Evaluation of Patient Satisfaction Surveys in Pediatric Orthopaedics
Lee S Segal1, Carla Plantikow, Randon Hall
1Center for Pediatric Orthopaedics, Phoenix Children's Hospital, Phoenix, AZ.
Insights
Point-of-care patient satisfaction surveys in pediatric orthopaedics yield higher scores than mailed surveys. This highlights methodological concerns for accurately measuring patient experience and quality of care.
Area of Science:
- Health Services Research
- Patient Experience Measurement
- Pediatric Healthcare Quality
Background:
- Patient satisfaction scores increasingly influence healthcare compensation, practice, and accreditation.
- Accurate measurement of patient satisfaction is crucial for assessing healthcare quality.
- The study addresses the growing importance of patient feedback in healthcare settings.
Purpose of the Study:
- To compare patient satisfaction survey results from internal point-of-care distribution versus external mail distribution.
- To evaluate patient satisfaction in a high-volume pediatric orthopaedic practice.
- To identify potential biases in different survey distribution methods.
Main Methods:
- A pediatric outpatient survey was administered both internally at the point of care (INP) and externally via mail (EXM).
- Data were collected over a 3-month period (Q2 2013) for direct comparison.
- Survey responses were dichotomized into 'excellent' (9-10) or 'not excellent' (0-8) for analysis, with additional evaluation of an 8-10 scale for provider ratings.
Main Results:
- Internal point-of-care surveys achieved a significantly higher response rate (69.4%) compared to mailed surveys (15.4%).
- Provider ratings were higher in the INP group (84.8% excellent) than the EXM group (72.2% excellent) (P=0.015).
- Most INP responses were consistently higher than EXM responses, with 6 out of 7 items showing statistical significance.
Conclusions:
- Patient satisfaction surveys are vital for healthcare outcomes and quality assessment, as mandated by CMS.
- Methodological differences in survey distribution (INP vs. EXM) significantly impact results in pediatric subspecialty practices.
- Further research is needed to validate survey methodologies for accurately capturing patient experiences in ambulatory pediatric settings.
Background:
Patient satisfaction survey scores are increasingly being tied to incentive compensation, impact how we practice medicine, influence decisions on where patients seek care, and in the future may be required for accreditation. The goal of this study is to compare the results of an internal distribution of patient satisfaction surveys at the point of care to responses received by mail in a hospital-based, high-volume pediatric orthopaedic practice.
Methods:
A pediatric outpatient survey is used at our institution to evaluate patient satisfaction. Surveys are randomly mailed out to families seen in our clinic by the survey vendor, and the results are determined on a quarterly basis. We distributed the same survey in a similar manner in our clinic. The results of the surveys, external/mailed (EXM) versus internal/point of care (INP) over the same 3-month time period (second quarter 2013) were compared. The survey questions are dichotomized from an ordinal scale into either excellent (9 to 10) or not excellent (0 to 8) commonly used in patient satisfaction methodology. We evaluated the raw data from the INP surveys for the question on provider rating by evaluating the mean score, the standard excellent response (9 to 10), and an expanded excellent response (8 to 10).
Results:
Response rate was 72/469 (15.4%) for EXM, and 231/333 (69.4%) for INP. An excellent response for the "rating your provider" question was 72.2% (EXM) versus 84.8% (INP) (P=0.015). Our analysis of the raw data (INP) has a mean rating of 9.42. The expanded scale (8 to 10) for an excellent response increased the provider rating to 94.4% (P=0.001). Waiting time response within 15 minutes was the only item that correlated with rating of provider (P=0.02). For the majority of the items, the INP responses were consistently higher than the EXM responses, including 6/7 responses that were statistically significant (P<0.05).
Conclusions:
As mandated by the Centers for Medicare and Medicaid Services, patient satisfaction surveys will be important in determining health care outcomes. Properly designed and administered surveys provide robust measures of quality. Our study reinforces methodological concerns about patient satisfaction surveys distributed in a high-volume pediatric subspecialty practice. Further research is needed to evaluate the patients' health care experience and true quality of care in pediatric subspecialty ambulatory settings.
