiting areas (1.7%) and hallways (10.1%). Unlike patient-reported confusion (7.6%), most staff thought self-rooming led to more patient confusion (63.8%), except in early-adopter clinics (44.4%). CONCLUSIONS Self-rooming is a patient-centered innovation that is also acceptable to staff. We demonstrated that pragmatic implementation is feasible across primary care without expensive technology or specially designed buildings. Key words: primary care; self-rooming; organizational innovation; patientcentered care, INTRODUCTION Self-rooming is a relatively new process where patients direct themselves to an assigned exam room immediately after checking in, bypassing the traditional experience in which a staff member would [...]

Background and Objectives Concern about mistreatment and abuse during childbirth care is growing, and evidence suggests that many women worldwide experience mistreatment during childbirth. The study aimed to assess the prevalence of abused women during labor, types of abuse, rate of satisfaction with birth care among abused women, and associated sociodemographic and obstetric factors with mistreatment and abuse in the delivery room. Methods A cross-sectional study was conducted with data from 1196 women who experienced a vaginal delivery at least once within the past year in a public health setting in Erbil city, Kurdistan Region, Iraq. The author developed a questionnaire after a comprehensive review of the literature. Data were collected through direct interviews with the sample. Frequency, percentage, and chi-square tests were used for data analysis. Results About half of the study sample (49.9%) mentioned that they experienced mistreatment and/or abuse during labor and delivery. The most experienced type of mistreatment and abuse were as follows: lack of privacy (84.6%), patient-blaming (58.5), purposeful neglect (51.6%), abandonment of care, and detention in facilities (43.9%), Non-consented care (42.9%). The rate of physical and verbal abuse was 24.3% and 29.8%, respectively. There was a highly significant association between parity and general satisfaction with birth care with experiencing abuse (P = 0.006, P [less than or equal to] 0.001). Conclusions Mistreatment and abuse of women during childbirth are present among Kurdish women, leading to generally non-satisfaction with birth care, and exploring the reasons behind why health care providers mistreatment and abuse women during childbirth is critical., Author(s): Hamdia Mirkhan Ahmed [sup.1] Author Affiliations: (1) grid.412012.4, 0000 0004 0417 5553, College of Health Sciences & Center for Research and Education in Women's Health, Hawler Medical University, , [...]

The diagnostic experiences of autistic adults in New Zealand have not been investigated and little is known globally about autistic adults' satisfaction with the autism diagnostic process. This study describes the diagnostic experiences of 70 autistic adults living in New Zealand and explores how these experiences are related to satisfaction during three stages of the diagnostic process. The results show that autistic adults were reasonably satisfied with the early query and diagnostic assessment stages, but were dissatisfied with the post-diagnostic support stage, with significant unmet needs. Dissatisfaction during the post-diagnostic support stage was also related to satisfaction during previous stages and poor coordination of supports. Suggestions are made on how to improve the autism diagnostic pathway for autistic adults in New Zealand., Author(s): Kiah Evans [sup.1] [sup.2] [sup.3] , Larah van der Meer [sup.3] [sup.4] [sup.5] , Matthew J. F. Eggleston [sup.6] , Lauren J. Taylor [sup.7] , Hiran Thabrew [sup.8] , [...]

Objective The objective of this study was to identify factors related to satisfaction with virtual visits during pregnancy in an effort to prioritize intervention targets for pregnant women during the COVID-19 pandemic. Methods The study relied on data obtained from pregnant women (N = 416) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to November 22, 2020. Using a cross-sectional design, this study examined factors including COVID-19 related experiences and prenatal care changes in association with patient satisfaction of virtual prenatal care. Results Overall, women reported being very or extremely satisfied (27.9%) or moderately satisfied (43.5%) with their virtual prenatal experiences, however, 89.9% indicated a preference for in-person care under non-pandemic conditions. Those who completed the survey further into the pandemic were less satisfied with virtual prenatal care ([beta] = - 0.127, p < 0.01). After accounting for this and other sociodemographic characteristics, COVID-19 pregnancy worries ([beta] = - 0.226, p < 0.001) and the number of prenatal care changes due to the pandemic ([beta] = - 0.137, p < 0.01) were associated with lower satisfaction. Conclusion Our findings demonstrate general satisfaction with virtual visits among pregnant women in this study although in general women would prefer in-person care if it weren't for a pandemic. Women worried about the impact of pandemic on their pregnancy, as well as those experiencing transitions in their prenatal care may need more information and reassurance. Additional studies are needed to understand the unmet needs through virtual care compared to in-person care., Author(s): Cindy H. Liu [sup.1] [sup.2] [sup.3] , Deepika Goyal [sup.4] , Leena Mittal [sup.2] [sup.3] , Carmina Erdei [sup.1] [sup.3] Author Affiliations: (1) grid.62560.37, 0000 0004 0378 8294, Department [...]

