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通过医生教育、反馈和激励措施提高患者满意度。

Improving patient satisfaction through physician education, feedback, and incentives.

作者信息

Banka Gaurav, Edgington Sarah, Kyulo Namgyal, Padilla Tony, Mosley Virgie, Afsarmanesh Nasim, Fonarow Gregg C, Ong Michael K

机构信息

UCLA Department of Medicine, University of California, Los Angeles, Los Angeles, California.

UCLA Health Office of the Patient Experience, University of California, Los Angeles Hospitals, Los Angeles, California.

出版信息

J Hosp Med. 2015 Aug;10(8):497-502. doi: 10.1002/jhm.2373. Epub 2015 May 27.

Abstract

BACKGROUND

Patient satisfaction has been associated with improved outcomes and become a focus of reimbursement.

OBJECTIVE

Evaluate an intervention to improve patient satisfaction.

DESIGN

Nonrandomized, pre-post study that took place from 2011 to 2012.

SETTING

Large tertiary academic medical center.

PARTICIPANTS

Internal medicine (IM) resident physicians, non-IM resident physicians, and adult patients of the resident physicians.

INTERVENTION

IM resident physicians were provided with patient satisfaction education through a conference, real-time individualized patient satisfaction score feedback, monthly recognition, and incentives for high patient-satisfaction scores.

MAIN MEASURES

Patient satisfaction on physician-related and overall satisfaction questions on the HCAHPS survey. We conducted a difference-in-differences regression analysis comparing IM and non-IM patient responses, adjusting for differences in patient characteristics.

KEY RESULTS

In our regression analysis, the percentage of patients who responded positively to all 3 physician-related Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions increased by 8.1% in the IM and 1.5% in the control cohorts (absolute difference 6.6%, P = 0.04). The percentage of patients who would definitely recommend this hospital to friends and family increased by 7.1% in the IM and 1.5% in the control cohorts (absolute difference 5.6%, P = 0.02). The national average for the HCAHPS outcomes studied improved by no more than 3.1%.

LIMITATIONS

This study was nonrandomized and was conducted at a single site.

CONCLUSION

To our knowledge, this is the first intervention associated with a significant improvement in HCAHPS scores. This may serve as a model to increase patient satisfaction, hospital revenue, and train resident physicians.

摘要

背景

患者满意度与改善的治疗结果相关,并已成为报销的重点。

目的

评估一项旨在提高患者满意度的干预措施。

设计

2011年至2012年进行的非随机前后对照研究。

地点

大型三级学术医疗中心。

参与者

内科住院医师、非内科住院医师以及这些住院医师的成年患者。

干预措施

通过会议、实时个性化患者满意度评分反馈、月度表彰以及对高患者满意度评分给予奖励等方式,为内科住院医师提供患者满意度教育。

主要测量指标

医疗保健消费者评估医疗服务提供者和系统(HCAHPS)调查中与医生相关问题及总体满意度问题的患者满意度。我们进行了差异回归分析,比较内科和非内科患者的回答,并对患者特征差异进行了调整。

关键结果

在我们的回归分析中,对所有三个与医生相关的HCAHPS问题给出肯定回答的患者百分比在内科队列中增加了8.1%,在对照组中增加了1.5%(绝对差异6.6%,P = 0.04)。肯定会向朋友和家人推荐这家医院的患者百分比在内科队列中增加了7.1%,在对照组中增加了1.5%(绝对差异5.6%,P = 0.02)。所研究的HCAHPS结果的全国平均改善幅度不超过3.1%。

局限性

本研究为非随机研究,且在单一地点进行。

结论

据我们所知,这是首次与HCAHPS评分显著改善相关的干预措施。这可作为提高患者满意度、医院收入以及培训住院医师的范例。

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