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Background: High-quality physician communication is the foundation for achieving high patient satisfaction. Increasing importance is placed on eliciting feedback from patients. However, there have been few studies looking at the impact of resident involvement on patient satisfaction. Our hospital system values the patient's likelihood to recommend the practice as the top marker for patient satisfaction., Methods: Between May 2016 and December 2016 at University of California, San Diego, all outpatient appointments were randomly mailed Press-Ganey surveys or an eSurvey regarding their experience. The surveys were filtered based on resident participation, and an χ test was performed to assess the impact of residents. An additional aim was to determine the degree to which the impact of resident involvement differed between surgical specialties. Binomial probability was calculated for each specialty using the 'no resident' group as the reference percentage., Results: A total of 73,834 surveys were mailed or sent electronically, and 17,653 surveys were returned (23.9% response rate). Overall, patients expressed high levels of satisfaction with the quality of physician communication. Patients who had residents involved in their care reported a decrease in satisfaction with physician communication and a decrease in the likelihood to recommend the practice (88.7% vs 90.4%, P < 0.001). In the analysis of resident impact by surgical specialty, 9 specialties qualified for analysis. Resident involvement was associated with lower physician communication scores in orthopedic surgery (P = 0.032), otolaryngology (P = 0.015), and vascular surgery (P = 0.01). In all other surgical subspecialties, there was no statistically significant difference between groups., Conclusions: Overall, patients expressed high levels of satisfaction with the quality of physician communication with and without resident involvement. Resident physician involvement in surgical clinic visits was associated with lower overall patient satisfaction and decreased likelihood of recommending the practice. In addition, we observed that resident involvement was not associated with lower communication scores in most surgical specialties, including Plastic Surgery.

Objectives/hypothesis: Electronic health records have brought many advantages but also placed a documentation burden on the provider during and after the clinic visit. Some otolaryngologists have countered this challenge by employing clinical scribes. This project aimed to better understand the influence of scribes on patient experience in the otolaryngology clinic., Study Design: Retrospective cohort survey study., Methods: Patients presenting to the otolaryngology clinic for new and follow-up appointments were recruited to complete surveys about their experience., Results: A total of 153 patients completed the survey, and 96 of those patients (62.7%) interacted with a scribe. Patient satisfaction was not significantly associated with participation of the scribe (P = .668). Similarly, patient rating of their physician on a scale of 1 to 10 was not associated with scribe involvement (P = .851). The patients who did interact with a scribe responded that the scribe positively impacted the visit 77.1% of the time. Participation of a resident, primary language other than English, and use of interpreter were associated with lower satisfaction (P = .004, P < .001, and P < .001, respectively)., Conclusions: There are no published data on the effect of scribes on patient experience in the otolaryngology clinic. In other specialties, scribes have been demonstrated as having a positive effect on provider satisfaction, clinical productivity, and patient perception. These data demonstrate that patient satisfaction was neither impaired nor improved by the presence of the scribe in this clinic. In light of benefits demonstrated by prior studies, these findings support the conclusion that scribes are a useful adjunct in providing high-level otolaryngology care., Level of Evidence: 4 Laryngoscope, 130:E134-E139, 2020., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives: To identify factors that influence patient satisfaction during outpatient visits in various settings of otolaryngology clinics in an academic medical center. Study design: Retrospective review. Setting: Academic medical center. Methods: We reviewed Press Ganey patient satisfaction survey responses for new, outpatient visits between January 1, 2014 and December 31, 2018. Self-reported race was identified using electronic medical records. Multivariate binary logistic regression analyses were used to identify continuous and categorical variables associated with patient satisfaction. Results: There were 3998 unique new patient visits with completed surveys. Multivariate analysis revealed that responses for patients <18 years old are less likely to be satisfied with their care compared to patients ≥18 years old (OR 0.66; P <.001). For each 10-minute increase in wait time, patients were 43.4% less likely report satisfaction (P <.001). African American patients were also less likely to report satisfaction (OR 0.22; P =.043) while Native Hawaiian and Pacific Islanders were over 3 times more likely to be satisfied (OR 3.6; P =.013). Additionally, Medicare patients and those who were seen at community satellite clinics compared to the main University Hospital had increased odds of achieving satisfactory care (OR 1.3; P =.005 and OR 1.3; P =.002, respectively). Conclusions: Wait time, clinic location, patient race, insurance provider, and age were all shown to significantly influence patient-reported satisfaction. Understanding how these variables influence patient satisfaction will hopefully lead to processes that improve patient satisfaction. Level of evidence: Level 3. [ABSTRACT FROM AUTHOR]

The aim was to evaluate patient satisfaction with virtual care, and identify factors associated with level of satisfaction. Surveys were mailed to all patients who had a phone visit at The Ottawa Hospital Rheumatology division. Patients' satisfaction with various aspects of the phone visits was assessed on a 5-point scale and analyzed according to demographic variables using chi-square and regression analyses. Of 2423 surveys mailed, we received 742 responses (31%). Eighty-nine percent of patients were satisfied overall with the phone visit. Statistically significant less satisfaction was seen in patients who spoke to a resident compared to their rheumatologist (p < 0.001), were not called on time (p < 0.001), had difficulty using a telephone (p < 0.001), needed assistance of a second person (p < 0.01), or had new consultations (versus routine follow-up, p = 0.01), the former 3 factors being significant in a multivariate regression analysis. Rheumatology patients expressed a high level of satisfaction with virtual care; however, areas of improvement were identified. Patients' satisfaction will be important to inform future decisions regarding the sustainability of virtual care. Further research is required to understand the impacts of virtual care on patients' Key Points • Patients in rheumatology practice were satisfied with phone visits and preferred this method to in-person visits during the pandemic. • Speaking directly to the rheumatologist, being phoned on time, and the capability of using the telephone were the major determinants of high patient satisfaction. • Based on the identified factors, further improvement of the quality of and satisfaction with phone visits can be pursued given that virtual care may continue longer, beyond the pandemic. [ABSTRACT FROM AUTHOR]

