Improvement of patient satisfaction with the neurosurgery service at a large tertiary care, London-based hospital

Abstract

Patient satisfaction is central to healthcare provision and the effective running of any surgical unit. Following on from both formal and informal feedback, we decided to look objectively at patient satisfaction with the neurosurgery service at a large tertiary care hospital in London and identify areas that needed improvement within the unit. Patient satisfaction was looked at with respect to four different aspects of the neurosurgery service: the surgeons, ward doctors, nurses, and hospital services. A questionnaire-based cross-sectional study was conducted and once the data were collected a plan of action to improve service provision was put into place. Data were collected from 150 patients over a 3 month period from September to November 2012. Interventions were made and data re-collected from 150 patients from January to March 2013. With regards to satisfaction with the neurosurgery service, 76.7% (n=115) were satisfied; following implementation of our measures for improvement, which included staff education, meetings and posters, this figure increased to 90.6% (n=136, p<0.001 on Chi-square testing). In conclusion, patient satisfaction should be at the crux of patient care, with a strong focus on effective communication skills, and can be improved by identification of issues by direct patient feedback and subsequent action based on this.

<p>Patient experiences: a systematic review of quality improvement interventions in a hospital setting</p>

“…These can be categorized into staff education, patient education, audit and feedback, clinician reminders, organizational change, promotion of self-management, and policy change 36. The most common strategies are organizational change21,22,24,26–35,37,38 and staff education 23–25,29–32,34,37,39–42. These strategies all relate to changing ward procedures and staff behavior.…”

“…These strategies all relate to changing ward procedures and staff behavior. Most studies applied multiple QI strategies,21,23–26,29–32,34,37–39,41,42 while other studies used only one of the aforementioned QI strategies 22,27,28,33,35,40. Eleven studies reported to use a specific change management approach or tool.…”

“…Eleven studies reported to use a specific change management approach or tool. These include Lean or Lean Six Sigma,24,29,30,32,33,38 Plan-Do-Study-Act,22,34,35 Kotter’s Model of Change,42 and a 30-step-scenario 27. One study used The CAHPS improvement guide 37…”

“…With the exception of one study,27 all studies reported at least one improved patient experience score following intervention. A dichotomy can be approximately found; six studies focused on improving the interaction of staff with patients (eg, communication, compassion, respect),23,24,32,34,38,40 and 10 studies focused on improving processes (eg, waiting time, noise disturbance, pain management) 21,22,27–31,35,39,42. Five studies had objectives in both areas 25,26,33,37,41.…”

Development of a real-time physician–patient communication data collection tool

“…A key component of delivering high-quality care is effective physician–patient communication, which correlates with medication compliance, readmission rates, clinical outcomes and the patient experience 1–3. Through standardised communication protocols, training sessions, educational tools, real-time feedback and incentive programme, several studies have shown improved physician communication, the overall patient experience and HCAHPS scores 4–10. Most of these interventions focus on the ‘knowledge’ aspect of communication, targeting delivery of medical information and patient education.…”