Introduction: Brief Cognitive Behavioral Therapy for Chronic Pain (Brief CBT-CP) is a biopsychosocial treatment designed to improve access to nonpharmacological pain care in primary care. Results from a clinical demonstration project in Veterans Health Administration (VHA) clinics showed rapid improvement in pain outcomes following Brief CBT-CP treatment in Primary Care Behavioral Health (PCBH). As part of this larger project, the current work aimed to understand patients' perspectives of Brief CBT-CP via a self-report survey completed posttreatment. Method: Thirty-four primary care patients received Brief CBT-CP as part of their usual VHA care and subsequently completed an anonymous survey that included questions regarding treatment modality, intervention content, utility, and satisfaction, as well as global assessment of change in pain-related functioning. Results: Participants reported that Brief CBT-CP content was useful (91%) and that they were satisfied with the intervention overall (89%), including appointment length, frequency of encounters, and comprehensibility of content. On average (M = 4.50, SD = 1.71), participants reported 'somewhat better' to 'moderately better' pain-related functioning following treatment. Exploratory descriptive analysis indicated that self-reported change in function following treatment may vary by patient characteristics, including gender and opioid use history. Discussion: Patients were receptive to Brief CBT-CP, were satisfied with their experience during treatment, and reported benefit in pain-related functioning after treatment. Further development and evaluation of Brief CBT-CP as a feasible biopsychosocial treatment option for pain in primary care clinics using the PCBH model of integration is warranted. Public Significance Statement This study showed that patients who completed Brief Cognitive Behavioral Therapy for Chronic Pain found treatment to be highly acceptable in terms of the length and frequency of appointments, understandability and utility of treatment content, and impact on pain-related functioning. This protocol is well suited for delivery in integrated primary care settings and may serve to extend the reach of safe, behavioral treatments for chronic pain. Keywords: chronic pain, primary health care, mental health services, primary care behavioral health, cognitive behavioral therapy, Recommendations for chronic pain management increasingly emphasize nonpharmacological interventions due to safety concerns over opioids (Dowell et al., 2016). Psychological therapies are effective treatments for chronic pain (Williams et al., [...]

Objective To examine the impact of the COVID-19 pandemic on birth satisfaction and perceived health care discrimination during childbirth, and in turn, the influence of these birth experiences on postpartum health. Study Design We conducted a cross-sectional, bilingual web survey of 237 women who gave birth at two hospitals in New York City and assessed patient-reported experience and outcomes following the first wave of SARS-CoV-2 infections in the New York region. We ascertained SARS-CoV-2 status at delivery from the electronic medical record using participant-reported name and date of birth. We compared birth experience during the COVID-19 pandemic (March 15, 2020-May 11, 2020) to a pre-pandemic response period (January 1, 2020-March 14, 2020). We estimated risk ratios for associations between birth experience and anxiety, depressive symptoms, stress, birth-related PTSD, emergency department visits, timely postpartum visit, and exclusive breastfeeding. Multivariable models adjusted for age, race-ethnicity, insurance, education, parity, BMI, previous experience of maltreatment/abuse and cesarean delivery. Results Women who gave birth during the peak of the pandemic response, and those that were SARS-CoV-2 positive, Black, and Latina, had lower birth satisfaction and higher perceived health care discrimination. Women with lower birth satisfaction were more likely to report higher postpartum anxiety, stress, depressive symptoms, and lower exclusive breastfeeding. Experiencing one or more incident of health care discrimination was associated with higher levels of postpartum stress and birth-related PTSD. Conclusion Hospitals and policy-makers should institute measures to safeguard against a negative birth experience during the ongoing COVID-19 pandemic, particularly among birthing people of color., Author(s): Teresa Janevic [sup.1] [sup.2] [sup.3] , Sheela Maru [sup.1] [sup.4] [sup.5] , Sarah Nowlin [sup.2] [sup.6] , Katharine McCarthy [sup.2] [sup.3] , Veerle Bergink [sup.1] [sup.3] [sup.7] , Joanne [...]

