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Patient and Family Experience: A Comparison of Intensive Care and Overall Hospitalization
Soowhan Lah1, Emily L Wilson1, Ronen Rozenblum1
1Soowhan Lah was a fellow in pulmonary and critical care medicine, University of Utah School of Medicine, Salt Lake City, Utah, and is an assistant professor of medicine, Metropolitan Hospital, New York Medical College, New York, New York. Emily L. Wilson is a statistician, Center for Humanizing Critical Care and the Division of Pulmonary and Critical Care Medicine, Intermountain Healthcare, Murray, Utah. Ronen Rozenblum is founding director, Unit for Innovative Healthcare Practice and Technology, director of business development, Center for Patient Safety Research and Practice, Brigham and Women's Hospital; and an assistant professor, Harvard Medical School, Boston, Massachusetts. Eliotte L. Hirshberg is associate director, Center for Humanizing Critical Care, Intermountain Healthcare; an associate professor, Department of Pulmonary and Critical Care Medicine, University of Utah; and an intensivist in both the Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, and the Department of Pediatrics, Division of Critical Care, Primary Children's Hospital and the University of Utah. Ramona O. Hopkins is a research psychologist, Center for Humanizing Critical Care, a researcher, Pulmonary and Critical Care Medicine, Intermountain Medical Center, and a professor, Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah. James Orme is director, shock-trauma intensive care unit, Pulmonary and Critical Care Division, Intermountain Medical Center, and professor of medicine, University of Utah. Samuel M. Brown is director, Center for Humanizing Critical Care, Intermountain Healthcare; an intensivist, Pulmonary and Critical Care Medicine, Intermountain Medical Center; and an associate professor, Pulmonary and Critical Care Medicine, University of Utah.
Background:
The Hospital Consumer Assessment of Healthcare Providers and Systems survey is the most commonly used instrument for measuring patients' perceptions of the quality of inpatient care.
Objective:
To determine if the hospital survey can also be used to measure patients' experience of intensive care as indicated by scores on a parallel questionnaire, the Patient Perception of Quality.
Methods:
Scores on both instruments of all adult patients admitted to an intensive care unit from 2007 through 2012 were analyzed.
Results:
A total of 1766 matching pairs of hospital and critical care surveys were identified. Patients' ratings of the overall hospital and critical care experiences had low correlation: r = 0.32 (95% CI, 0.28-0.37). Using the standard reporting convention, 77% of the participants rated the hospital as 9 or 10 on a 10-point scale, and 65% rated the intensive care unit as 5 on a 5-point scale. Although the hospital survey was always completed by the patient, the critical care survey was completed by a patient's family member or friend in 76% of cases and by the patient in 24%. Patient-completed critical care surveys had more correlation with hospital surveys (r = 0.45) than did critical care surveys completed by family members (r = 0.30), but the overall correlation remained modest.
Conclusion:
Scores on the hospital survey were at best modestly associated with scores on the critical care survey and did not reflect the specific experiences of patients and patients' families in the intensive care unit.
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