Why High Technical Quality Might Not Mean High Patient Satisfaction

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Two recent studies by The Delta Group's CareChex titled "2010 CareChex Quality of Care by U.S. Geographic Area" and "2010 CareChex Patient Satisfaction by U.S. Geographic Area" identified an interesting discrepancy between technical quality of hospital care and patient satisfaction scores.

The study indicated the top 10 states in the United States for overall quality of care, naming Ohio, Michigan and Delaware as the nation's quality leaders. However, when it came to patient satisfaction, the top three quality leaders were absent from the top 10. The top three states for patient satisfaction were Vermont, Maine and New Hampshire, none of which were granted a spot in the top 10 for quality.

Ohio, named number one in quality of care in the CareChex study, came in at number 34 in patient satisfaction, with a score of 33.3. Delaware, which ranked number three in quality of care, was placed in the bottom 10 for patient satisfaction with a low score of 19.6.

According to M. Thane Forthman, MBA, managing principal for The Delta Group, the discrepancy between patient satisfaction scores and quality scores may be due to the patient's perception of a hospital visit. "Technical quality incorporates items like patient safety events, patient falls and infection rates, and patients typically aren't really informed about those items in terms of whether they're actually receiving good medical care," he says. "They'll know if they had to take extra medication, but they may not know they had a complication of care that shouldn't have happened because that information isn't openly discussed with patients."

He says that hospitals who want to boast high patient satisfaction ratings should focus their energy on customer service as well as technical quality. Though patients will obviously be unhappy with post-surgical infections and readmissions, often the aspects that contribute to high satisfaction scores are more subtle.

"The hospitality aspects of the business are much easier to pick up on, such as timeliness in the administration of a pain killer, how quickly the staff responds to a problem and the cleanliness of the hospital," he says. "It's focusing on those aspects that make a hospital visit pleasant and not frustrating."

He says the hospitals that will benefit from increased patient volumes in the future are those that combine technical quality with patient satisfaction scores. Since patients often talk about their hospital experiences with friends and family members, a bad experience with a rude staff member or long wait time can hurt a hospital's reputation despite high quality of care. That patient satisfaction can also transfer to physician referrals. If a hospital is consistently receiving low patient satisfaction scores, physicians may be less likely to refer their patients to the facility or recommend the hospital to their colleagues.

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