Objective High maternal and neonatal mortality rates in developing regions like Pakistan are linked to low rates of institutional deliveries. One way to improve rates of institutional deliveries is through improving institutional delivery service satisfaction in women. The aim of this research is to identify which factors influence delivery service satisfaction during the period of COVID-19 and which socio-demographic characteristics of women are associated with greater fear of catching COVID-19 during institutional deliveries. Methods A total of 190 women who had given birth between May to June, 2020, were sampled from two private and two public sector hospitals in Lahore, Pakistan. A standardized tool was modified for use and a combination of descriptive statistics and multivariate regression was applied. Results The results reveal that a majority of women, at 74.7%, are afraid of contracting COVID-19; specifically, women delivering at public hospitals, those who are illiterate or semi-literate, with more than four children, with low household income, and who are unemployed. Regression models are used to identify factors related to higher satisfaction, including the following: (i) pre-delivery care (explanatory power of R.sup.2 = 0.651); (ii) during delivery care (R.sup.2 = 0.716); (iii) after delivery care for women (R.sup.2 = 0.525); and (iv) after delivery care for newborn (R.sup.2 = 0.780). The main areas which influence satisfaction include the following: service quality of staff and administration; maintenance of hygiene and sanitation; involvement in decision-making; provision of necessary information; and advice for breastfeeding, immunization and family planning. Conclusions for Practice Based on our findings, we recommend improved regulation of delivery services in both public and private hospitals and increased protection for disadvantaged women groups to maintain service quality during the pandemic., Author(s): Sara Rizvi Jafree [sup.1] , Ainul Momina [sup.2] , Amina Muazzam [sup.3] , Rabia Wajid [sup.4] , Gloria Calib [sup.5] Author Affiliations: (1) grid.444905.8, 0000 0004 0608 7004, Department [...]

Context: At onset of the COVID-19 pandemic, primary care quickly transitioned to the use of virtual care. Although much is known about the challenges and opportunities of virtual care for providers and practices, little remains known about the patient experience with virtual care in primary care. The involvement of patients and other key stakeholders as partners in the research process is crucial to generate relevant findings to guide policy and decision-makers in a way that enhances quality of care and patient outcomes. Objective: Describe a multi-pronged approach to inform a population based, mixed-methods research study investigating patients' experiences with virtual care in Ontario, Canada. Study Design: Mixed-methods--a province-wide survey and descriptive qualitative interviews running in parallel. Our multi-pronged approach engaged Patients, Researchers, Policy makers and other data users throughout the study. I) Patients: We recruited a Patient Advisory Committee through patient advocacy groups and health-oriented organizations, and selected individuals to maximize geographical, gender, and sociocultural variation. II) Professional Organizations: We integrated the Association of Family Health Teams of Ontario, Alliance for Healthier Communities, and Ontario College of Family Physicians as key members of the research team. III) Primary Care Practices: We partnered with primary care practices who were data users. Practices disseminated the survey to their patients. IV) Policy and Decision-Makers: We conducted ongoing consultations with stakeholders from Ontario Health and Ontario Ministry of Health for a reciprocal dynamic that informed the research process and enabled rapid uptake of research findings by key stakeholders. Our multi-pronged process used a mixture of involvement and collaboration models of engagement. Results: 55 interviews were conducted with patients and 534 survey respondents met eligibility criteria. The multi-pronged approach provided success with rapid dissemination of results to inform immediate system and practice-level decisions on the use of virtual care. We produced a comprehensive report for provincial policy and decision-makers, conducted 3 presentations to provincial policy and decisionmakers, provided each participating practice with detailed practice-specific reports, and participated in an invited panel. Conclusions: Patient and stakeholder engagement is a key component to primary care research., Presenters Rachelle Ashcroft, PhD, Simone Dahrouge, PhD, Kiran Saluja, PhD, Simon Lam, BA, [...]

