BackgroundThe patient perspective is increasingly recognized as a central pillar of quality in hospital care. International evidence suggests that an array of interacting factors may influence patient satisfaction with hospital care, whereas only a few studies have examined the impact of hospital characteristics.ObjectiveTo explore which hospital characteristics exert an influence on patient satisfaction with inpatient care.DesignCross‐sectional study using secondary data.Setting and participantsA total of 999 hospitals in Germany with 300 200 patient surveys from 2013 formed the study population. Patient satisfaction was surveyed using the Patients’ Experience Questionnaire, and hospital characteristics were extracted from mandatory quality reports. Only hospitals with at least 75 surveys were included in the analysis.Main variables studied and main outcome measuresFour dimensions of patient satisfaction (medical care, nursing care, organization and overall impression) were studied as the outcome measures. Region, profit orientation, size, staffing per bed and quality scores were considered possible influencing hospital characteristics. We performed risk‐adjusted multivariate analyses.ResultsAll of the characteristics had a significant influence on the patient satisfaction dimensions (P<.05), and patients in East Germany, in small hospitals or in not‐for‐profit hospitals, were more satisfied. Additionally, more staffing per bed as well as a better process and outcome quality were associated with more satisfied patients.ConclusionStructural and quality characteristics of hospitals have a significant impact on patient satisfaction. This association confirms that patients are sensitive to important hospital quality measures and reinforces the consideration of patient satisfaction as an indicator of the quality of care.

Background: Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction. Methods: The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes). Discussion: This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users' motivation. Insights gained from this study can inform other patient safety interventions and health policy developments.

ZusammenfassungZur digitalen Transformation des Gesundheitswesens sind vom Bundesgesundheitsministerium in jüngster Zeit mehrere Gesetze verabschiedet worden, die weitreichende Innovationen zur Verbesserung der Versorgung und Erhöhung der Leistungsfähigkeit des Gesundheitssystems beinhalten. Gleichzeitig steigen damit die Anforderungen an die Nutzer:innen im Umgang mit digitalen Anwendungen und Informationen. Digitale Gesundheitskompetenz erhält dadurch besondere Relevanz. Vorliegende Studien zeigen jedoch, dass die digitale Gesundheitskompetenz der Bevölkerung in Deutschland nicht gut ausgeprägt ist. In dem Beitrag werden daher die Herausforderungen, Lücken und Perspektiven bei der Einführung und Umsetzung der neuen Digitalisierungsgesetze diskutiert und 6 Punkte benannt, wie die digitale Gesundheitskompetenz gefördert und Nutzer:innen stärker einbezogen werden können.

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