Patient and Hospital Characteristics Associated with Patient Assessments of Hospital (original) (raw)

Adjusting for Patient Characteristics When Analyzing Reports From Patients About Hospital Care

Medical Care, 2001

OBJECTIVES. To determine which patient characteristics are associated with reports and ratings of hospital care, and to evaluate how adjusting reports and ratings for hospital differences in such variables affects comparisons among hospitals. DESIGN. A telephone survey of a sample of patients hospitalized in 22 hospitals in a single city and a statewide mail survey of hospitalized patients. MEASURES. The surveys assessed: respect for patients' preferences, coordination of care, information exchange between patient and providers, physical care, emotional support, involvement of family and friends, and transition and continuity. The surveys also asked patients to rate their doctors, nurses, and other hospital staff. RESULTS. The variables with the strongest and most consistent associations with patientreported problems were age and reported health status. Patient gender and education level also sometimes predicted reports and/or ratings. Models including these variables explained only between 3% and 8% of the variation in reports and ratings. CONCLUSIONS. The impact of adjusting for patient characteristics on hospital rankings was small, although a larger impact would be expected when comparing hospitals with more variability in types of patients. Nevertheless, we recommend adjusting at least for the most important predictors, such as age and health status. Such adjustment helps alleviate concerns about bias. It also may be useful to present data for certain groups of patients (ie, medical, surgical, obstetric) separately to facilitate interpretation and quality improvement efforts.

Inpatients' Ratings of Care in 5 Common Clinical Conditions

OBJECTIVE: Using the dimensions of patient-centered care defined by the Institute of Medicine, this study examined patient satisfaction within 5 clinical conditions. METHOD: Items from the Press Ganey Inpatient Questionnaire were mapped onto the Institute of Medicine dimensions of patient-centered care. A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. SAMPLE: Patients hospitalized for heart attack, heart failure, stroke, pneumonia, or childbirth were included in the study. The sample contained 10,000 patients at 210 hospitals. RESULTS: Patients hospitalized for different clinical conditions expressed different levels of satisfaction. There may be different care needs, expectations, and evaluations of care based on these clinical conditions. However, it is probable that an all-encompassing patient-centered focus would improve care for all of these groups. CONCLUSIONS: Quality improvement professionals should attend to 2 Institute of Medicine dimensions: (1) respect for patient's values, preferences, and expressed needs and (2) emotional support, relieving fear and anxiety. It is in these areas that improved performance will be associated with the greatest increases in patient satisfaction. Four specific issues were identified as quality improvement priorities, regardless of condition: response to complaints; sensitivity to the inconvenience of hospitalization; including patients in decision making; addressing emotional and spiritual needs.

Inpatientsʼ Ratings of Care in 5 Common Clinical Conditions

Quality Management in Health Care, 2004

Using the dimensions of patient-centered care defined by the Institute of Medicine, this study examined patient satisfaction within 5 clinical conditions. Method: Items from the Press Ganey Inpatient Questionnaire were mapped onto the Institute of Medicine dimensions of patient-centered care. A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. Sample: Patients hospitalized for heart attack, heart failure, stroke, pneumonia, or childbirth were included in the study. The sample contained 10,000 patients at 210 hospitals. Results: Patients hospitalized for different clinical conditions expressed different levels of satisfaction. There may be different care needs, expectations, and evaluations of care based on these clinical conditions. However, it is probable that an all-encompassing patient-centered focus would improve care for all of these groups. Conclusions: Quality improvement professionals should attend to 2 Institute of Medicine dimensions: (1) respect for patient's values, preferences, and expressed needs and (2) emotional support, relieving fear and anxiety. It is in these areas that improved performance will be associated with the greatest increases in patient satisfaction. Four specific issues were identified as quality improvement priorities, regardless of condition: response to complaints; sensitivity to the inconvenience of hospitalization; including patients in decision making; addressing emotional and spiritual needs.

Inpatients’ opinions on a hospital in Portugal

F1000Research, 2013

Little is known about the relationship between the opinions of Background: inpatients and the degree to which hospitals are improving in performance over time. The aim of this study was to determine the personal assessment level of inpatients or their representatives regarding aspects of health care in an internal medicine ward. We carried out a questionnaire in September 2011 with 284 Methods: discharged patients and patient representatives, focusing on their opinions about the department, health professionals and amenities, with response options ranging from 1 (very bad) to 5 (very good). The relationships between domains from the questionnaire and socio-demographic factors were examined using a t-test and one-way ANOVA. The response rate was 78%. The patients showed a slightly Results: higher mean score (m) for factors in the medical care domain than did the patient representatives (m = 4.51 vs. m = 4.27; p = 0.014). The mean score of all the items in all domains was 4.24; this allowed us to determine the difference from the overall mean (DIFM) for medical care (DIFM = 0.18; p = 0.000), foods (DIFM =-0.31; p = 0.000), diagnostic tests (DIFM =-0.15; p = 0.036) and transport (DIFM =-0.41; p = 0.000). Respondents with a medium or higher educational level gave lower scores to the domains food (m = 3.74; p = 0.004), diagnostic tests (m = 3.72; p = 0.04) and transport (m = 3.62; p = 0.025) than those with lower educational levels. The domains facilities (m = 2.4; p = 0.04) and diagnostic tests (m = 3.63; p = 0.009) were given lower scores by those aged <50 years compared with older respondents. Our findings suggest that the evaluation of the responders Conclusions: will allow the hospital management to make improvements in the quality of care.