Introduction: Physician-patient communication involves complex skills that affect quality, outcome, and satisfaction for patients, families, and health care teams. Yet, institutional, regulatory, and scientific demands compete for physicians' attention. A framework is needed to support physicians continued development of communication skills: Coaching is 1 such evidence-based practice, and we assessed the feasibility of implementing such a program. Method: Participants were 12 physicians, representing high and low scorers on the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey. We added items to capture empathy and family experience to the Calgary-Cambridge Observation Guide for the Medical Interview. Coaches observed communication associated with patient satisfaction and quality measures: introductions (I), asking about concerns (C), and check for understanding (U), or ICU. Participants received a report describing their communication behaviors, emphasizing strengths, and identifying areas for improvement. Results: Scores on the ICU significantly discriminated between low and high HCAHPS scorers, physicians from surgical and cognitive specialties, men and women. We collected anonymous feedback regarding the value of this training; participants recommended expanding the program. Discussion: Based on physician endorsement, experienced coaches are expanding the coaching program to physicians throughout our institution. Public Significance Statement The patient-physician relationship depends on a foundation of effective communication skills by physicians. One-to-one coaching helps physicians recognize patterns in their communication style that can be enhanced to promote improved patient-physician relationships, clinical outcomes, patient and family satisfaction, and physician well-being. A coaching framework developed at the University of Rochester Medical Center has been well received by physicians and supported by patients, such that it has expanded significantly. Keywords: communication, coaching, patient satisfaction, patient-family-centered, physician-patient relationship, Skilled communication among physicians, patients, and families improves clinical outcomes and patient satisfaction and protects against medical errors (Duffy et al., 2004). Compassionate patient- and family-centered communication represents the moral [...]

Byline: Sri. Chalasani, C. Gurudatt, Madhan. Ramesh Introduction Patient satisfaction encompasses a multidimensional approach to determining how well the patient's expectations about the service provided by medical care have been [...]

Byline: Suparna. Bharadwaj, G. Umamaheswara Rao, Arjun. Hegde, Dhritiman. Chakrabarti Background: Quality of health care is a major issue. Providing care that accommodates individual patient preferences and values is termed [...]

Author(s): Micaela Q. Dugan [sup.1], Jorge R. Delgado [sup.3], Elizabeth De Souza [sup.2], T. Anthony Anderson [sup.2] Author Affiliations: (1) grid.168010.e, 0000000419368956, Department of History, Stanford University, , Stanford, CA, [...]

Context.--Assessment of customer satisfaction is a vital component of the laboratory quality improvement program. Objective.--To survey the level of physician satisfaction with hospital clinical laboratory services. Design.--Participating institutions provided demographic information and survey results of physician satisfaction, with specific features of clinical laboratory services individually rated on a scale of 5 (excellent) to 1 (poor). Results.--Eighty-one institutions submitted 2425 surveys. The median overall satisfaction score was 4.2 (10th percentile, 3.6; 90th percentile, 4.6). Of the 16 surveyed areas receiving the highest percentage of excellent/good ratings (combined scores of 4 and 5), quality of results was highest along with test menu adequacy, staff courtesy, and overall satisfaction. Of the 4 categories receiving the lowest percentage values of excellent/good ratings, 3 were related to turnaround time for inpatient 'STAT' (tests performed immediately), outpatient STAT, and esoteric tests. The fourth was a new category presented in this survey: ease of electronic order entry. Here, 11.4% (241 of 2121) of physicians assigned below-average (2) or poor (1) scores. The 5 categories deemed most important to physicians included quality of results, turnaround times for inpatient STAT, routine, and outpatient STAT tests, and clinical report format. Overall satisfaction as measured by physician willingness to recommend their laboratory to another physician remains high at 94.5% (2160 of 2286 respondents). Conclusions.--There is a continued trend of high physician satisfaction and loyalty with clinical laboratory services. Physician dissatisfaction with ease of electronic order entry represents a new challenge. Test turnaround times are persistent areas of dissatisfaction, representing areas for improvement. (doi: 10.5858/arpa.2015-0486-CP), As physicians are the primary customers of the clinical laboratory, it is important for laboratories to assess physician satisfaction with services that are being provided. Both the College of American [...]

Context: Telepsychiatry has become a common modality for the provision of psychiatric consultations to patients in rural regions. Aims: The aims of this study were to assess and compare patient [...]

