Becker's Clinical Quality & Infection Control

19 PATIENT EXPERIENCE The problem with patient surveys By Megan Knowles P atient satisfaction is an important part of hospital operations, but hospital leaders should consider the nuances of measuring patient experience before acting on survey results, according to a blog post on the AMA Wire. Three concerns about patient experience surveys for physicians, hospi- tal administrators and policymakers to consider: 1. Patients may get unneeded treatments. Physicians frequently spend less time than they would like with their patients and may feel pressure to hasten the choice and explanation of treatments. If physi- cians face low patient satisfaction scores, they may approve requests for low-value or unneeded treatments to fulfill patients' wants. 2. High survey scores may increase disparities. Safety-net hospitals often score lower on patient satisfaction than hospitals giving less care to underserved populations, meaning one-size-fits-all financial incentives for experience scores could lead to larger disparities in care and satisfaction. Concerns over penalties for low satisfaction scores may also make physi- cians avoid caring for poorer patients and patients with mental illness. 3. Responses may be suspect. Patients' expectations and perceptions of care may not accurately reflect care quality measures. Additionally, voluntary surveys are often long and may not be completed immedi- ately after patients received care, producing selection and recall biases in patients with experiences at the extremes. n Patient experience key to driving brand loyalty, report finds By Mackenzie Bean P atient experience is five times more likely to influence patients' brand loyalty than traditional marketing strategies used by health systems, according to a report from Press Ganey. For the report, researchers surveyed more than 1,000 household healthcare decision-makers nationwide to examine the role patient experience plays in consumer acquisition and brand awareness. Four report findings: 1. Consumers said they are more likely to research a new physician via the internet than by talking to family and friends. When conducting on- line research, consumers said they were most likely to look at insurance information (81.8 percent), patient ratings (70.7 percent), and hospital or health system affiliations (67.3 percent). 2. Before accepting a referral from their primary care physician, 72 percent of consumers said they were "likely or very likely" to look at the recommended specialist's website. 3. Consumers also reported actively looking for and being influenced by patient ratings and reviews. Nearly 70 percent said they'd previously chosen a physician based on positive reviews or avoided one based on negative reviews. 4. Consumers also said they valued both negative and positive patient comments in online reviews. n What hospitals can do to avoid disrupting patients' sleep By Megan Knowles A lthough physicians and nurses oen have to wake patients at odd hours for medication and tests, hospitals can employ strategies that minimize patient sleep disruptions that hinder recovery, e New York Times reported. Peter Ubel, MD, a physician with Duke University in Durham, N.C., recognized the problem of hospital sleep disruption as both a physician and patient. His sleep was interrupted several times by machines beep- ing and lab tests aer he spent a night in the hospital recovering from surgery in 2013. "Not an hour went by without some kind of disruption," Dr. Ubel recalled. "It's a terrible way to start recovery." Short sleep durations are linked to reduced immune function, delirium, hypertension and mood disor- ders. Hospital sleep disruptions may also contribute to posthospital syndrome, when patients face health problems aer their discharge that are unrelated to their initial hospitalization. Providers often turn to sedatives to help pa- tients deal with the stresses of a hospital stay, but hospitals could make their environments more conducive to sleep to curb the risks these powerful drugs present, Dr. Ubel said. Environmental changes include hospital workers coor- dinating to ensure one sleep disruption serves multiple needs, such as having a blood draw and a vitals check at the same time as opposed to two hours apart. Staff could also let patients' needs guide sleep inter- ruption schedules — if a patient can go six or eight hours without a vitals check, staff could ensure they aren't doing that check once every four hours. e report highlighted several hospitals with initia- tives to let patients get more rest: • Yale New Haven (Conn.) Hospital has encour- aged nurses to alter medication schedules to minimize sleep disruptions and to check off other tasks before patients go to bed. • Boston-based Massachusetts General Hos- pital installed rubber floors in some areas to reduce noise. • Michigan Medicine in Ann Arbor is working to reduce noise at night by changing when floors are cleaned and installing sound-absorbing tiles. n

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