Patient satisfaction with hospital stay does not reflect quality of surgical care

April 17, 2013, Johns Hopkins University School of Medicine

Patient satisfaction is an important indicator of a hospital's service quality, but new Johns Hopkins research suggests that it doesn't necessarily reflect the quality of the surgical care patients receive.

"We found that the quality of what goes on in the doesn't closely correlate with the patient's of the quality of his or her medical care," says Martin A. Makary, M.D., M.P.H., an associate professor of surgery at the Johns Hopkins University School of Medicine, and leader of the study described online in JAMA Surgery. "It is important for patient satisfaction to be tracked and transparent, but the quality of the actual care may be independent of that. It's misleading to say a patient satisfaction score says it all."

Patient satisfaction is becoming a front-and-center issue in the health care conversation, Makary notes, because in 2012, the Centers for Medicare & Medicaid Services finalized details of a new reimbursement method that adjusts payments based on patient satisfaction scores—a measure also being adopted by private insurers. And patient satisfaction scores often appear as the only scores on websites purported to help patients make more informed choices about where to seek health care.

But the growing idea that patient satisfaction is the ultimate metric of quality was an idea that Makary and his colleagues felt needed to be evaluated. Their research found that while the metric may be easy to apply, it doesn't appear to be a comprehensive measure of overall quality, particularly for procedure-based care like surgery.

For the study, the researchers compared the performance of 31 U.S. hospitals on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS), the Centers for & Medicaid Services Improvement Program (SCIP) and the employee Safety Attitudes Questionnaire (SAQ).

Among the questions asked of patients on the HCAHPS—the patient satisfaction survey—were inquiries about nursing care, cleanliness of the hospital, experiences such as pain management and explanations of new medicines and follow-up on discharge. Surgical care quality was judged on such evidence-based measures as infection prevention, blood clot prevention and timely removal of catheters. Safety attitude questions focused on teamwork, job satisfaction, working conditions and perceptions about the management of the hospital.

Results showed no link between patient satisfaction scores and surgical care quality scores, although the researchers did find a correlation between patient satisfaction scores and employees' feelings about the teamwork and safety climate in their hospital.

"The better the workplace culture for staff, the more satisfied the patients," Makary says. "In any industry, if the employees feel good about their workplace, they are more likely to have satisfied customers. Doctors and nurses feel strongly that wide variations in teamwork culture are behind wide variations in quality, but there hasn't been a lot of focus on culture in the past."

Makary emphasizes that should be one important hospital priority, that patients should receive prompt and timely care, should be educated about their medical options, and should feel they have been treated with courtesy and respect. But he wants to see better instruments developed to capture good technical skills, sound medical judgment and other aspects of quality .

Explore further: The patient satisfaction chasm

Related Stories

The patient satisfaction chasm

March 1, 2013
Quality is a central component of any discussion around health care and one of the key dimensions and measurements of quality care is the patient experience. However, many healthcare organizations struggle to become 'patient ...

Minority ethnic patients not satisfied with NHS primary care

September 8, 2011
Minority ethnic patients are not satisfied with NHS primary care services, despite the fact that they are using a national healthcare system that is supposed to be providing universal coverage, reveals research published ...

Value of hospital environmental services linked to efficiency not expenses

July 18, 2011
The amount of money that hospitals spend on environmental services, such as cleaning and maintenance service is not as important in influencing patient satisfaction scores as the way the money is spent, according to Penn ...

Guided care provides better quality of care for chronically ill older adults

January 17, 2013
Patients who received Guided Care, a comprehensive form of primary care for older adults with chronic health problems, rated the quality of their care much higher than patients in regular primary care, and used less home ...

Staff satisfaction at hospitals may affect the quality of patient care

February 20, 2013
The satisfaction levels among a hospital's staff are closely linked to the quality of healthcare it provides, say a team of doctors from Imperial College London.

Recommended for you

Juul e-cigarettes pose addiction risk for young users, study finds

October 19, 2018
Teens and young adults who use Juul brand e-cigarettes are failing to recognize the product's addictive potential, despite using it more often than their peers who smoke conventional cigarettes, according to a new study by ...

Adding refined fiber to processed food could have negative health effects

October 19, 2018
Adding highly refined fiber to processed foods could have negative effects on human health, such as promoting liver cancer, according to a new study by researchers at Georgia State University and the University of Toledo.

Self-lubricating latex could boost condom use: study

October 17, 2018
A perpetually unctuous, self-lubricating latex developed by a team of scientists in Boston could boost the use of condoms, they reported Wednesday in the journal Royal Society Open Science.

How healthy will we be in 2040?

October 17, 2018
A new scientific study of forecasts and alternative scenarios for life expectancy and major causes of death in 2040 shows all countries are likely to experience at least a slight increase in lifespans. In contrast, one scenario ...

Adequate consumption of 'longevity' vitamins could prolong healthy aging, nutrition scientist says

October 16, 2018
A detailed new review of nutritional science argues that most American diets are deficient in a key class of vitamins and minerals that play previously unrecognized roles in promoting longevity and in staving off chronic ...

Study finds evidence of intergenerational transmission of trauma among ex-POWs from the Civil War

October 16, 2018
A trio of researchers affiliated with the National Bureau of Economic Research has found evidence that suggests men who were traumatized while POWs during the U.S. Civil War transmitted that trauma to their offspring—many ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.