Munjal Ankita, Steinberg Joshua M, Mossaad Afnan, Kallus Samuel J, Mattar Mark C, Haddad Nadim G
Department of Internal Medicine, Georgetown University Hospital, Washington, DC 20007, United States.
Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC 20007, United States.
World J Gastrointest Endosc. 2018 Jan 16;10(1):23-29. doi: 10.4253/wjge.v10.i1.23.
To organize post-procedure satisfaction data into a useful reference and analyze patient-centered parameters to find trends that influence patient satisfaction.
A robust database of two cohorts of outpatients that underwent an endoscopic procedure at Georgetown University Hospital at two separate three-month intervals ranging from November 2012 to January 2013 and November 2015 to January 2016 was compiled. Time of year was identical to control for weather/seasonal issues that may have contributed to the patient experience. The variables recorded included age, sex, body mass index (BMI), type of procedure, indication for procedure, time of the procedure, length of the procedure, type of prep used, endoscopist, satisfactory score, and comments/reasons for score. For continuous variables, differences in averages were tested by two sample -test, Wilcoxon rank sum test, and ANOVA as appropriate. For categorical variables, differences in proportions between two groups were tested by χ test. Correlation test and linear regression analyses were conducted to examine relationships between length of procedure and continuous predictors. A value < 0.05 used to indicate statistically significant relationship.
The primary outcome of this study was to assess if telephone outreach after an endoscopic intervention was a satisfactory method of obtaining post-procedure satisfaction scores from patients at a tertiary care center. With the addition of post-procedure calls, instilled in January 2014, the response rate was 40.5% (508/1256 patients) from a prior completion rate of 3.4% (31/918) with the mail out survey initially. There was a statistically significant improved response rate pre and post intervention with < 0001. The secondary outcome of this study was to assess if we could use predictive analytics to identify independent predictors of procedure length, such as gender, age, type of procedure, time of procedure, or BMI. The combined pre and post intervention data was used in order to optimize the power to identify independent predictors of procedure length. The total number of patient's data analyzed was 2174. There was no statistically significant difference in procedure length between males and females with value 0.5282. However, there was a small (1 min), but statistically significant difference ( = 0.0185) in procedure length based on the time of day the procedure took place, with afternoon procedures having a longer duration than morning procedures. The type of procedure was an independent predictor of procedure length as demonstrated with value < 0.0001. There is a statistically significant correlation between age and procedure length, although it is only a weak relationship with a correlation coefficient < 0.3. Contrary to patient age, BMI did not have a statistically significant correlation with procedure length ( = 0.9993), which was also confirmed by linear regression analysis.
Our study proves calling patients after endoscopy improves post-procedure satisfaction response rates and changing procedural time allotment based on patient characteristics would not change endoscopic workflow.
整理术后满意度数据,形成有用的参考资料,并分析以患者为中心的参数,以找出影响患者满意度的趋势。
编制了一个强大的数据库,该数据库包含两组门诊患者队列的数据,这两组患者分别于2012年11月至2013年1月以及2015年11月至2016年1月这两个不同的三个月时间段内在乔治敦大学医院接受了内镜检查。一年中的时间相同,以控制可能影响患者体验的天气/季节因素。记录的变量包括年龄、性别、体重指数(BMI)、手术类型、手术指征、手术时间、手术时长、所使用的准备类型、内镜医师、满意度评分以及评分的评论/原因。对于连续变量,根据情况通过双样本t检验、威尔科克森秩和检验以及方差分析来检验平均值的差异。对于分类变量,通过χ²检验来检验两组之间比例的差异。进行相关性检验和线性回归分析,以检查手术时长与连续预测变量之间的关系。P值<0.05用于表示具有统计学意义的关系。
本研究的主要结果是评估内镜干预后的电话随访是否是在三级医疗中心从患者那里获得术后满意度评分的令人满意的方法。自2014年1月开始增加术后电话随访后,响应率为40.5%(508/1256例患者),而最初通过邮寄调查的完成率为3.4%(31/918)。干预前后的响应率有统计学意义的显著提高,P<0.0001。本研究的次要结果是评估我们是否可以使用预测分析来识别手术时长的独立预测因素,例如性别、年龄、手术类型、手术时间或BMI。使用干预前后的合并数据,以优化识别手术时长独立预测因素的效能。分析的患者数据总数为2174例。男性和女性之间的手术时长没有统计学意义的差异,P值为0.5282。然而,根据手术进行的时间,手术时长存在微小(1分钟)但具有统计学意义的差异(P = 0.0185),下午的手术持续时间比上午的手术长。手术类型是手术时长的独立预测因素,P值<0.0001表明了这一点。年龄与手术时长之间存在统计学意义的相关性,尽管只是弱相关性,相关系数<0.3。与患者年龄相反,BMI与手术时长没有统计学意义的相关性(P = 0.999),线性回归分析也证实了这一点。
我们的研究证明,内镜检查后给患者打电话可提高术后满意度响应率,并且根据患者特征改变手术时间分配不会改变内镜检查工作流程。