Inpatients' ratings of care in 5 common clinical conditions

Using the dimensions of patient-centered care defined by the Institute of Medicine, this study examined patient satisfaction within 5 clinical conditions.

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.

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.

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.

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.