Factors in patient experience of hospital care

The use of measures of patient-centered care to evaluate hospital care is mandated by The Patient Protection and Affordable Care Act of 2010. Using three years of data from 315 California acute Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, we seek to evaluate patients' hospital-care experience by (1) analyzing patients' experience structural characteristics, and outcomes in 2011, and (2) determining and analyzing the extent of changes in patients' experience of care over the three-year period 2009 care scores associated with hospitals' different patient profiles and structural characteristics. In spite of these single differences, virtually all aspects of patients' experience of care showed improvement over the 2009

Patient and hospital characteristics associated with patient assessments of hospital obstetrical care

Medical Care

The goals of this study were to examine the relationship of patient assessments of hospital care with patient and hospital characteristics. In addition, the authors sought to assess relationships between patient assessments and other patient-derived measures of care (eg, how much they were helped by the hospitalization and amount of pain experienced). The authors surveyed 16,051 women (response rate, 58%) discharged after labor and delivery from 18 hospitals during the study period of 1992 to 1994. Patient assessments were obtained using a previously validated survey instrument, Patient Judgment of Hospital Quality, that includes eight scales assessing different aspects of the process of care (eg, physician care, discharge procedures) and other single item assessments (eg, overall quality). For this study, we utilized five of the scales (physician care, nursing care, information, discharge preparation, global assessments [willingness to brag, recommend or return to the hospital]). F...

Pain: identifying methods of evaluation and describing the nursing care

Journal of Nursing Ufpe on Line Jnuol Doi 10 5205 01012007, 2012

Objectives: finding out the comprehension of professionals of nursing about the pain; identify the methods of evaluation of the pain used by professional of nursing; and check the nursing care of the patient with pain. Method: descriptive-exploratory study with qualitative nature developed in the medical clinic of a school hospital in the city of João Pessoa-PB, which sample is constituted of 21 professionals of nursing. With the use of the technique of the interview, the data collection was performed in August 2010, after approval of the research by the Ethic Committee of the University Hospital Lauro Wanderley under protocol nº 367/10. The declarations obtained were analyzed based on the technique of the Speech of the Collective Subject. Results: the participants understood relatively the meanings of the pain; however none of them uses specific methods validated for its evaluation. The identification of the location and intensity of the pain, observation of the facial/body expression and sensitive listening of the complaint substantiates as the informal methods used to evaluate the pain. Among the care given to the patient with the pain are the administration of medication, listening to the complaints and application of comfort procedures. Conclusion: although it is an intensely lived phenomenon, the pain continues to be very little explored by the professionals of nursing and in the care to the patient, aware the need for a bigger use of instruments of evaluation and the consistent development of knowledge and procedures for its handling. Descriptors: pain; evaluation of the pain; pain handling; nursing care. RESUMO Objetivos: averiguar a compreensão de profissionais de enfermagem sobre a dor; identificar os métodos de avaliação da dor utilizados por profissionais de enfermagem e verificar o cuidado de enfermagem frente ao paciente com dor. Método: estudo exploratório-descritivo, de natureza qualitativa, desenvolvido na clínica médica de um hospital escola do município de João Pessoa-PB, cuja amostra constituiu-se por 21 profissionais de enfermagem. Com uso da técnica da entrevista, a coleta de dados foi realizada em agosto de 2010, após aprovação do projeto de pesquisa pelo Comitê de Ética do Hospital Universitário Lauro Wanderley sob protocolo nº 367/10. Os depoimentos obtidos foram analisados com respaldo na Técnica do Discurso do Sujeito Coletivo. Resultados: os participantes compreendem de modo relativo os significados da dor, todavia nenhum deles emprega métodos específicos validados para sua avaliação. A identificação da localização e intensidade da dor, observação da expressão facial/corporal e escuta sensível da queixa evidenciam-se como os métodos informais usados para avaliar a dor. Dentre os cuidados prestados ao paciente com dor estão: a administração de medicamentos, a escuta das queixas e a aplicação de medidas de conforto. Conclusão: embora seja um fenômeno intensamente vivenciado, a dor continua sendo pouco explorada pelos profissionais de enfermagem no cuidado ao paciente, suscitando a necessidade de maior utilização de instrumentos de avaliação e o desenvolvimento consistente de conhecimentos e procedimentos para o seu manejo. Descritores: dor; avaliação da dor; manejo da dor; cuidados de enfermagem. RESUMEN Objetivos: averiguar la comprensión de los profesionales de la enfermaria acerca del dolor; identificar los métodos de evaluación de la dolor utilizados por los profesionales de la enfermaria; y verificarse el cuidado de la enfermería en el paciente con dolor. Método: estudio exploratório discriptivo de la naturaleza cualitativa desarrollo con en la clinica medica de uno hospital escuela de lo município de João Pessoa-PB, cuya muestra fue compuesta por los 21 profesionales

Predictors of patient satisfaction with hospital health care

BMC Health Services Research, 2006

We used a validated inpatient satisfaction questionnaire to evaluate the health care received by patients admitted to several hospitals. This questionnaire was factored into distinct domains, creating a score for each to assist in the analysis.

Satisfaction of needs and Patient's Expectations of Hospital Care

There is an increasing interest in eliciting feedback from patients to highlight aspects of care that need improvement and to monitor performance and quality of care. Hospitals increasingly need to adopt a patient-centred attitude. Traditionally, assessments have ignored the reports of patients in preference to technical and physiological reports of outcome. Healthcare systems have sought to achieve a balance in services that offer not only clinically effective and evidence based care, but which are also judged by patients as acceptable and beneficial. Questionnaires that ask patients to rate their care in terms of how satisfied they are tend to elicit very positive ratings, which are not sensitive to problems with the specific processes that affect the quality of care delivery. A more valid approach is to ask patients to report in detail on their