Background: Patient experience is valuable because it reflects how patients perceive the care they receive within the healthcare system and is associated with clinical outcomes. Also, as part of the Hospital Value-Based Purchasing (HVBP) program, the Center for Medicare and Medicaid Services (CMS) rewards hospitals with financial incentives for patient experience as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. It is unclear how the addition of residents and advanced practice clinicians (APCs) to hospitalist-led inpatient teams affects patient satisfaction as measured by the HCAHPS and Press Ganey survey. Objective: To compare patient satisfaction with hospitalists on resident, APC, and solo hospitalist teams measured by HCAHPS and Press Ganey physician performance domain survey results. Design: Retrospective observational cohort study. Participants: All patients discharged from the Internal Medicine inpatient service between July 1, 2015, and July 1, 2018, who met HCAHPS survey eligibility criteria and completed a patient experience survey. Main Measures: HCAHPS and Press Ganey physician performance domain survey results. Key Results: No differences were observed in the selection of "top box" scores on the HCAHPS physician performance domain between resident, APC, and solo hospitalist teams. Adjusted Press Ganey physician performance domain survey results demonstrated significant differences between solo hospitalist and resident teams, with solo hospitalists having higher scores in three areas: time physician spent with you (4.58 vs. 4.38, p = 0.050); physician kept you informed (4.63 vs. 4.43, p = 0.047); and physician skill (4.80 vs. 4.63, p = 0.027). Solo hospitalists were perceived to have higher physician skill in comparison with hospitalist-APC teams (4.80 vs. 4.69, p = 0.042). Conclusion: While Press Ganey survey results suggest that patients have greater satisfaction with physicians on solo hospitalist teams, these differences were not observed on the HCAHPS physician performance survey domain, suggesting physician team structure does not impact HVBP incentive payments by CMS. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction is increasingly being used to assess, and financially reward, provider performance. Previous studies suggest that race/ethnicity (R/E) may impact satisfaction, yet few practices adjust for patient R/E. The objective of this study is to examine R/E differences in patient satisfaction ratings and how these differences impact provider rankings.Methods: Patient satisfaction survey data linked to electronic health records from two large outpatient centers in northern California - a non-profit organization of community-based clinics (Site A) and an academic medical center (Site B) - was collected and analyzed. Participants consisted of adult patients who received outpatient care at Site A from December 2010 to November 2014 and Site B from March 2013 to August 2014, and completed Press-Ganey Medical Practice Survey questionnaires (N = 216,392 (Site A) and 30,690 (Site B)). Self-reported non-Hispanic white (NHW), Black, Latino, and Asian patients were studied. For six questions each representing a survey subdomain, favorable ratings were defined as top-box ("very good") compared to all other categories ("very poor," "poor," "fair," and "good"). Using multivariable logistic regression with provider random effects, we assessed whether the likelihood of giving favorable ratings differed by patient R/E, adjusting for patient age and sex.Results: Asian, younger and female patients provided less favorable ratings than other R/E, older and male patients. After adjustment, Asian patients were less likely than NHW patients to provide top-box ratings to the overall assessment question "likelihood of recommending this practice to others" (Site A: Asian predicted probability (PP) 0.680, 95% confidence interval (CI): 0.675-0.685 compared to NHW PP 0.820, 95% CI: 0.818-0.822; Site B: Asian PP 0.734, 95% CI: 0.733-0.736 compared to NHW PP 0.859, 95% CI: 0.859-0.859). The effect sizes for Asian R/E were greater than the effect sizes for older age and female sex. An absolute 3% decrease in mean composite score between providers serving different percentages of Asian patients translated to an absolute 40% drop in national ranking.Conclusions: Patient satisfaction scores may need to be adjusted for patient R/E, particularly for providers caring for high panel percentages of Asian patients. [ABSTRACT FROM AUTHOR]

Patient experience is positively associated with superior medical outcomes, clinical quality, patient safety measures, physician job satisfaction, doctor-patient communication, and patient compliance with treatment recommendations. A concrete pediatrics-focused methodology for improving patient experience in a multispecialty ambulatory setting has not been described, nor has the impact on practice outcomes been assessed. The primary aim of this study was to improve patient experience care provider scores at a single multiclinic children's hospital in the Midwest to the 70th percentile in a 5-year period. The secondary aim sought to determine the impact of quality improvement efforts on practice growth, patient complaint rate, and provider/staff engagement. Patient experience was measured by returned Press-Ganey surveys. Interventions involved establishing infrastructure, promoting feedback and transparency, providing education, and transforming culture. Provider scores improved from the 19th to the 70th percentile within 5 years. Practice volume increased by 17.1%; patient complaint/grievance frequency decreased 33-fold; and provider/staff engagement did not appreciably change. [ABSTRACT FROM AUTHOR]