What matters most to patients when they assess quality of their care?

Abstract

Objectives: To report the capabilities of a patient satisfaction questionnaire in capturing factors which are important to patients in their evaluations of the quality of care they receive.Design: An experienced research officer introduced the study to all patients with defined tracer conditions in the Saskatoon Health Region from Jan to April of 2009. Patients who agreed to participate returned their completed questionnaire directly to the research officer or placed them in a special box held by the nursing unit clerk on their unit. Measures:The instrument contained: 18 items of the General Practice Assessment Questionnaire for physicians and nurses; as well as single items capturing patient observations regarding: attentiveness of nurses; tidiness of facilities; efficiency of tests and treatments; patient comments; and a grading scale assessing overall quality of care. Contextual items covered health status, expenses, insurance and demographics. A provider care model and a client satisfaction model were constructed and tested.Results: Almost 96 percent of eligible patients (n=378) completed the questionnaire. The provider care model explained 84.2 percent of the variation in patients' assessments of overall quality; and the client satisfaction model explained 67.6 percent of the variation. The qualities of nursing and medical care were the most important factors; however, attentiveness, tidiness, efficiency, and quantified comments each explained small but significant percentages of variance in overall quality. Conclusions:Patients consider separate dimensions in their assessments of overall quality of care. While quality of care by professionals trumps other considerations, patients also consider attentiveness, tidiness and efficiency to be important.

Patients’ decision‐making experiences in the acute healthcare setting – a case study

“…Not surprising, the participants’ responses demonstrate differences between feelings of control, home and hospital. Although hospitals are not homes, patients who are confined in them for over a 24‐hour period, as indicated by two different Canadian studies, are less willing to be passive recipients of care and services and they want to express themselves . One way of implementing professional practices and hospital services which are sensitive to and responsive to the challenges faced by patients is to consider how decisions by hospital management influence the ways in which nurses deliver patient care and to the quality of that care .…”