Evaluation of an Inpatient Service by Consumer Feedback

Abstract

Over the past few years, the Sound View-Throgs Neck Community Mental Health Center has conducted a number of studies of client satisfaction with our services. The findings suggest that the majority of clients are generally satisfied with the help they receive. However, the level of satisfaction apparently depends on specific aspects or features of the program being evaluated, as well as the particular unit which is providing the services. We have used face-to-face, telephone, and mail survey procedures in these studies; and we have sampled both clients who have completed their treatment and those in the early phases of the treatment process. In one of the studies, the former SVTN-CMHC patients we surveyed had been hospitalized in the inpatient unit located at Bronx Municipal Hospital Center. We randomly selected one hundred patients who had been discharged from the unit during the first six months of 1971. After excluding children under the age of sixteen, patients who were subsequently hospitalized or were too symptomatic to be interviewed, and those living outside New York City, we interviewed twenty-five ex-patients. We asked questions about their feelings related to the need for hospitalization, their present problems, whether hospitalization had helped them, their satisfaction or dissatisfaction with ward life, and their feelings about discharge. The results indicated that these ex-patients felt at least moderately satisfied with their hospital experience. However, they were relatively dissatisfied with provisions for privacy on the ward, the fact that doctors and other hospital staff were not readily available to them, the doctor's understanding of their problems, and the evening recreation programs. There was some discrepancy between the ratings, which were mostly favorable, and the comments, which were predominantly unfavorable. There are various possible explanations for this, ranging from the limited validity of rating items in such a study to the possibility that this group of ex-patients were so accustomed to negative experiences that their overall assessments were not significantly influenced by them. There is some possibility that the highly positive ratings may stem from an unexpected source. For approximately half of the sample, the major purpose of hospitalization was to provide an opportunity to get away from their usual surroundings. The in-hospital treatment per se was relatively unimportant to them, and their favorable ratings may be a way of indicating that the hospital simply served as a refuge, which they were seeking. Since a patient may approach the hospital with self-defined needs either for treatment or mainly for refuge--it may be worth while to provide alternative programs to meet these different needs. A "refuge" program, for example, may not require an in-hospital environment; and even if it does, the staffing pattern should be different from that of a hospital with a treatment-oriented program.

Consumer satisfaction with mental health treatment.

“…Moreover, in the published studies, where more careful reporting of return rates is likely, response rates are even lower. Of the studies of consumer satisfaction reviewed for this article, 31 indicated return rates; of these 10 report return rates between 21% and 40%, 8 between 41% and 60%, 7 between 61% and 80%, and 6 between 81% and 100% (Ahmed & Koltuv, 1976;Balch, Ireland, Mc-Williams, & Lewis, 1977;Birnbaum & Suits, 1979;Burgoyne, Wolken, Staples, Kline, & Powers, 1977;Ciarlo & Reihman, 1977;Denner & Halprin, 1974a, 1974bEdwards, Yarvis, Mueller, & Langsley, 1978;Fiester & Fort, 1978;Frank, 1974;Getz, Fujita, & Allen, 1975;Gilligan & Wilderman, 1977;Glenn, 1978;Goyne & Ladoux, 1973;Hart & Bassett, 1975;Heineman & Yudin, 1974;Jansen & Aldrich, 1973;Justice & McBee, 1978;Kissel, 1974;Kline, Adrian, & Spevak, 1974;Koltuv et al, 1978;Landsberg, 1975;Love et al, 1979;Mayer & Rosenblatt, 1974;Noll & Block, 1979;Powell et al, 1971;Preston, Schoenfeld, & Adams, 1975;Reinhart & Cazavelan, 1975;Slem & Cotler, 1973;Snelling & Walker, 1978;Strupp, Fox, & Lessler, 1969;Woodward et al, 1978). High rates of return are virtually limited to captive samples in which responses are likely to be highly reactive (typical phone and mail surveys average 41 % and 46% responding, respectively).…”

“…3 Among the 26 studies that examine satisfaction in outpatient or in mixed community mental health center populations (which are principally outpatient) and that report summary statistics, 3 find satisfaction in 91%-100% of clients, 10 in 81%-90%, 8 in 71%-80%, 4 in 61%-70%, and 1 in 51%-60% (Balch et al, 1977;Birnbaum & Suits, 1979;Burgoyne et al, 1977;Ciarlo & Reihman, 1977;Denner & Halprin, 1974a, 1974bEdwards etal, 1978;Fiester, 1979;Frank etal., 1977;Gilligan & Wilderman, 1977;Goyne & Ladoux, 1973;Hart & Bassett, 1975;Heineman & Yudin, 1974;Justice & McBee, 1978;Kaufmann, Sorenson, & Raeburn, 1979;Kissel, 1974;Kline et al, 1974;Landsberg, 1973Landsberg, , 1975Love et al, 1979;McCoy, Penick, Powell, & Read, 1975;Noll & Block, 1979;Powell et al, 1971;Reinhart & Cazavelan, 1975;Strupp et al, 1969;Woodward et al, 1978). Among the inpatient studies, 2 show satisfaction in 81%-90% of clients, 2 in 71%-80%, and 2 in 61%-70% (Ahmed & Koltuv, 1976;Eder & Kukulski, 1975;Glenn, 1978;Landsberg, 1973;Mayer & Rosenblatt, 1974;Snelling & Walker, 1978). 4 Among crisis units, 1 study found satisfaction in more than 91% of clients, 2 in 71%-80%, and 1 in 61%-70% (Getz et al, 1975;King, 1977;…”

“…In those instances where most consu-mers express satisfaction, efforts should be made to explore satisfaction more specifically. Focusing on the comparative satisfactions of individuals across multiple treatments received (e.g., Dowds & Fontana, 1977), on satisfaction with changes in routine (e.g., Smith, Oswald, & Faruki, 1976), on dissatisfactions underlying a general view of satisfaction (e.g., Ahmed & Koltuv, 1976;Gutek, 1978), and on the views of dissatisfied clients (e.g., Larsen et al, 1979) or early terminators should prove useful in attempts to improve treatment. 5.…”

Predicting post treatment client satisfaction between behavioural activation for depression delivered either in-person or via home-based telehealth

“…8–10 It is, therefore, not surprising that attempts to measure patient satisfaction, starting in the early 1950s, involved mental health services. 11–13…”