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Quality defined by patient experience

August 2nd, 2011

by Anthony Cirillo

Did you catch the Duke University's Fuqua School of Business study that compared patient satisfaction surveys with clinical performance measures to see which is a better gauge of clinical quality?

Researchers measured 30-day readmission rates at roughly 2,500 hospitals and found that patient satisfaction scores were more closely linked with fewer 30-day readmissions than clinical performance measures.


"If you want to figure out if a hospital is providing high-quality care, asking patients if they were satisfied with their care is a better indicator than whether the staff competently performs a battery of tests," co-author Richard Staelin, professor of business administration at Fuqua, said in a release.

What struck me was that hospitals that scored highly on patient satisfaction with discharge planning also tended to have the lowest number of patients return within a month. The authors recommended hospitals that wish to improve their clinical performance focus on improving the interactions between patients and hospital staff.

To me, a great last impression is not only good for HCAHPS scores. That last impression usually involves discharge planning, and when you get it right through education and communication, patients will follow the instructions and not end up back in the hospital.

That is why companies that offer innovative patient education are great adjuncts to clinical care at hospitals.

More evidence: A recent HealthGrades report showed modest gains in patient satisfaction based on data from 3,800 hospitals measured between April 2009 and March 2010. It noted that 81 percent of patients said they were most satisfied at the time of hospital discharge because they received instructions.

So then add this wrinkle: A study in the Journal of General Internal Medicine found that 41 percent of inpatients desired a discussion of religion/spirituality (R/S) concerns while hospitalized, but only half of those reported having such a discussion. Overall, 32 percent of inpatients reported having a discussion of their R/S concerns. Religious patients and those experiencing more severe pain were both more likely to desire and to have discussions of spiritual concerns.

What's more, patients who had discussions of R/S concerns were more likely to rate their care at the highest level on four different measures of patient satisfaction, regardless of whether or not they had desired such a discussion. These data suggest that many more inpatients desire conversations about R/S than have them. Healthcare professionals might improve patients' overall experience with being hospitalized, as well as patient satisfaction, by addressing this unmet patient need.

Yet, pastoral care is sometimes the first to get "booted" should there be budget cuts. That's why we have a Director of Healing Solutions on our team.

So there you have it. That's more evidence that it really is the total hospital experience that matters. So why do we continue to ignore that there are financial implications for poor patient experience?

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in experience management and strategic marketing for healthcare facilities. He is also the expert guide in Assisted Living for


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