“Improvements in Patient Experience”–Really?

December 15, 2010

Hospitals improve their communication with patients when  patient survey results are publicly reported, say researchers with the RAND Corporation and the federal Centers for Medicare and Medicaid Services (CMS).

Writing in Health Affairs, the researchers report that hospitals participating in the first two rounds of annual reporting improved overall in eight of nine survey measures.  The measures comprised communication with nurses and doctors, staff responsiveness, communication about medicines, pain management, and discharge information.  The surveys took place in 2008 and 2009.

Hand-lettered sign reading, "Stop complaining"The problem is that none of the average improvements exceed one percent. And, physician communication didn’t improve at all–although, interestingly, it scored first or second both years, with four in five patients reporting positive experiences.

Surveying patients is now de rigueur (I took French but, alas, had to look up how to spell this phrase–I hope my use of it impresses you).  The federal survey program is widespread–the vast majority of hospitals now participate–allowing comparisons to be drawn across hospitals and over time.  Hospitals survey patients for marketing purposes and because CMS penalizes hospitals that fail to participate in the program.

CMS pushes the program to improve quality of care, which, in the view of many advocates of quality (this blogger being one), includes patient satisfaction.

Author Marc N. Elliott and colleagues say the result is “encouraging.”  This is because hospitals that take part in the program are improving.  The title of their article is probably an over-reach: “Hospital Survey Shows Improvements in Patient Experience.”  Elliott is a statistician and sounds a bit more interested in the use of statistical measures than in quality of care.

My problems with the results are: Read the rest of this entry »