Introduction: Diabetes care in Canada is usually provided in family practice offices, which may not have nurses to provide planned, proactive care as recommended by guidelines. The use of medical office assistants (MOAs) to do key tasks in diabetes care may improve the effectiveness of care and reduce costs. We sought to determine whether an expanded MOA role in a rural practice was beneficial to patients and the practice. Methods: We systematically evaluated the provision of diabetes care as measured by key indicators, patient and provider satisfaction, and use of health care services. Results: Involvement by MOAs improved adherence to selected aspects of guideline-based care, and patient and provider satisfaction was high. The actual outcomes of the surrogate markers measured in care and downstream use of acute care services appeared to be unchanged during this study. Conclusion: Use of MOAs to help provide team-based diabetes care in family practice resulted in improved performance of key indicators for diabetes care. Introduction : Les soins aux personnes atteintes de diabete au Canada sont habituellement fournis par des pratiques de medecine familiale qui ne disposent pas necessairement d'infirmieres pour dispenser les soins proactifs planifies recommandes par les lignes directrices. Le recours aux adjointes de bureau medical (ABM) pour effectuer des taches cles en soin du diabete peut ameliorer l'efficacite des soins et reduire les couts. Nous avons cherche a determiner si un role elargi pour les ABM dans une pratique rurale etait benefique pour les patients et la pratique. Methodes : Nous avons evalue systematiquement la prestation de soins aux personnes atteintes de diabete telle que mesuree par des indicateurs cles, par la satisfaction des patients et des fournisseurs et par l'utilisation des services de sante. Resultats : L'intervention des ABM a ameliore l'observation de certains aspects des soins bases sur les lignes directrices, et la satisfaction des patients et des fournisseurs etait elevee. Les resultats concrets au niveau des marqueurs substituts mesures pour les soins et l'utilisation en aval des services de soins actifs n'ont pas semble changer au cours de l'etude. Conclusion : Le recours aux ABM pour aider a fournir les soins du diabete en equipe dans une pratique de medecine familiale a ameliore le rendement d'indicateurs cles en soin du diabete., INTRODUCTION Given the major burden of diabetes in Canada, it is vital to improve health outcomes through improved care. (1-7) Diabetes care in Canada is largely provided by family doctors. [...]

Background: The objective of this study is to determine patient participation rates and insights related to patient-reported outcomes following breast cancer (BC) surgery. Methods: Female patients with unilateral, nonrecurrent BC [...]

Background: Innovative strategies are paramount in a country that has a huge social disparity and an HIV epidemic concentrated in key populations (KP), who commonly experience barriers to access health [...]

Background: Provider-collected swabs are an unappealing procedure for many transgender women due and may have led to suboptimal rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) testing. Self-collection for [...]

Purpose To determine to what extent intensive care unit environment affects family and patient satisfaction. Methods A before-after study was performed in one university hospital in The Netherlands, 2 months before and 2 months after the migration of an intensive care unit (ICU) with multiple beds on a ward to a newly built ICU with all single rooms. Family and patient satisfaction were determined by two surveys: family satisfaction with care in the ICU and patient satisfaction with care in the ICU, respectively. Results From 387 of 617 (63 %) discharged patients at least one survey (patient and/or family) was returned. Both family and patients were more satisfied with their overall ICU experience in the new ICU as compared with the old ICU. Mean scores for family satisfaction increased from 69.5 [standard deviation (SD) 16.6] to 74.1 (SD 15.2) for old and new ICU, respectively (p = 0.02). For patients, satisfaction rates increased from 63.6 (SD 18.9) to 69.6 (SD 18.3) for old and new ICU, respectively (p = 0.02). The largest differences on single items of the surveys were noted on environmental aspects. Conclusions This is the first study to quantify the effect of ICU environment on family and patient satisfaction. Family and patient satisfaction with ICU experience increased by 6 % in the new ICU environment with noise-reduced, single rooms with daylight, adapted colouring and improved family facilities., Author(s): Irene P. Jongerden [sup.1], Arjen J. Slooter [sup.1], Linda M. Peelen [sup.2], Hester Wessels [sup.3], Colette M. Ram [sup.1], Jozef Kesecioglu [sup.1], Margriet M. Schneider [sup.4], Diederik van Dijk [...]

Background We examined the association of a migration background and patient satisfaction in a pediatric nephrology outpatient clinic in Germany. Methods This was a cross-sectional study of 348 families presenting at the Pediatric Nephrology Outpatient Department of Charite University Children's Hospital in Berlin during 2008. Parents were asked to complete a questionnaire containing basic sociodemographic information, a subjective categorical rating of disease severity and communication with the medical team, and a validated patient satisfaction score (ZUF-8) derived from a customer satisfaction score used by industry and modified for healthcare providers. Results Of the 348 families included in the study, 131 patients (38 %) had a migration background (20 different nationalities, 22 different native languages). Patient satisfaction (rated on a scale from 8 to 40) was significantly higher in families without (32.9 [+ or -] 4.6) than in those with a migration background (30.8 [+ or -] 4.7; p Conclusions Migrant families were less satisfied with the provision of the outpatient care provided by our department than non-migrants. Keywords Migration background * Children * Parents * Patient satisfaction * Healthcare, Introduction The socioeconomic and public health-related implications of migration are increasingly being recognized as having strong effects on society as a whole and the medical profession in particular. Data on [...]

