What do measures of patient satisfaction with the doctor tell us?

Objective: To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. Methods: A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. Results: The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. Conclusions: Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. Practice implications: The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment

Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration

<p>Abstract</p> <p>Background</p> <p>Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA) conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities.</p> <p>Methods</p> <p>We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period. A semi-structured interview was used to gather information from staff who worked with patient survey data at the study facilities. Data were analyzed using a previously developed qualitative framework describing organizational, professional and data-related barriers and promoters to data use.</p> <p>Results</p> <p>Respondents reported more promoters than barriers to using survey data, and particularly support for improvement efforts. Themes included developing patient-centered cultures, quality improvement structures such as regular data review, and training staff in patient-centered behaviors. The influence of incentives, the role of nursing leadership, and triangulating survey data with other data on patients' views also emerged as important. It was easier to collect data on current organization and practice than those in the past and this made it difficult to deduce which factors might influence differing facility performance.</p> <p>Conclusions</p> <p>Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care.</p

Factor structure and psychometric properties of the Danish adaptation of the Quality in Psychiatric Care : Forensic In-patient Staff (QPC-FIPS)

There is a need for an internationally standardized and psychometrically tested instrument to measure the perceptions of staff members on the quality of forensic inpatient care provided. The aim of the present study was to adapt the Swedish instrument Quality of Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) to the Danish context and to evaluate its psychometric properties and factor structure in this context. All permanently employed staff members at all 27 forensic inpatient wards in Denmark were invited to answer the Danish version of the QPC-FIPS. In total, 641 staff members participated, resulting in a response rate of 80%. The Danish version of the QPCFIPS showed adequate psychometric properties and excellent goodness of fit of the hypothesised factor structure. Hence, the Danish QPC-FIPS is an excellent instrument for evaluating quality of forensic inpatient care both in clinical practice and in cross-cultural research. The members of staff generally reported that the care provided to patients was of high quality. The quality of the forensic-specific dimension was rated the highest, followed by the support, secluded environment, encounter, discharge and participation. The quality of the secure environment dimension was perceived to be the worst. The QPC-FIPS includes important aspects of staff members’ assessments of quality of care and offers a simple and inexpensive way to evaluate psychiatric forensic inpatient care. The QPC-FIPS can be used together with the Quality of Psychiatric Care-Forensic In-Patient (QPC-FIP) instrument, which covers the same items and dimensions as the QPC-FIPS, to identify patients’ and staff members’ views on quality of care and to improve the quality of forensic psychiatric care and benchmarking

Are the Dutch long-term care organizations getting better? A trend study of quality indicators between 2007 and 2009 and the patterns of regional influences on performance

Item does not contain fulltextOBJECTIVE: and setting The Dutch long-term care organizations, providing somatic care, psycho-geriatric care and home care, have to measure the quality of care through client-related and professional indicators since 2007. At the same time, competition was introduced with regional stimuli from healthcare insurers. The first aim of this study is to determine the trends of the national performance on client-related and professional quality indicators for the period 2007-09 in long-term care organizations in the Netherlands. The second aim is to determine the influence of the region on the quality performance in 2009. DESIGN AND PARTICIPANTS: We performed trend analyses on the indicators of clients of 2115 long-term care organizations. We used multivariate analyses to determine the difference in national performance between 2007 and 2009 and to calculate the influence of the region on the performance of 2009. INTERVENTION: None. MAIN OUTCOME MEASURES: Client-related and professional indicators. RESULTS: The national performance on client-related indicators for somatic care and home care increased and for psycho-geriatric care the quality performance became worse. The professional indicators for intramural care improved between 2007 and 2009. Region influences the performance. In general, organizations in the west of the Netherlands performed worse than other regions (with exception of home care). CONCLUSIONS: The study suggests that working with quality indicators in long-term care organizations for older people may lead to a better performance on several indicators. The influence of the region on the quality is significant, which could be caused by Dutch healthcare insurers