Patient Experience and Hospital Environment Measures at Military Treatment Facilities

Abstract

SUMMARY Goal: We examined the relationship of nine hospital environment measures (room cleanliness, room quietness, food temperature, food variety, mattress comfort, room temperature, room privacy, hospital signage, adequate parking) to two patient outcome measures (likelihood of recommending hospital, overall satisfaction with hospital) by type of services received (medical, obstetric, surgical) at all military medical treatment facilities globally. Our aim was to understand the impact of various hospital environment measures on the patient experience. Methods: We analyzed six logistic regression models, one for each patient satisfaction measure and each service line (medical, obstetric, surgical). The patient characteristic variables were gender, patient age group, and beneficiary category (active duty, active duty family member, retiree, retiree dependents). Results are based on 20,534 completed surveys representing inpatient care delivered October 2019 to March 2020. Data are from the Military Health System TRICARE Inpatient Satisfaction Survey, which is based on the Hospital Consumer Assessment of Healthcare Providers and Systems survey with additional Department of Defense questions. Principal Findings: Across all models, nearly all hospital environment measures were found to be significantly related to patient satisfaction outcomes, aside from food variety in two models and room privacy and temperature in one model. The strongest environment impact factor was room cleanliness for both outcomes with odds ratios ranging from 2.1 to 2.7, p < .01 in all cases. The order of impact for the other eight environment factors varied across service lines with some playing dominant roles dependent on the type of care being received. Significant odds ratios (p < .05) ranged from 1.3 to 2.0 for room quietness, 1.5 to 1.9 for hospital signage, 1.3 to 1.5 for both food variety and food temperature, 1.3 to 1.8 for mattress comfort, 1.3 to 1.6 for room temperature, and 1.3 to 1.8 for adequate parking. Hospital environment measures represented a breadth of the patient experience and were significantly related to a patient’s overall satisfaction and likelihood to recommend military inpatient facilities. Applications to Practice: Healthcare leaders continuously focus on improving the overall patient experience. Fostering a positive experience includes many factors such as provider and nurse interactions and communications with patients. Moreover, the hospital environment should not be overlooked as also having an impact on patient satisfaction, and hospital leaders—both military and civilian—should continue to emphasize hospital amenities as well.

Determinants of patients' satisfaction and trust toward healthcare service environment in general practice clinics

“…In 2017, the number of GP clinics in Malaysia surpassed 7,000 (Thomas, 2017), which inflicts both competitive pressure and threat on GP clinics' business (Teo, 2017). The soaring cost of medical procedures makes general practice services a less attractive investment, especially in the economic downturn the nation currently faces (Teo, 2017;Apergis et al, 2020;Grifka et al, 2022). Additionally increasing operational expense, which includes the cost of drugs, medical devices, rental, legal, and regulatory expenses have hiked GP clinics' fees.…”

Evidence-Based Performance Indicators of Positive Inpatient Experiences

“…Customers compare perceptions with expectations when evaluating a provider (Parasuraman et al, 1985). Service quality elements, including tangible components of healthcare such as the physical environment (Bitner, 1992), provide the foundation on which patients' experiences are shaped (Grifka et al, 2022). Tangibles and the servicescape help convey the organization's image and ensure health and safety (Nordin et al, 2021; Sag et al, 2018).…”

“…Patient experience involves both functional and relational dimensions of care (Kumah, 2019). Inherent to the patient experience are aspects of service quality, repeated interactions, and patient activation and engagement (Grifka et al, 2022; Hibbard et al, 2004; Lipsitz & Markowitz, 2016).…”