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Biomedical subjects

Robert J Wolosin

Publications and source records attributed to Robert J Wolosin.

10 recordsLinked to original sources
PubMed2005

Patient satisfaction with pain control during hospitalization.

BACKGROUND: The Joint Commission on Accreditation of Healthcare Organizations standards for pain management for hospitals took effect on January 1, 2001. A study was conductedto determine whether, and to what degree, patients' ratings of their satisfaction with pain control had changed during the four years after implementation of the Joint Commission standards compared with a baseline period of 2(1/2) years earlier. Patient satisfaction with pain control is a valid measure of a hospital's efforts to assess pain management and implementation of Joint Commission standards, insofar as it reflects the subjective nature of the pain experience. METHODS: Survey data representing identical hospitals for 26 quarters (2(1/2) years before and 4 years after January 1, 2001) were analyzed. More than 3,000,000 surveys, from 240 hospitals across the United States, were included in the analysis. RESULTS: The average score for all patients treated before the new standards were put into place was 85.2 (sigma = 19.7), while the average for those treated after that date was 85.7 (sigma = 19.6). Although small in absolute size, the difference is statistically significant at the .001 level. DISCUSSION: Although satisfaction with pain control varied within a relatively narrow range in the 10 quarters before the institution of the Joint Commission standards, it has subsequently shown an overall upward trend, as well as a cyclical pattern. Such evidence for even a modest increase might encourage caregivers to continue their efforts to monitor their patients' pain and to help patients control it.

Adolescent↗
PubMed2004

Elderly inpatients' priorities for acute care service quality.

This study examines elderly and advanced elderly inpatients' perceptions of acute care service quality, prioritises opportunities for quality improvement, and assesses variation in patients' satisfaction with care. Psychometrically-validated postal questionnaires were sent to random samplings of patients discharged from the US acute care facilities in 2002 (n = 2,057,164). Quality improvement priorities among non-elderly (< 65 years), elderly (65-74 years), and advanced elderly (> 74 years) were similar but substantial variation was found comparing single items between age groups. Elderly and advanced elderly patients rated the quality of meals and rooms significantly lower than the non-elderly, and the advanced elderly rated treatment decision making involvement significantly lower than the other two age groups. The data reveals specific, actionable areas for quality improvement and a non-linear relationship between age and satisfaction. Findings question assumptions regarding older patients' evaluations of care and indicate directions for quality improvement that account for their unique needs.

Acute Disease↗
PubMedDate not supplied

HIV/AIDS patient satisfaction with hospitalization in the era of highly active antiretroviral therapy.

The purpose of this study was to investigate how HIV/AIDS patients evaluate hospitalizations and to contrast such evaluations with those of inpatients who were diagnosed with pneumonia or pleurisy. In all, 302 satisfaction survey records collected in 2002 from patients of U.S. hospitals were analyzed. Potential confounding variables were kept constant or statistically controlled. Patients with HIV/AIDS rated their care lower than patients with pneumonia or pleurisy. The survey section, Tests and Treatments, yielded a significant effect of diagnosis. In addition, there was a significant effect of diagnosis for two survey items: skill of the person who took your blood, and skill of the person who started the intravenous line. Results were discussed in terms of caregiver attitudes toward HIV/AIDS patients, and implications for nursing care were drawn.

Adolescent↗
PubMedDate not supplied

Patient satisfaction in gastroenterology clinics.

Satisfaction surveys of patients who had a gastrointestinal procedure at an ambulatory surgery center in 2002 were drawn from a national database and analyzed. The resulting data were used to report the status of patient satisfaction with their care and to illustrate several ways in which patient satisfaction data can be used to guide quality improvement efforts. It was found that patient satisfaction is generally quite high, with ratings of nurses and physicians topping the list. On the other hand, convenience factors such as parking and waiting times were rated lower. Uses of data to guide quality improvement efforts were illustrated in terms of response category percentages (i.e., percentage of time an item was rated "good," "poor," etc.) and a measure of item priority.

Ambulatory Care Facilities↗
PubMedDate not supplied

Am I safe here?: improving patients' perceptions of safety in hospitals.

Little is known about the current status of hospitalized patients' perceptions of safety or what affects them. This study analyzes safety ratings data of more than 600,000 patients. After describing how patients rate their safety in US acute care hospitals, we delineate the greatest opportunities for improving patient experiences of safety in hospitals. In addition, we offer practical strategies for planning improvements in safety-related elements of care from the patient's perspective.

