Associations between patient experience and clinical outcomes at a level I trauma center: a cross-sectional survey-based study

Abstract

Background: Helping survivors of traumatic injuries achieve optimal recovery is a crucial global health issue. Traumatic injuries present major implications for the health of patients, care systems, and world economies. Focusing on the improvement of structures and processes that influence hospitalized trauma patient experience is a potentially important way to improve outcomes and health-related finances. The purpose of this study is to determine if there are associations between patient experience and clinical outcomes for hospitalized trauma patients. Methods:The study used a cross-sectional design. Primary data was collected in March and April 2020.Potential participants were 95 trauma patients who received care for traumatic injuries at a United States urban Level I trauma center from November 2018 to January 2020 and consented to be contacted for future research. Phone surveys were used to collect quantitative and qualitative data on participants' patient experiences and health outcomes related to their hospitalization. Additional health outcomes were collected from participants' electronic health records. General linear and Poisson regressions were used to analyze associations between experience and outcomes. Differences between injury severity groups were analyzed using chi-square and t-tests.Results: Thirty participants completed the phone survey, a response rate of 31.6%. Positive nurse communication was associated with a significantly lower risk of hospital-acquired complications compared to negative nurse communication (−33%; 95% CI, −61% to −5.5%). Patients with severe injuries had a lower risk of 30-day readmissions when reporting positive nurse communication (−56% decrease; 95% CI, −88% to −23%), positive doctor communication (−50%; 95% CI, −81% to −19%), and positive overall hospital rating (−56%; 95% CI, −99% to −13%) when compared to severely injured patients who reported negative nurse and doctor communication and overall rating.Conclusions: This study shows that aspects of patient experience, especially those related to communication with providers, are significantly associated with clinical outcomes for acute trauma patients, with potential implications for Continuous Quality Improvement and value-based reimbursement. Additional research would confirm if these associations exist for larger samples and patients treated for traumatic injuries in non-urban settings.