Sheean Andrew J, Foster James N, Aden James K, Tubb Creighton C, Johnson Anthony E, Stinner Daniel J
San Antonio Military Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234.
United States Army Institute of Surgical Research, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234.
Mil Med. 2017 Jul;182(7):e1878-e1882. doi: 10.7205/MILMED-D-16-00379.
The importance of patient satisfaction as a measure of quality has grown with initiatives intended to enhance demand for services, refocus reimbursement paradigms, encourage health care efficiencies, and ultimately improve clinical outcomes. The purpose of our performance improvement project was to (1) characterize the effect of a two-pronged multimedia initiative on patient perceptions of health care quality and satisfaction as assessed by the Army Provider Level Satisfaction Survey (APLSS) and (2) assess for differences in APLSS scores between the surgeons that did and did not participate in the program.
Baseline APLSS data for our Department of Orthopaedic Surgery were collected and subsequently compared to APLSS results 3 months after the implementation of a department-wide multimedia campaign. The multimedia initiative consisted of two concurrently implemented interventions to the orthopaedic surgery outpatient clinics. One intervention involved placing large-framed posters about the orthopaedic clinic waiting areas on which were written, "We helped write the book," and included pictures of various orthopaedic textbooks of which attending surgeons and/or residents had contributed to as authors. The other intervention provided patients with surgeon "face sheets" upon arrival to their clinic appointments. These sheets included a picture of their attending surgeon, contact information for the surgeon's nurse care coordinator, and a brief biographical sketch of the surgeon's training, clinical interests and expertise, and other information at each surgeon's discretion.
Among APLSS survey results for the orthopaedic surgery clinic including all surgeons, significant increases were observed between baseline data and 3-month data for Top 1 and Top 2 responses to the questions, "How satisfied do you feel about your visit?" and "Did your surgeon listen to you carefully about your concerns and questions?" (p = 0.003 and p = 0.004, respectively).
The implementation of a multimedia campaign resulted in significant improvements among indices of orthopaedic patient satisfaction. We believe this model could be used at other military or nonmilitary treatment facilities as a means to engender patients' familiarity with their surgeon and prompt an appreciation for his/her expertise and enhance overall patient perceptions of department-wide health care quality.
随着旨在增加服务需求、重新调整报销模式、提高医疗效率并最终改善临床结果的各项举措的推行，患者满意度作为衡量医疗质量的一项指标，其重要性日益凸显。我们绩效改进项目的目的在于：（1）通过陆军医疗服务提供者满意度调查（APLSS）评估一项双管齐下的多媒体举措对患者对医疗质量的认知及满意度的影响；（2）评估参与和未参与该项目的外科医生在APLSS评分上的差异。
收集了我们骨科手术部的APLSS基线数据，并在全科室多媒体宣传活动实施3个月后，将其与APLSS结果进行对比。该多媒体举措包括同时在骨科手术门诊实施的两项干预措施。一项干预措施是在骨科诊所候诊区张贴大幅海报，上面写着“我们参与了著书工作”，并配有各种骨科教科书的图片，这些教科书的作者包括主治医生和/或住院医师。另一项干预措施是在患者预约就诊到达诊所时，为其提供外科医生“信息单”。这些单子包括主治医生的照片、外科医生护士护理协调员的联系信息，以及外科医生培训经历、临床兴趣和专业技能的简要传记式介绍，还有每位外科医生自行决定添加的其他信息。
在包括所有外科医生的骨科手术诊所的APLSS调查结果中，对于“您对此次就诊的满意度如何？”以及“您的外科医生是否认真听取了您的担忧和问题？”这两个问题的前两项回答，基线数据与3个月后的数据相比有显著提高（p值分别为0.003和0.004）。
多媒体宣传活动的实施使骨科患者满意度指标有了显著改善。我们认为，这种模式可在其他军事或非军事治疗机构中使用，作为一种让患者熟悉其外科医生、促使患者欣赏其专业技能并提高患者对全科室医疗质量整体认知的手段。
