Physician and Patient Moves in the Hospital Do Not Move Patient Satisfaction: A Single-Center Retrospective Analysis

Background. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey for measuring patient\u27s experiences at US hospitals. There is a shift towards geographically assigning patients and physicians. However, its impact on patient satisfaction scores has not been studied. Objective: Examine the correlation between patient experience and overall hospital rating with the number of physicians seen and the number of times the patient was moved during a hospitalization. Methods: A retrospective observational study was performed using select HCAHPS & Press Ganey survey questions to assess physician satisfaction scores and overall hospital rating and recommendation scores. Results: There was no significant difference across the select survey questions based on the number of times a patient was moved or the hospitalists seen during a hospitalization on most questions. A higher case mix index was associated with an increased likelihood of receiving the highest rating for the hospital (OR 1.39,95% CI 1.03-1.88), p 0.03), and two other physician communication questions. An increase in the length of stay was associated with a lower likelihood of receiving the highest rating for similar physician communication questions (OR 0.91, 95% CI 0.83 to 0.99,p 0.04) Conclusions: The number of hospitalists seen by the patient and the number of times a patient is moved during a hospitalization is not associated with physicians related patient satisfaction scores, overall care received in the hospital, or if the patient would recommend the hospital to others

Hospital Medicine Case Review: The Case of the Patient(s) Who Just Can\u27t Go

Hospital Medicine Case Review: The Case of the Patient(s) Who Just Can\u27t Go, Walter Polashenski, MD, Executive Medical Director, Hospital Medicine RRH; Anil Job, MD, Director, Integration and Optimization, Hospital Medicine Objectives: Identify patient characteristics and issues that prevent or delay discharge and prolong Length of Stay Identify strategies and actions to address discharge barrier

Could Our Pretest Probabilities Become Evidence Based?: A Prospective Survey of Hospital Practice

OBJECTIVE: We sought to measure the proportion of patients on our clinical service who presented with clinical problems for which research evidence was available to inform estimates of pretest probability. We also aimed to discern whether any of this evidence was of sufficient quality that we would want to use it for clinical decision making. DESIGN: Prospective, consecutive case series and literature survey. SETTING: Inpatient medical service of a university-affiliated Veterans' Affairs hospital in south Texas. PATIENTS: Patients admitted during the 3 study months for diagnostic evaluation. MEASUREMENTS: Patients' active clinical problems were identified prospectively and recorded at the time of discharge, transfer, or death. We electronically searched medline and hand-searched bibliographies to find citations that reported research evidence about the frequency of underlying diseases that cause these clinical problems. We critically appraised selected citations and ranked them on a hierarchy of evidence. RESULTS: We admitted 122 patients for diagnostic evaluation, in whom we identified 45 different principal clinical problems. For 35 of the 45 problems (78%; 95% confidence interval [95% CI], 66% to 90%), we found citations that qualified as disease probability evidence. Thus, 111 of our 122 patients (91%; 95% CI, 86% to 96%) had clinical problems for which evidence was available in the medical literature. CONCLUSIONS: During 3 months on our hospital medicine service, almost all of the patients admitted for diagnostic evaluation had clinical problems for which evidence is available to guide our estimates of pretest probability. If confirmed by others, these data suggest that clinicians' pretest probabilities could become evidence based