Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA.
BMJ Qual Saf. 2013 Mar;22(3):242-50. doi: 10.1136/bmjqs-2012-001045. Epub 2012 Nov 23.
Achieving high levels of patient satisfaction requires hospital management to be proactive in patient-centred care improvement initiatives and to engage frontline clinicians in this process.
We developed a survey to assess the attitudes of clinicians towards hospital management activities with respect to improving patient satisfaction and surveyed clinicians in four academic hospitals located in Denmark, Israel, the UK and the USA.
We collected 1004 questionnaires (79.9% response rate) from four hospitals in four countries on three continents. Overall, 90.4% of clinicians believed that improving patient satisfaction during hospitalisation was achievable, but only 9.2% of clinicians thought their department had a structured plan to do so, with significant differences between the countries (p<0.0001). Among responders, only 38% remembered targeted actions to improve patient satisfaction and just 34% stated having received feedback from hospital management regarding patient satisfaction status in their department during the past year. In multivariate analyses, clinicians who received feedback from hospital management and remembered targeted actions to improve patient satisfaction were more likely to state that their department had a structured plan to improve patient satisfaction.
This portrait of clinicians' attitudes highlights a chasm between hospital management and frontline clinicians with respect to improving patient satisfaction. It appears that while hospital management asserts that patient-centred care is important and invests in patient satisfaction and patient experience surveys, our findings suggest that the majority do not have a structured plan for promoting improvement of patient satisfaction and engaging clinicians in the process.
要实现高水平的患者满意度,医院管理层需要积极主动地开展以患者为中心的护理改进举措,并让一线临床医生参与这一过程。
我们开发了一项调查,以评估临床医生对医院管理层在提高患者满意度方面的活动的态度,并在丹麦、以色列、英国和美国的四家学术医院调查了临床医生。
我们从三大洲四个国家的四家医院共收集了 1004 份问卷(79.9%的回复率)。总体而言,90.4%的临床医生认为在住院期间提高患者满意度是可行的,但只有 9.2%的临床医生认为他们所在的科室有一个结构化的计划来实现这一目标,各国之间存在显著差异(p<0.0001)。在回答者中,只有 38%的人记得有针对提高患者满意度的具体行动,只有 34%的人表示在过去一年中收到过医院管理层关于其所在科室患者满意度状况的反馈。在多变量分析中,从医院管理层收到反馈并记得有针对提高患者满意度的具体行动的临床医生更有可能表示他们所在的科室有一个结构化的计划来提高患者满意度。
临床医生态度的这一写照凸显了医院管理层与一线临床医生在提高患者满意度方面存在差距。尽管医院管理层声称以患者为中心的护理很重要,并投资于患者满意度和患者体验调查,但我们的研究结果表明,大多数人并没有一个结构化的计划来促进患者满意度的提高,并让临床医生参与这一过程。