Abstract Purpose--The purpose of this paper is to determine the factors that have an impact on customer satisfaction as regards the working of select Indian universal banks. Design/methodology/approach--The study was [...]

Abstract A patient experience survey was undertaken by the South West London Cancer Network in 2009. It involved all the acute trust providers and was carried out under the auspices [...]

Summary Health boards in Scotland are challenged with reducing emergency department (ED) attendances against a backdrop of year-on-year increases. It is often assumed that patients who attend EDs with non-urgent [...]

Summary This article discusses the findings of a multi-hospital satisfaction survey of men with newly diagnosed prostate cancer. The survey was designed to enable direct comparison with a previously published [...]

Abstract Aim This audit aimed to identify patients' experience of a bone marrow procedure performed by the lymphoma clinical nurse specialist (CNS), particularly in relation to the pain relief used [...]

Objective To explore what determines people&apos;s satisfaction with the health-care system above and beyond their experience as patients. Methods Data on health system responsiveness, which refers to the manner and environment in which people are treated when they seek health care, provides a unique opportunity to better understand the determinants of people&apos;s satisfaction with the health-care system and how strongly this is influenced by an individual&apos;s experience as a patient. The data were obtained from 21 European Union countries in the World Health Survey for 2003. Additive ordinary least-squares regression models were used to assess the extent to which variables commonly associated with satisfaction with the health-care system, as recorded in the literature, explain the variation around the concept of satisfaction. A residual analysis was used to identify other predictors of satisfaction with the health-care system. Findings Patient experience was significantly associated with satisfaction with the health-care system and explained 10.4% of the variation around the concept of satisfaction. Other factors such as patient expectations, health status, type of care, and immunization coverage were also significant predictors of health system satisfaction; although together they explained only 17.5% of the observed variation, while broader societal factors may largely account for the unexplained portion of satisfaction with the health-care system. Conclusion Contrary to published reports, people&apos;s satisfaction with the health-care system depends more on factors external to the health system than on the experience of care as a patient. Thus, measuring the latter may be of limited use as a basis for quality improvement and health system reform. Objectif Etudier ce qui determine la satisfaction des individus a l&apos;egard du systeme de sante au-dela de leur experience en tant que patients. Methodes Les donnees sur,l&apos;aptitude du systeme de sante a repondre aux attentes, qui portent sur les conditions et renvironnement dans lesquels sont traites les patients lorsqu&apos;ils sollicitent des soins, fournissent une occasion unique de mieux comprendre les determinants de la satisfaction des individus a l&apos;egard de ce systeme et dans quelle mesure cette satisfaction est influencee par leur experience en tant que patients. Ces donnees ont ete obtenues aupres de 21 pays de l&apos;Union europeenne dans le cadre de l&apos;Enquete sur la sante dans le monde de 2003. Des modeles de regression multiple additifs (methode des moindres carres ordinaires) ont ete utilises pour evaluer dans quelle mesure des variables&apos;couramment associees a la satisfaction a l&apos;egard du systeme de sante d&apos;apres les indications de la litterature peuvent expliquer la variation autour du concept de satisfaction. Une analyse des residus a servi a identifier d&apos;autres facteurs predictifs de la satisfaction a l&apos;egard du systeme de sante. Resultats II existait une association significative entre l&apos;experience des patients et la satisfaction a regard du systeme de sante, qui expliquait 10,4 % de la variation autour du concept de satisfaction. D&apos;autres facteurs tels que les attentes des patients, l&apos;etat de sante, le type de soins et la couverture vaccinale, presentaient egalement une valeur predictive importante pour la satisfaction a l&apos;egard du systeme, meme si globalement, ils n&apos;expliquaient que 17,5 % de la variation observee, tandis que des facteurs societaux plus larges pouvaient amplement rendre compte de la fraction inexpliquee de cette satisfaction. Conclusion Contrairement a ce qu&apos;indiquent les rapports publies, la satisfaction des personnes a l&apos;egard du systeme de sante depend plus de facteurs externes a ce systeme que de l&apos;experience vecue par ces personnes en tant que patients. La mesure de cette satisfaction devrait donc etre d&apos;une utilite limitee comine base pour ameliorer la qualite et reformer le systeme de sante. Objetivo Estudiar que factores determinan la satisfaccion de las personas con el sistema de atencion de salud por encima de su experiencia como pacientes. Metodos Los datos sobre la responsividad de los sistemas de salud, entendiendose por tal la manera y el entorno en que se trata a las personas cuando buscan atencion de salud, son una valiosa herramienta para conocer mas a fondo los determinantes de la satisfaccion de las personas con el sistema de atencion de salud y la medida en que esa percepcion se ve influida por la experiencia de cada cual como paciente. Los datos utilizados proceden de la informacion sobre 21 paises de la Union Europea recogida en la Encuesta Mundial de Salud 2003. Se utilizaron modelos de regresion de minimos cuadrados ordinarios aditivos para determinar el grado de explicacion de la variacion dei nivel de satisfaccion atribuible a algunas variables que segun la bibliografia al respecto aparecen asociadas generalmente a ese concepto. Mediante analisis residual se identificaron otros factores predictivos de la satisfaccion con el sistema de atencion de salud. Resultados La experiencia de los pacientes estaba relacionada de forma significativa con la satisfaccion con el sistema de atencion de salud y explicaba el 10,4% de la variacion de la satisfaccion. Otros factores, como las expectativas de los pacientes, su estado de-salud, el tipo de atencion y la cobertura de inmunizacion, tambien se revelaron como factores predictivos relevantes de la satisfaccion con el sistema de salud; sin embargo, globalmente explicaban solo un 17,5% de la variacion observada, lo que Ileva a pensar que hay otros factores sociales mas generales que determinarian en gran medida el componente no explicado de la variacion de la satisfaccion con el sistema de atencion de salud. Conclusion Contrariamente a lo senalado en algunas publicaciones, la satisfaccion de la poblacion con el sistema sanitario depende mas de factores externos al sistema de salud que de la experiencia vivida por cada persona como paciente. Asi pues, la medicion de esta ultima tendria una utilidad limitada como base para mejorar la calidad de la atencion y reformar el sistema sanitario., Introduction Across the United States of America and Europe, consumer satisfaction is playing an increasingly important role in quality of care reforms and health-care delivery more generally. However, consumer satisfaction [...]