Acute Disease↗
PubMedDate not supplied

Inpatients' ratings of care in 5 common clinical conditions.

OBJECTIVE: Using the dimensions of patient-centered care defined by the Institute of Medicine, this study examined patient satisfaction within 5 clinical conditions. METHOD: Items from the Press Ganey Inpatient Questionnaire were mapped onto the Institute of Medicine dimensions of patient-centered care. A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. SAMPLE: Patients hospitalized for heart attack, heart failure, stroke, pneumonia, or childbirth were included in the study. The sample contained 10,000 patients at 210 hospitals. RESULTS: Patients hospitalized for different clinical conditions expressed different levels of satisfaction. There may be different care needs, expectations, and evaluations of care based on these clinical conditions. However, it is probable that an all-encompassing patient-centered focus would improve care for all of these groups. CONCLUSIONS: Quality improvement professionals should attend to 2 Institute of Medicine dimensions: (1) respect for patient's values, preferences, and expressed needs and (2) emotional support, relieving fear and anxiety. It is in these areas that improved performance will be associated with the greatest increases in patient satisfaction. Four specific issues were identified as quality improvement priorities, regardless of condition: response to complaints; sensitivity to the inconvenience of hospitalization; including patients in decision making; addressing emotional and spiritual needs.

Diagnosis-Related Groups↗
PubMedDate not supplied

Physician gender and primary care patient satisfaction: no evidence of "feminization".

BACKGROUND: Observers predict that the influx of women into the medical profession will alter the way in which medicine is practiced, incorporating more "feminine" values of caring, listening to patients, and patient centeredness, in contrast to the "masculine" values of curing, dictating to patients, and care provider centeredness. Consequently, patient satisfaction with medical care will improve. SUBJECTS AND METHODS: Retrospective database analysis of satisfaction survey data. A total of 3985 surveys from primary care patients were examined after having identified the gender of the patient's physician. Ten survey items that pertained to physician attributes were analyzed, individually and in the aggregate, in a series of 2 x 2 analyses of covariance, with physician gender and patient gender serving as independent variables, and patient age and the overall level of patient satisfaction from the physician's facility serving as covariates. An additional analysis of covariance, with the same independent variables and covariates, examined patients expressed likelihood of recommending their physician to others. RESULTS AND CONCLUSIONS: There were no main or interaction effects for physician gender or patient gender after adjusting for patient age and facility-level satisfaction. The implications of these results for the "feminization" hypothesis are discussed.

Cross-Sectional Studies↗
PubMedDate not supplied

Construct validation of a physician satisfaction survey.

Hospitals continuously look for ways to improve patient care and retain high-quality physicians. Previous research indicates that physicians' satisfaction with where they practice is a crucial part of addressing these issues. A reliable and valid method to assess physician satisfaction is needed in order to identify potential areas of discontent. The purpose of the present study was to develop and validate a self-administered medical staff satisfaction survey. The survey contains 13 Likert-type items divided into three reliable subscales: Quality of Patient Care (alpha = .84), Ease of Practice (alpha = .76), and Relationship with Leadership (alpha = .92). Results from both exploratory and confirmatory factor analyses supported the survey's structure and robustness across three independent samples.

Adult↗
PubMedDate not supplied

The voice of the patient: a national, representative study of satisfaction with family physicians.

OBSERVATION: Among quality-of-care data types, patient satisfaction with care is a direct expression of patients and is related to important outcomes. To what degree are patients of family physicians satisfied with their care? What do their responses indicate about opportunities for quality improvement? Until now, national, representative data pertaining to patient satisfaction with family physicians' care have not been available. This article provides such data. SUBJECTS AND METHODS: A national sample, representative of the age-sex distribution of US ambulatory care visits, was drawn from a large database of surveys from patients of family physicians. Survey responses were analysed for levels of satisfaction with the salient aspects of care. RESULTS AND CONCLUSIONS: Data indicated general satisfaction with care provided by family physicians. Physicians themselves obtained the highest ratings, followed by nurses. Patients were less satisfied with access to care issues; items pertaining to waiting for the physician were rated the least satisfactory of all. Patient gender affected ratings of several survey items; women were more satisfied with physician-related items than were men; men were more satisfied with process-related issues than were women. If family physicians want more satisfied patients, they should show more respect for patients' time.

Adolescent↗