ideas for patient satisfaction scores

[discharged]

Most of us bicker about press ganeys and how deceiving and inaccurate they are in regards to scoring patient satisfaction. I've been thinking about what we could do to improve those scores, but with the type of patients we see on a daily basis, it's just so hard to formulate a one size fits all. Maybe that's just it, one size wont fit all and we need different scoring systems for different sets of patients..

As much as we like to ignore the fact that healthcare a business, it is what it is. Patient satisfaction scores wont disappear.. Has anyone thought about a better system we could use? I hope to see it improve some day.. because it's bogus how it is right now, and it affects the way each doctor practices medicine, if you want to call it "medicine".

Anyway, just wanted to see if anyone had any good ideas out there.. Maybe we can spark some minds to advocate for change, although it's hard to see since press ganey has become such a powerhouse

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[Old_Mil]

The key to improving this system is an understanding that is common in most industries but seems to be absent from most administrative circles in medicine: not every customer is a customer worth having.

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[shopsteward]

The key to improving this system is an understanding that is common in most industries but seems to be absent from most administrative circles in medicine: not every customer is a customer worth having.

The problem with this is 1) it's true, and 2) acknowledging it is, and always will be, politically unacceptable to the rule-makers (hospital management and politicians).

Patient satisfaction is always going to be subjective. That subjective view is always going to be prone to error, for many reasons. The main ones are that they are uninformed consumers (haven't had the years of education and training necessary to be fully informed) and that what they want isn't necessarily what is best for them.

There is also a system error in the way costs are borne. This in part relates to the costs borne/not borne by individual patients, which skews their perception what is good/appropriate, but there are bigger problems with it than that.

The way to deal with the patient satisfaction problem is to cross-reference to outcomes. There is evidence that higher satisfaction brings worse outcomes: there needs to be further work which can verify and incorporate that evidence into surveys - eg discounting satisfaction which relates to over-testing or to over-prescribing narcotics.

Press-Ganey is one firm with a flawed model. In the land of free enterprise, someone needs to set up a better rival.

 

[diphenyl]

Just offer complimentary massages. Happy ending optional, their choice not yours.

 

[FSU2013]

Attach $5, a snickers and a couple percocets to each questionnaire?

 

[DreamingTheLive]

The key to improving this system is an understanding that is common in most industries but seems to be absent from most administrative circles in medicine: not every customer is a customer worth having.

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Agree. I think EM docs do need to be as nice/accomodating as reasonably possible given the circumstances. However, if a drunk, violent, 43 year old patient who was just the vector in a severe MVA thinks they should be treated like Jordan returning to a Chicago Ritz Carlton they (and much of the American public at-large) sorely need to be "re-educated" on the basics of manners and how to act in public settings, especially when people are trying to take care of you/save your life.

 

[WILLMD]

You raise some really good points, shopsteward and discharged. I'm a card carrying emergency physician that's long been frustrated with traditional approaches to measuring patient "satisfaction" in the ED. About two years ago, I'd had just about enough (like many of us) and set out on a mission to change things. Since that time I've been working with a team of physician scientists to develop an entirely different approach to measuring the patient experience. It's designed as a change management platform (not a benchmarking or "scoring" system) that leverages forward technology (cloud based e-mail and smartphone delivery) to get highly actionable information from patients to help emergency physicians and nurses deliver better patient care. It's a system designed by emergency physicians for emergency physicians and most importantly is supported by a statistical framework designed to provide a fairer and more accurate evaluation of individual providers. We've been using it in our ED since last year as our primary patient experience survey tool with great success.

Feel free to PM if you'd be interested in learning more about how it works. As discharged said in his post, it would be really cool if the EM community created more advocacy around patient satisfaction surveys and could help shift the current mindset and approaches toward patient satisfaction that are predominant in hospitals today. It's a tough road ahead but I remain optimistic that as a specialty we are well positioned to lead the way!