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Study: Management not attuned to quality improvement

Sunday March 3, 2013
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Hospital management may provide insufficient support to improve patients’ experiences by engaging physicians and nurses in quality improvement processes, according to a multination study.

"Twelve years after the Institute of Medicine’s 'Quality Chasm’ report called for fundamental improvement to patient-centered care, our findings raise concern as to whether hospital management is actively engaging clinicians in enhancing patient satisfaction," Ronen Rozenblum, PhD, MPH, the study’s lead author and a researcher in the Center of Patient Safety Research & Practice at Brigham and Women’s Hospital in Boston, said in a news release.

The research findings are based on a survey of 1,004 physicians and nurses at four academic hospitals in Denmark, Israel, the United Kingdom and the United States. Results indicate that despite expanding initiatives, and the belief of most healthcare organizations that patient experience and satisfaction is important, the majority do not have a structured plan for how frontline providers can improve patient satisfaction during hospitalization.

Specifically researchers reported that while 90.4% of clinicians surveyed believed improving patient satisfaction during hospitalization was achievable, only 9.2% said their department had a structured plan for improving patient satisfaction during hospitalization.

The researchers also found that of the clinicians surveyed, 38% remembered targeted actions that were conducted in their department to improve patients’ satisfaction; and 34% stated that during the last 12 months they had received feedback from hospital management regarding the level of patient satisfaction in their department.

Meanwhile, 85% thought hospital management should take a more active role in patient satisfaction improvement programs; and 83% believed achieving a high level of patient satisfaction was important for the clinical success of healthcare organizations.

"Organizations that are successful in fostering a culture of patient-centered care have incorporated it as a strategic investment priority by committed leadership, active measurement, feedback of patient satisfaction and engagement of patients and staff," said David Bates, MD, the senior author of the paper and chief quality officer at Brigham and Women’s Hospital.

"We, in healthcare organizations, need to take a more active role in developing and implementing programs to improve patient experience and satisfaction and also in identifying ways to engage frontline clinicians in this process as well as ensuring they get routine feedback about patient experience and satisfaction. Ultimately, the patient experience is at the bedside."

Bates and Rozenblum created a framework for a patient experience culture and have begun to take the next steps to test and implement this model. "In order to improve, we need a systematic approach that starts at the bedside and grows up through hospital management levels to policymakers, all of whom should be committed to shifting healthcare organizations toward a culture of patient experience by making patient experience a strategic investment priority," Rozenblum said.

The study appears in the March issue of BMJ Quality and Safety. The study abstract is available at http://qualitysafety.bmj.com/content/22/3/242.abstract.


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