Becker's Clinical Quality & Infection Control

9 PATIENT EXPERIENCE How Mount Sinai is harnessing the power of bright light to boost patient satisfaction By Megan Knowles A clinical trial at New York City- based Mount Sinai Health System is testing whether brighter lights in cancer patients' rooms during the morning can boost their mood and help them sleep through the night, e Wall Street Journal reported. e researchers are working with the hypothesis that strong light affects patients' circadian rhythms, which can improve sleep quality. "We believe that light will affect circadian rhythms, which in turn will affect sleep, depression and fatigue," Heiddis Valdi- marsdottir, PhD, a researcher in the Sinai study and assistant professor at Sinai's Tisch Cancer Institute, told the WSJ. Sinai worked with the Lighting Research Center at Troy, N.Y.-based Rensselaer Poly- technic Institute, where its director, Mariana Figueiro, PhD, an architect with a back- ground in biology, worked to design light fixtures for the randomized trial. e fixtures provide dim light or circadi- an-stimulating high-intensity light. All types of light can affect circadian rhythms, Dr. Figueiro said, "as long as you develop the right spectrum [or color] and the right inten- sity." Although strong fluorescent lights could work, patients tend to prefer light-emitting diodes or LEDs, Dr. Figueiro added. Approximately 44 patients have taken part in the trial so far, with half being exposed to intense light in the morning. e other half remained in the "placebo" or dim light, ac- cording to Dr. Valdimarsdottir. Although the findings on sleep and fatigue still need to be examined, the early results related to depres- sion are promising, Dr. Valdimarsdottir said. Around 40 percent of participants were clinically depressed aer the first week in the hospital. at percentage remained constant for those who underwent light therapy, but increased to 70 percent among patients in the dimmer "placebo" light. "What I find amazing is that having more intense light, changing the light in the room will prevent depression" from getting worse, Dr. Valdimarsdottir said. "Usually when you are sick, you want dark around you. You want the curtains closed and the lights off. But...for a few hours, we are stimulating the circadian rhythms." Researcher William Redd, PhD, a professor at Sinai's Icahn School of Medicine, said dim light in hospital rooms does not cause patients' depression, fatigue or sleep issues. Rather, their cancer and intense treatments trigger these problems. Despite this, Dr. Redd added, "it is quite possible the hospital lighting makes it worse." e researchers plan to present their find- ings in November 2018 at the International Congress of Behavioral Medicine's annual meeting in Santiago, Chile. n Study: Negative online physician reviews fail to reflect patient satisfaction survey responses By Megan Knowles P atients who give physicians negative reviews online do not give similar responses in formal patient sat- isfaction surveys, according to a study published in Mayo Clinic Proceedings. However, when compared with colleagues who do not have negative reviews, physicians score lower on factors beyond their immediate control. In a pilot study between September and December 2014, the researchers used Google to follow negative online reviews of physicians at Mayo Clinic's Rochester, Minn.-based campus. Out of 2,148 physicians, who represented 28 departments and divisions, 113 had negative online reviews. The researchers then compared how these physicians' scored in the Press Ganey Patient Satisfaction Survey with the scores of other Mayo Clinic physicians in similar fields who did not receive negative online reviews. The researchers did not find any statistical differences in the overall scores or in scores for patient communication. However, the group of physicians with negative reviews scored significantly lower on factors spanning beyond patient-physician communication. These factors included interaction with desk staff, nursing, physical environment, appointment access, waiting time, problem resolution, bill- ing and parking. The data did not identify specific instanc- es or patient experiences that led to negative reviews. The researchers acknowledged the limitations of the study, including the small physician groups, limited time period to collect the data, using a single search engine and that the online reviews reflected single experiences of patients. However, the study findings shed light on how differing scores affect patient experience and physician reputation. "Our study highlights the disconnection between indus- try-vetted patient satisfaction scores and online review comments," senior study author Sandhya Pruthi, MD, said in a press release. "Patients need to be aware of these distinctions as they make decisions about their health. Physicians also need to be aware, as they manage their online reputations." n

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