Department of Surgery, Mayo Clinic, Rochester, MN, USA; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA.
The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Surgical Outcomes Program, Mayo Clinic, Rochester, MN, USA.
Am J Surg. 2019 Jul;218(1):175-180. doi: 10.1016/j.amjsurg.2018.12.004. Epub 2018 Dec 8.
Given the growing emphasis on patient-centered care, we determined contributory factors to a positive experience among patients undergoing outpatient breast procedures.
We retrospectively identified patients ≥18 years-old who underwent a breast operation 7/2015-12/2016 and completed a survey within two weeks. Univariate analyses evaluated associations of factors with top survey composite measures. Key driver analysis identified top-priority survey factors for improving the overall assessment measure.
Of 270 patients, patients who gave a top surgeon score were older (mean 62.5 vs 58.6 years, p = 0.048), more likely to report a pain score of 0 before discharge (87% vs 68%, p < 0.01), and were 30.8 times more likely to give a top rating overall (p < 0.01) than those who gave a lower surgeon score. Key driver analysis identified personal issues as the main target for improvement.
To achieve top outpatient ratings, providers should focus on personal issues, including pain control, especially in younger patients. Surgeons should consider focusing on involving the patient in treatment decisions and emphasizing pain control and overall needs to improve the patient experience.
鉴于患者为中心的护理日益受到重视，我们确定了门诊乳腺手术患者获得积极体验的促成因素。
我们回顾性地确定了 2015 年 7 月至 2016 年 12 月期间接受乳腺手术且在两周内完成调查的年龄≥18 岁的患者。单因素分析评估了各因素与顶级调查综合指标的关系。关键驱动因素分析确定了改善整体评估指标的首要调查因素。
在 270 名患者中，给予顶级外科医生评分的患者年龄更大（平均 62.5 岁 vs 58.6 岁，p=0.048），出院前报告疼痛评分 0 的可能性更高（87% vs 68%，p<0.01），给予顶级总体评分的可能性高 30.8 倍（p<0.01），而给予较低外科医生评分的可能性低。关键驱动因素分析确定个人问题是改进的主要目标。
要获得顶级的门诊评价，提供者应关注个人问题，包括疼痛控制，尤其是在年轻患者中。外科医生应考虑专注于让患者参与治疗决策，并强调疼痛控制和整体需求，以改善患者体验。
