How to measure your practice's level of patient satisfaction. (Practice Management Clinic).

In previous installments of PRACTICE MANAGEMENT CLINIC, we have reviewed the usefulness of data management technology in monitoring the financial aspects of our practices. This same technology can also be used to track patient satisfaction. When properly collected and analyzed, patient satisfaction data can offer huge rewards in both the clinical and business aspects of your practice. In this month's installment, we discuss ways to collect patient satisfaction data and to put these data to practical use.

Importance of patient satisfaction

Our patients base their opinions of us on many factors tangential to the actual medical aspect of their visits. They judge our practices by how they are treated on the telephone, by the appearance of the reception area, and by how long they must wait to see us, among other factors. These and other perceptions contribute to their overall impression of the entire practice.

Any dissatisfaction that a patient might experience with one particular area of our practice can carry over to other areas. As an analogy, if you were to be seated on an airplane and found that the tray was dirty, you might wonder if the entire airplane was poorly maintained.

How to measure patient satisfaction

Methods of determining patient satisfaction have been the subject of a fair amount of study and comment, and several measurement instruments have been developed. (1-13) Measurements of patient satisfaction should be undertaken with the same degree of scientific rigor that we apply to our daily practice of medicine. A valid scientific survey--such as the nine-item patient visit rating questionnaire--is the most practical means of obtaining information on patient satisfaction. (5)

A good survey program not only measures access (e.g., time it took to get an appointment, convenience of office location, waiting time in the office, and ease of reaching the office by phone) and attributes (technical skills of the physician, explanation provided, time spent with the provider, and personal manner of the provider), it also benchmarks the findings with results that have been obtained by other physicians. Although it might be appealing to use a patient satisfaction survey that is customized to your particular practice, the lack of comparative, benchmarked data limits the usefulness of such a survey. Benchmarked data allow you to assess how your practice compares with your peers' practices.

Practical applications

You should use the data you obtain to improve all processes that have a direct effect on patient services. The impact of such improvements will reverberate throughout your practice in the way of fewer complaints, a consistent patient flow, more self-referrals, a better collection rate, and expanded marketing opportunities.

One of the best ways to use benchmarked patient satisfaction data is to link your findings to employee compensation. This program--Patient-Assessed Compensation for Employees (PACE)--is designed to foster a team atmosphere in the office. (10,11,13) When patient satisfaction improves, everyone benefits. PACE is a useful method of motivating your staff while simultaneously improving your bottom line.

Information technology is available in the marketplace that allows all of us to obtain benchmarked, scientific, patient satisfaction measurement tools. Project Quality Card (PQC) is sponsored by Ear, Nose and Throat Resources, Inc., the wholly owned for-profit subsidiary of the AAO-HNS. A step-by-step description of PQC: Step 1. Patient registers and provides complete demographic information. Step 2. Physician receives a confidential user code and 59 Quality Cards. Step 3. Physicians' offices give Quality Cards to patients. Step 4. Patients dial a toll-free number and listen to a brief introductory message, then digitally answer 1 to 5 on the scientifically valid nine-item patient visit rating questionnaire. Step 5. The patient receives 20 minutes of free long distance time. Step 6. The physician visits www.good4docs.com and retrieves his/her benchmarked overall patient satisfaction data.

References

(1.) Piccirillo JF. Outcomes research and otolaryngology. Otolaryngol Head Neck Surg 1994;111:764-9.

(2.) Ellwood PM. Shattuck lecture--outcomes management. A technology of patient experience. N Engl J Med 1988;318:1549-56.

(3.) Isenberg SF, Stewart MG. Utilizing patient satisfaction data to assess quality improvement in community-based medical practices. Am J Med Qual 1998;13:188-94.

(4.) Berwick DM. Continuous improvement as an ideal in health care. N Engl J Med 1989;320:53-6.

(5.) Rubin HR, Gandek B, Rogers WH, et al. Patients' ratings of outpatient visits in different practice settings. Results from the Medical Outcomes Study. JAMA 1993;370:835-40.

(6.) Isenberg SF, Davis C, Keaton S. Project Solo: An independent practitioner initiative for confidential self-assessment of quality. Am J Med Qual 1996;11:214-21.

(7.) Isenberg SF, Rosenfeld RM. Problems and pitfalls in community-based outcomes research. Otolaryngol Head Neck Surg 1997;116:662-5.

(8.) Isenberg SF. Community-based outcomes research: The Project Solo experience. Laryngoscope 2000;110(Pt 3):21-3.

(9.) Isenberg SF, ed. Managed Care, Outcomes, and Quality: A Practical Guide. New York: Thieme Medical Publishers, 1998.

(10.) Isenberg SF, Gliklich RE. Profiting from Quality: Outcomes Strategies for Medical Practice. San Francisco: Jossey-Bass, 1999.

(11.) Isenberg SF, Davis C, Adams C. The Practice Improvement Program. Indianapolis: Isenberg Medical Communications, 1999.

(12.) Berwick DM, Godfrey AB, Roessner J. Curing Health Care. New Strategies for Quality Improvement: A Report on the National Demonstration Project on Quality Improvement in Health Care. San Francisco: Jossey-Bass, 1990.

(13.) Isenberg SF, Davis CL, Adams CE, et al. Incentivized digital outcomes collection. Am J Med Qual 2001;16:202-11.

Dr. Isenberg is an otolaryngologist in private practice in Indianapolis; [e-mail].