Ma Daniel C, Singh Abhiram, Bloom Beatrice, Adair Nilda, Chen William, Rahman Husneara, Potters Louis, Parashar Bhupesh
Department of Radiation Medicine, Zucker School of Medicine, Northwell Health, Lake Success, New York.
Worcester Academy, Worcester, Massachusetts.
Adv Radiat Oncol. 2023 Apr 8;8(5):101240. doi: 10.1016/j.adro.2023.101240. eCollection 2023 Sep-Oct.
Patient experience tools are used throughout health care to evaluate physician and departmental performance. In radiation medicine, these tools are important in evaluating patient-specific metrics throughout their care journey. This study compared patient experience outcomes from a central tertiary cancer program with network clinics in a health care network.
Radiation medicine patient experience surveys (Press Ganey, LLC) were collected from a central facility and 5 network locations from January 2017 through June 2021. Surveys were distributed to patients after treatment completion. The study cohort was divided into the central facility and satellites. Questions were converted to a 0 to 100 scale from the Likert scale (1-5). To compare scores between site types, 2-way analysis of variance tests for the significance of sites adjusted for years of operations and adjustments for multiple comparisons (Dunnett's test) were completed on each question.
The number of consecutively returned surveys analyzed was 3777; a response rate of 33.3% was observed. The central site conducted 117,583 linear accelerator, 1425 Gamma Knife, 273 stereotactic radiosurgery, and 830 stereotactic body radiation therapy procedures. All satellites combined conducted 76,788 linear accelerator, 131 Gamma Knife, 95 stereotactic radiosurgery, and 355 stereotactic body radiation therapy procedures. The central facility fared better than the satellites on "Convenience of parking" (95.9 vs 87.9; = .0001) but worse in other domains of care.
All sites yielded exemplary patient experience rates. Community clinics scored higher than the main campus. The higher scores at the network sites require a deeper analysis of factors influencing the central facility, as the survey did not account for varying patient volumes and disparities in care complexity across sites. Attributes to satellites include lower patient volumes and easily navigable layouts. These results counter the impression that increased resources at the main campus create a better patient experience relative to network clinics and suggest that high-volume tertiary facilities will require unique initiatives to improve the patient experience.
患者体验工具在整个医疗保健领域用于评估医生和科室的绩效。在放射医学中，这些工具对于评估患者在整个治疗过程中的特定指标非常重要。本研究比较了一个中心三级癌症项目与医疗保健网络中的网络诊所的患者体验结果。
从2017年1月至2021年6月，收集了来自一个中心设施和5个网络地点的放射医学患者体验调查（Press Ganey公司）。调查在治疗完成后分发给患者。研究队列分为中心设施组和卫星组。问题从李克特量表（1 - 5）转换为0至100分制。为了比较不同地点类型的得分，对每个问题进行了双向方差分析，检验考虑运营年份调整的地点显著性以及多重比较调整（邓尼特检验）。
分析的连续返回调查数量为3777份；观察到的回复率为33.3%。中心地点进行了117583例直线加速器治疗、1425例伽玛刀治疗、273例立体定向放射外科治疗和830例立体定向体部放射治疗程序。所有卫星地点合计进行了76788例直线加速器治疗、131例伽玛刀治疗、95例立体定向放射外科治疗和355例立体定向体部放射治疗程序。中心设施在“停车便利性”方面得分高于卫星地点（95.9对87.9；P = 0.0001），但在其他护理领域得分较低。
所有地点的患者体验率都堪称典范。社区诊所得分高于主校区。网络地点的较高得分需要对影响中心设施的因素进行更深入分析，因为该调查未考虑各地点不同的患者数量和护理复杂性差异。卫星地点的特点包括患者数量较少和布局易于导航。这些结果与主校区资源增加会带来比网络诊所更好的患者体验这一印象相悖，并表明大型三级设施需要采取独特举措来改善患者体验。
