Assessing treatment outcomes using a single question

Abstract

Satisfaction with care is important to both patients and to those who pay for it. The Net Promoter Score (NPS), widely used in the service industries, has been introduced into the NHS as the 'friends and family test'; an overarching measure of patient satisfaction. It assesses the likelihood of the patient recommending the healthcare received to another, and is seen as a discriminator of healthcare performance. We prospectively assessed 6186 individuals undergoing primary lower limb joint replacement at a single university hospital to determine the Net Promoter Score for joint replacements and to evaluate which factors contributed to the response. Achieving pain relief (odds ratio (OR) 2.13, confidence interval (CI) 1.83 to 2.49), the meeting of pre-operative expectation (OR 2.57, CI 2.24 to 2.97), and the hospital experience (OR 2.33, CI 2.03 to 2.68) are the domains that explain whether a patient would recommend joint replacement services. These three factors, combined with the type of surgery undertaken (OR 2.31, CI 1.68 to 3.17), drove a predictive model that was able to explain 95% of the variation in the patient's recommendation response. Though intuitively similar, this 'recommendation' metric was found to be materially different to satisfaction responses. The difference between THR (NPS 71) and TKR (NPS 49) suggests that no overarching score for a department should be used without an adjustment for case mix. However, the Net Promoter Score does measure a further important dimension to our existing metrics: the patient experience of healthcare delivery.

Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population

“…We also administered the Net Promoter Score (NPS), which is an overarching one-question measure of patient satisfaction widely used in service industries, recently introduced into the National Health Service, UK. This ‘friends and family test’ assesses the likelihood of the patient recommending the healthcare received to another and is seen as a discriminator of healthcare performance 31. Three categories of responders are identified and classified as ‘promoters’, ‘passives’ and ‘detractors’.…”

Increased satisfaction after total knee replacement using sensor-guided technology

“…[4][5][6][7] Also, patients who undergo TKR consistently report higher levels of pain, greater impairment of function, and lower levels of satisfaction than those who undergo total hip replacement (THR). [8][9][10][11] A number of explanations for these findings have been suggested. Satisfaction correlates closely with function.…”

Exploring Patient Engagement: A Qualitative Analysis of Low-Income Urban Participants in Asthma Research

“…At completion, participants universally responded that they would recommend this study to a friend with asthma, providing evidence of their support 14 . Participants from both groups appreciated an educational and interpersonal intervention, and felt that the study improved healthcare and medication adherence, visit preparation, and communication.…”