Surveys, tools and patient satisfaction

Sheenu Jhawar

The cliched statement for better patient services is understand your patient. I would like to put a suffix to that i.e. ‘Touch your patient by understanding your employee.’ Generally speaking, employee opinions are found to be strongly and positively related to patient opinions.

And that is because:-

Patient satisfaction is mostly related to an employee’s opinions on doctors, organisational flexibility, and training for customer service and vice versa. ú Service training also helps in building the patient’s perceptions in general.

Your patient is not a happy customer, and that’s a fact, because he is coming to be treated in a hospital. In that respect, there are essentially three categories:

The first is an ailing person, your patient. The second is a pregnant woman, not ailing but anxious, as she enters your organisation, and is full of worries. And the third is the attendant, your prospective customer, or if not, definitely the marketing man by word of mouth.

The entire organisation has to be in that framework of mind when it deals with a customer. It’s not just the clinical team that I am talking about here, but down to your receptionist who shall be the first point of contact for the patient. If you were to actually chart your patient’s movement through the operational lattice of the organisation, each node of patient contact would have to be worked upon in the same way to reach optimisation of patient satisfaction. To understand how and what your patient expects or perceives of your organisation, and to identify, where improvement is indicated, a common tool ‘patient satisfaction survey’ is used.

The main point of consideration is whether the right questions are being asked and the right cross tabulations are being made to get realistic and specific reasons for patient dissatisfaction. A method combining qualitative and quantitative aspects is probably the best. It provides objectivity and allows for patient perceptions rather than just obtaining figures.

The related question of who to ask for their views and how many people to include in a project are ones that worry most people. This is not surprising, because we can’t have a single right answer. It depends on the aim of the project, the case mix size, the time frame available, the priority on the agenda of improvement and of course the method used.

Some research questions make it necessary to divide patients up into categories.

For example an in-depth study carried out by the Royal College of Surgeons (UK), on patient satisfaction with surgical care found that there were important differences between the responses of those who had received ‘potentially life saving’ and those who had received ‘repair surgery’. Patient satisfaction tended to be higher among those in the latter category because the patient was given more control.

Also the object of repair surgery is to improve what the patient immediately feels or sees whereas in most potentially life saving cases, patients find themselves having to submit to serious, painful surgery.

A medical condition maybe as important as age, gender, ethnicity and class in affecting a person’s expectations and so their responses to questions about their views on the care they have received. Their condition may also affect the way they are treated and this may have an impact on their views. There are two principal occasions when service users can be asked for their views: at the time they receive the service, or at home after they have received the care. Once we have an understanding of these issues we can make room for collecting the relevant information at relevant nodes.

For example despite the clinical services being of high value, if access to the hospital is delimiting, it poses concern.

Another valuable aspect to be considered here is: customer complaint management which should form a priority and be addressed and resolved with promptness. Proper information systems help identify these as soon as they happen and get them resolved soon enough.

Root cause analysis of the complaints can help to throw light on many other related issues surrounding the compliant. Similar to complaint, another important aspect is risk management. Any medical or non-medical errors arising within the system need to be addressed and acted upon. In this respect clinical audit can play a major role in highlighting errors or deviations.

Understanding your patient and believing that he is most important, goes a long way towards organisational success, because ultimately the satisfaction of your patient is your core business asset.

The writer is clinical auditor at Midstafford General Hospital,UK.
sheenujhawar@yahoo.com