Patient satisfaction with divided anesthesia care

Abstract

Background Up to now, no prospective cohort study using a validated questionnaire has assessed patients’ expectation and perception of divided anesthesia care and its influence on patient satisfaction. Objective We assessed patient satisfaction with divided anesthesia care in a district general hospital in Switzerland. We hypothesized that patient expectations, combined with their perceptions of the (un)importance of continuous anesthesia care would influence patient satisfaction. Material and methods A total of 484 eligible in-patients receiving anesthesia from October 2019 to February 2020 were included and received preoperative information about divided care via a brochure and face-to-face. The primary outcome was the assessment of patient satisfaction with divided anesthesia care using a validated questionnaire. In group 1 continuity of care was considered important but not performed. In group 2 continuity was ensured. In group 3 continuity was regarded as not important and was not performed. In group 4 patients could not remember or did not answer. A psychometrically developed validated questionnaire was sent to patients at home after discharge. Results A total of 484 completed questionnaires (response rate 81%) were analyzed. In group 1 (n = 110) the mean total dissatisfaction score was 25% (95% confidence interval [CI] 21.8–28.1), in group 2 (n = 61) 6.8% (95% CI 4.8–8.7), in group 3 (n = 223) 12.1% (95% CI 10.7–13.4), and in group 4 (n = 90) 15% (95% CI 11–18); ANOVA: p < 0.001, η = 0.43. Of the patients 286 (59%) considered continuity of care by the same anesthetist relatively unimportant (34%) or not important at all (25%). The other 40% considered it important (22%) or very important (18%). Conclusion Despite receiving comprehensive preoperative information about divided anesthesia care, 40% of patients still considered continuity of care by the same anesthetist important. We recommend further research evaluating whether and how patient expectations can be modified towards the common practice of divided care and patient satisfaction can be increased.

Patient-reported perioperative anaesthesia-related anxiety is associated with impaired patient satisfaction: a secondary analysis from a prospective observational study in Switzerland

“…This study was based on a secondary analysis of data from a prospective cohort study on patient satisfaction with divided anaesthesia care. This study was approved by the Medical Ethics Committee of St. Gallen, Switzerland (Business Administration System for Ethics Committees 2017–00,090; Registry of all Projects in Switzerland—RAPS—registration number: 2017-00090) 7 . The requirement for informed consent for secondary analysis was waived by the Medical Ethics Committee of St. Gallen, Switzerland.…”

“…The 55-item patient satisfaction questionnaire used in our study was psychometrically developed according to a stepwise protocol and retested several times for construct validity and reliability 5 , 7 , 10 , 11 . Three non-quality-of-care-related questions within the questionnaire specifically addressed anaesthesia-related anxiety (Table 1 ).…”

Prevalence of patient-reported perioperative anaesthesia-related anxiety, anxiety triggers and its association with patient satisfaction: a retrospective, observational study in Switzerland

“…Regarding the sub-dimension "continuity of care", modern anaesthesia services are limited in the scope of actions mostly by the development towards preoperative anaesthesia wards, thus divided care 7 . "Respect and trust" in the patient-anaesthetist relationship highly depends on non-technical skills of the treating physician [36][37][38][39] , which gained attention for resident and anaesthesia nurse training as well as continuing education only in recent years.…”

“…The 55-items patient satisfaction questionnaire used in our study has been psychometrically developed and re-validated several times 1,7,10,11 . Three non-quality of care related questions speci cally address anaesthesia-related anxiety.…”

Patient satisfaction in anesthesiology: a narrative review

“…Likewise, in some cultures, continuity of care is still important to patients [23], even though divided care has already become the new standard [51]. In a recent study, Koster et al [52] found that despite receiving comprehensive preoperative information about divided anaesthesia care, 40% of patients still considered continuity of care by the same anaesthetist important. The mean total dissatisfaction score of the group who considered continuity of care important but did not receive it (110 patients out of 484) was 25% (95% confidence interval, 21.8–28.1) compared with 12% in the group of patients (222 out of 484) who did not emphasize the importance of continuity of care (95% confidence interval 10.7–13.4).…”