Quality Care Isn’t Always a Picnic

Patient satisfaction scores were not reflective of quality surgical care

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Being satisfied with surgical care and receiving quality surgical care aren't the same thing. Being unsatisfied with surgical care doesn’t necessarily mean the surgical staff flubbed the job.

A recent study compared surveys from surgical patients and hospital employees to quality care measures used to treat patients in 31 hospitals.

The results showed that patient satisfaction had nothing to do with the quality of surgical care given to patients. Patient satisfaction scores did reflect how well hospital staff worked together as a team.

"Communicate your needs to hospital staff after surgery."

Martin A. Makery, MD, MPH, associate professor of surgery at the Johns Hopkins University School of Medicine, led an investigation into surgical patients’ level of satisfaction with their surgeries in relation to their quality of surgical care.

In 2010, The Centers For Medicare and Medicaid Services said they were going to begin taking patient satisfaction reports into account when calculating how much they were going to reimburse healthcare providers for surgical care, according to the study's authors.

“This new policy reflects the perception that patient satisfaction is an indicator of health care quality,” said the authors.

Previous studies have shown that low safety attitude scores reported by hospital employees, especially employee perceptions of management’s low safety attitude, were linked to longer hospital stays and lower quality of care for patients.

For this study, patients and employees from 31 hospitals of varying sizes in 10 different states filled out one of two surveys between 2009 and 2010. 

The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) was used to measure patient satisfaction.

The Safety Attitudes Questionnaire (SAQ) was used to measure employee perceptions of safety attitudes in their healthcare facility.

On average, 68 percent of patients were satisfied with their surgical care.

Each hospital’s process-of-care for surgical patients was measured through the appropriate use of preventive antibiotic prescriptions, pre-surgical hair removal, catheter removal and preventive blood clot prescriptions.

The researchers reported that process-of-care did not vary as much as patient satisfaction scores.

“Patient satisfaction was not associated with hospital compliance with process-of-care measures,” said the authors.

Only the employee ratings of the quality of teamwork between members of the hospital staff were linked to patient satisfaction scores. 

The authors concluded that patient satisfaction measures were important to the customer service aspect of hospital care, but did not reflect proper or improper surgical care.

This study was published in April in JAMA Surgery.

Mr. and Mrs. Chad and Nissa Richison provided funding for this project. No conflicts of interest were disclosed.

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Review Date: 
April 16, 2013
Last Updated:
December 4, 2013