Client satisfaction surveys in developing countries are increasingly being promoted as a means of understanding healthcare service quality and the demand for these services, However, concerns have been raised about the reliability of responses in such surveys: for example, 'courtesy bias' may lead clients, especially if interviewed upon exiting clinics, to provide misleadingly favorable responses, This study investigates this and other issues using unusual data from Madagascar in which identical questions about satisfaction with local health care centers were asked in user exit surveys and in a population-based household survey, the latter being less contaminated by courtesy bias as well as changes in provider behavior in response to being observed, The findings suggest that reported satisfaction in exit surveys is biased strongly upward for subjective questions regarding (for example) treatment by staff and consultation quality, but not for relatively objective questions about facility condition and supplies. The surveys do provide useful information on the determinants of consumer satisfaction with various dimensions of provider quality, Still, to obtain reliable estimates of consumer perceptions of health service quality, household-based sampling is strongly preferred, Keywords: Health service quality Patient satisfaction Survey methods Madagascar Household data

NHS Lanarkshire provides unscheduled care in a wide variety of settings, including emergency departments (EDs), acute receiving units, out-of-hours centres, community hospitals and GP minor injury units. As traditional clinical [...]

Ratings of treatment satisfaction are a means for cognitive behavior therapy clients to provide their unique personal perspective on their therapy experience. Treatment satisfaction is a variable of growing importance as a predictor of outcome for various medical and psychological treatments including treatments for chronic pain (D. C. Turk et al., 2003). Our goal was to determine whether satisfaction with cognitive behavior therapy sessions varied as a function of patient personality characteristics in a sample of 43 older adults (average age = 72.3 years, SD = 8.0) participating in a psychosocial pain management therapy program with a cognitive behavioral orientation. Participants completed the NEO Five Factor Inventory (P. T. Costa, Jr. & R. R. McCrae, 1992) prior to the commencement of treatment and a psychometrically valid questionnaire, assessing satisfaction with psychological therapy, after each therapy session. The core personality dimensions of neuroticism, openness, and agreeableness were predictive of aspects of satisfaction with therapy. These findings have the potential of being useful to clinicians concerned with the prediction of response to therapy. Keywords: treatment satisfaction; personality; cognitive behavior therapy; older adults; elderly

