Australian public hospital inpatient satisfaction related to early patient involvement and shared decision‐making in discharge planning

Abstract

Background Surveys of hospital inpatient satisfaction may help develop actionable plans for quality improvement, and patients have preferred to give feedback during admission at the point of service compared to after discharge. However, patient satisfaction measurement has often been done by questionnaires post‐discharge, and without focussing on an Australian general internal medicine setting. Aims To understand patients' perceptions of their admission experiences in an Australian public teaching hospital's general internal medicine unit, and to understand the opportunities for quality improvement. Methods A prospective study of 50 inpatients of a general internal medicine unit at an Australian public teaching hospital was carried out using a patient satisfaction questionnaire given to patients on the day of discharge. Results Patients perceived deficits in early communication about discharge destination planning, and provision of written discharge instructions. Responses highlighted the importance of checking with patients to elicit further information that was not previously captured during initial history‐taking, patient‐centred communication to enable informed consent and decision making, use of language readily understandable to laypersons, and checking for patients' understanding of messages as communicated by the treating clinician. Conclusions In an Australian general internal medicine service, early involvement and shared decision‐making in discharge planning are valued by patients. Incorporating checking of patients' understanding of diagnoses, management, discharge instructions, and follow‐up plans into ward round routines may benefit patient satisfaction. This study stimulates further research into the use of a proforma to capture and check patients' understanding of discharge diagnoses and plans.

The Effect of Physician Communication on Inpatient Satisfaction

“…All of the papers in this collection were written in English and published. There are differences in several research locations that were found; two studies were conducted in Ethiopia [ 36 , 37 ], two studies in China [ 38 , 39 ], one study in Hong Kong [ 25 ], one study in the USA [ 40 ], one study from Germany, Switzerland, and Austria [ 41 ], one study in Indonesia [ 42 ], one study in Iran [ 26 ], one study in Korea [ 43 ] and one study in Australia [ 44 ]. Nine articles used a cross-sectional study method, one article was an experimental study, and one article was a cohort study.…”

“…Six articles [ 25 , 26 , 39 , 41 , 42 , 43 ] out of the 11 articles met the review criteria, showing either that patient satisfaction with hospital services was more than 80%, or that an increase after intervention was higher than the national survey results. Conversely, five articles [ 36 , 37 , 38 , 40 , 44 ] demonstrated that the patients were less satisfied. Patient satisfaction was investigated with three types of study designs, namely cross-sectional studies (9 articles), experimental studies (1 article), and cohort studies (1 article).…”

“…Understand the demand of patients: The patient’s demands that affect physicians’ communication satisfaction are summarized from five articles [ 25 , 36 , 38 , 39 , 41 , 44 ] that support this argument. Several patient demands which affect patient satisfaction are expected to be obtained from physicians.…”

“…In this study, organizational determinants also affect patients’ satisfaction with physician communication, as the findings of four articles [ 36 , 40 , 44 ] have been collected. These findings are quite surprising because two-way communication only involves physicians and patients, but the hospital can influence patient satisfaction.…”

“…Almost unanimously, they expressed dissatisfaction with the lack of interpretation services. Additionally, it was discovered in this study that the language barrier was not solely due to the patient’s inability to communicate in the same language as the physician but was also due to the physician’s inability to translate medical terminology into plain terms that were easily understood by the patient [ 44 ]. Therefore, hospital management is obligated to provide translation services using terminologies that patients easily understand.…”