The evaluation ranking scale: clarification of methodological and procedural issues.

Compared with CSQ-8, a typical questionnaire approach to assessing global patient satisfaction, the Evaluation Ranking Scale (ERS) had equally good patient acceptability, yielded more normally distributed satisfaction scores, and results allowed comparative information about patients' evaluation of specific service dimensions. The study also addressed key questions that have emerged about the ERS procedure. Patients apparently do not distinguish conceptually between "importance" of dimensions and "satisfaction" with dimensions in the first phase (ranking) of the ERS. Results did confirm that the ERS sequence of ranking and then rating the dimensions is essential to achieving optimal utility of results. The ranking task seems to have an organizing effect on patients' approach to the rating task. This effect does not work to dictate results in the rating phase but rather seems to familiarize patients with the dimensions to be rated thereby yielding greater potential discriminative capacity for the ERS. Finally, results indicate that the ERS can be administered in a flexible fashion that yields additional information about the absolute importance of the six dimensions without loss of desired operating characteristics for the measure.