Utilizing patient satisfaction data to assess quality improvement in community-based medical practices

Our objective was to quantitatively measure the effect of quality improvement-based intervention on the improvement in patient satisfaction with physicians, office visits. A prospective nonrandomized case-control protocol was used at a multiple-site community-based medical and surgical office practices of members of Project Solo/Physicians Information Exchange. The study subjects were convenience samples of new and return patients seen between July 1996 and July 1997. One group of physicians (control group) surveyed patient satisfaction with office visits on two separate occasions with no intervention between the two occasions, except for seeing their own results after the first survey. A second group of physicians (intervention group) also surveyed patient satisfaction with office visits on two separate occasions, but were provided with a quality improvement poster between surveys. Changes in patient satisfaction between the two surveys were measured. The visit rating questionnaire, a nine-item patient-based questionnaire, was used to measure patient satisfaction; percentage excellent responses in the summary categories of patient access, physician attributes, and overall visit were used. Overall, 6088 patients from 59 physicians' offices participated; 3815 patients from 29 physicians in the control group, and 2273 patients from 30 physicians in the intervention group. The control group demonstrated small and nonsignificant changes in patient satisfaction between the two survey periods (0.6-1.4% increase, P = NS), and the intervention group demonstrated statistically significant improvements in patient satisfaction between the two survey periods (4.2-5.7% increase, P = 0.05-0.001). In addition, the two groups were compared directly using a stratified chi 2 analysis, and the differences were also statistically significant (chi 2 = 3.7-8.3, P = 0.05-0.004). We conclude that the use of a quality improvement-based intervention had a significant positive effect on patient satisfaction with office visits, when compared to a group of physicians who did not use any intervention.