Becker's Hospital Review

43 Are Patient Satisfaction Surveys Doing More Harm Than Good? By Heather Punke Leadership & Strategy that was and is treating patients — as well as teaching future generations of care providers. Q: Do you see the hospital's reputation as one of the oldest hos- pitals in America as being a strategic advantage in any way? If so, how? Is it ever a disadvantage? TL: Being the nation's first hospital is a wonderful recruitment tool; again linking the long history and rich tradition of innovation and compassionate care to our current business development goals. There is a long and growing list of "firsts" for Pennsylvania Hospital. I remind the PAH community that we must carry on that tradition of innovation. As for recruiting physicians, it's important that we convey to them that "old" doesn't mean "old-fashioned." Being a part of Penn Medicine — in- cluding the Perelman School of Medicine — helps us ensure that Penn- sylvania Hospital remains at the forefront of medical care, research and education. Q: How does this hospital's history impact its culture? TL: There is a deep-seated pride at Pennsylvania Hospital that certainly is rooted in the historic significance of the organization, but there is also mod- ern day esprit de corps that our physicians and staff bring to bear each day. Our patients, families and visitors are enveloped in the tenets of the Penn- sylvania Hospital seal of the Good Samaritan: "Take care of Him and I will repay Thee." The story of the Good Samaritan was purposely chosen in 1751 by our hospi- tal's co-founders, Benjamin Franklin and Dr. Thomas Bond, to be the official seal. Their views ushered in a new attitude of social responsibility, one that we're proud to maintain to this day. We also celebrate the hospital's May 11th birthday each and every year with a cake and party for hospital staff, employees and volunteers. Q: As executive director, what would you like your legacy to be at PAH? TL: I would like my legacy to be one in which I provided an environment that stimulated and encouraged physicians and staff to be modern-day in- novators who yield improved approaches to treating ailments in a seamless, highest quality, compassionate and patient-centric manner. Q: If you could serve as executive director for PAH in any time period (other than current day) when would it be? Why? TL: Given my appreciation for the vision of Dr. Thomas Bond and Benjamin Franklin, it would have to be at the inception of the idea for the nation's first hospital. A problem was identified and I would have welcomed being part of the solution n T hough the intention of patient satisfac- tion surveys may be positive, the focus on patient satisfaction and the surveys designed to measure it could actually lead to a decrease in care quality and an increase in costs, according to The Hastings Center, a nonparti- san research institution. "Patient satisfaction is an important, valuable element of good healthcare, yet some uses and consequences of patient satisfaction surveys may be problematic," the authors wrote. The report lists the following unintended con- sequences that patient satisfaction surveys could cause: 1. Providers giving unnecessary or inappropri- ate care. "An emphasis on patient satisfaction as an indicator of healthcare quality may lead to an excessive emphasis on patients' perspectives and wishes," the authors wrote, and could cause healthcare professionals to cater to those wishes, even if it's not medically necessary. 2. Clinicians telling patients what they want to hear. The authors cited a study that "suggests that the threat of low patient satisfaction scores may lead providers to permit, or even encour- age, false beliefs among their patients" because patients tend to rate physicians more poorly if they deliver bad news. 3. "Teaching to the test." This phenomenon happens when hospitals strive to meet high pa- tient satisfaction scores and put processes in place to "manipulate" patient responses on the HCAHPS survey. The authors say this practice "raises the question of whether higher HCAHPS scores truly represent higher patient care." 4. An ultimate decrease in healthcare quality and increase in costs. The report cites a 2012 study in the Archives of Internal Medicine that directly ties high satisfaction scores to higher overall healthcare costs. "Ultimately, patient satisfaction surveys may lead healthcare astray, undermining the provi- sion of optimum care for all," the authors con- clude. n Do you have thoughts on this topic? We'd like to hear them. Please email hpunke@beckershealth- care.com.

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