Patient Power March 31, 2008

     This year the hospital experiences of patients will not only be collected but reported.  As a physician rounding on patients in the hospital I often see patient surveys on food trays or on side tables.   In my experience at least 60% of hospital patient care surveys are never completed and when completed they are not effectively analyzed and acted on.  Well I wasn’t the only one asking questions because in 2002 the Hospital Quality Alliance (HQA) was formed, a national public-private collaboration to encourage hospitals to voluntarily collect and report hospital quality performance information.   HQA set out to give consumers three critical elements needed to make good sound decisions about the quality and value of the health care available to them by their local hospitals: quality information, patient satisfaction survey information, and pricing information for specific procedures.

     As such, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey (HCAHPS) was born and is the first national, standardized, publicly reported survey of patient perspectives on care they experience during a hospital stay. Over 2,500 hospitals around the country voluntarily collected information from discharged patients who were treated for multiple diseases and/or conditions between October 2006 and June 2007.    The survey contained 27 questions which were categorized into 3 groups: Summary measures, Individual Hospital measures and Global measures.  The summary measures contained questions about patient communication with nurses and physicians, hospital communication about medications; hospital staff responsiveness, pain management as well as hospital discharge instructions.  Individual measures captured hospital cleanliness and quietness.  Global measures captured overall ratings and a patient’s willingness to recommend friends and family to the hospital. 

     The survey results were released on Friday, March 28^th.  Many patients reported that they had not been treated with courtesy and respect by doctors and nurses; that they had not received adequate pain medication after surgery; and that they did not understand the instructions they received when discharged from the hospital.   To review your local hospital click on the following link: www.hospitalcompare.hhs.gov

What does this say to me:  One of the more alarming things to me is, there is still a significant communication gap between patients and health care providers.  Patients not understanding discharge instructions and not having adequate pain relief are reflections of this.  Inadequate communication between patient and providers has also been proven to increase medical errors that can subsequently lead to increase morbidity and mortality.  Although medical schools have paid more attention to training future doctors on their interpersonal and cultural interactions with patients there is still much work to be done not only on students but on all levels of the health care team. 

     I believe that increasing sensitivity and awareness of patients concerns and needs will improve patient satisfaction as well as the overall quality of their health care.  The work that HQA has initiated is a good first step towards providing the general public the information that they need to make informed decisions that will subsequently force health care providers and/or institutions to make the changes that are needed in their institutions.

Yours in Good Health 

Related links for additional information: 

http://www.hhs.gov/news/press/2008pres/03/20080328a.html 

http://www.nytimes.com/2008/03/29/washington/29hospital.html?_r=1&oref=slogin