Input from consumers has become an important part of quality improvement in long-term care and for consumer decision-making. This paper documents the development of the Ohio Nursing Home Resident Satisfaction Survey (ONHRSS) through a partnership of state government, research, and industry experts. The instrument was tested and refined through two waves of data--a pretest phase and later with statewide data. Exploratory and confirmatory analyses with statewide data identified eight primary factors along with an underlying, secondary Global Satisfaction factor. Reliability of the domains ranged from .69 to .95. Recommendations for further refinement and testing of the instrument are discussed along with policy and practice implications. doi: 10.1300/J031v19n02_05 KEYWORDS. Consumer satisfaction, long-term care, reliability

We report on a federal initiative to develop a CAHPS[R] (The Consumer Assessment of Healthcare Providers and Systems) survey to measure residents' experiences with quality-of-care and quality-of- life in nursing homes (known as NHCAHPS). We focus on how we created and tested questions for inclusion in the instrument and tested a possible cognitive screener to determine which residents could participate in a NHCAHPS interview. The major lessons learned were: (1) In contrast to other CAHPS surveys, ratings were more useful than reports because of the difficulty that residents had with summarizing over time and people; (2) consistent with other CAHPS surveys, the 0 to 10 response scale appeared to work well with nursing home residents for many of the quality-of-care questions; however, a different response scale was needed for many of the quality-of-life items; and (3) in contrast with typical survey methodology and other CAHPS surveys where explicit time reference periods are used, a non-specific present reference period in questions seemed to work best. doi: 10.1300/J031v19n02_04 KEYWORDS. Patient experience, satisfaction survey, quality-of-care, quality-of-life

In response to increased consumer demand, state governmerits are publishing more detailed information about the quality of nursing homes. In 2002, Ohio legislation mandated the publication of a Long-Term Care Consumer Guide that included information on nursing home resident and family satisfaction surveys. Using the 2002 Ohio Nursing Home Resident Satisfaction Survey as an example, this article addresses two research questions: (1) how can statewide resident face-to-face satisfaction interviews be implemented to maximize participation of residents and facilities and produce reliable and valid results, and (2) how satisfied are residents with their nursing home experiences, overall and by level of cognitive function, doi: 10.1300/J031v19n02_06 KEYWORDS. Structured interviews, satisfaction survey, nursing home residents, cognitive impairment, interviewer training

We review studies in the published literature using satisfaction surveys in long-term care settings. These settings include nursing homes, assisted living facilities, hospital long-term care units, and residential care homes. Rather than simply describe instruments in existence, we compare and contrast the format, content, and administration of these instruments. We identified 50 studies that have either developed or used satisfaction instruments in long-term care facilities. However, we also show that satisfaction instruments in the published literature vary greatly in numerous ways, including the number of questions they contain, the number of respondents included in the study, assessment of psychometric properties, and in the number of domains used. doi: 10.1300/J031v19n02_02 KEYWORDS. Satisfaction, resident surveys, customer satisfaction

Patient choice is at the heart of health-care reform programmes in the UK and in many other countries. The success of patient choice initiatives is dependent on a well-functioning agency relationship in health care. We interviewed 197 patients from 13 general practices in the West Midlands, UK, both before and after coronary screening. Our study suggests that, for patients presenting for coronary risk screening in primary care, the agency relationship is not working well--patients' expressed preferences relating to decisions to commence drug treatments were largely over-ridden in the clinical consultation. Therefore, if choice is to be a real driver of change in health care it needs to encompass patient empowerment and be based on a more collaborative approach to decision making between patients and professionals. Keywords: UK; Agency relationship; Choice; Coronary disease; Drug treatments

As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New Haven area in Connecticut. These sites included a community health center (n = 40), a community behavioral health center (n = 40), and a faith-based agency (n=23). As part of this study, the English version of the Therapeutic Alliance with Clinician (TAC) questionnaire was translated into Spanish and administered to our sample of Hispanic women. Results on the psychometric properties of the Spanish version of the TAC are presented in this article. KEY WORDS: behavioral health, community, Hispanic, relationship, therapeutic alliance

ABSTRACT Literature reviews, parental consultation and multi-disciplinary input informed the development of a questionnaire to evaluate parental satisfaction with a regional paediatric intensive care service. The questionnaire was tested in [...]