Biomedical subjects

Sabina B Gesell

Publications and source records attributed to Sabina B Gesell.

8 recordsLinked to original sources

PubMed2004

Patient perceptions of quality in discharge instruction.

The present study investigates patient perceptions of the quality of discharge instruction by assessing inpatients' ratings of care and service in the United States over the past 5 years (1997-2001) (n = 4,901,178). As expected, patients' ratings of "instructions given about how to care for yourself at home" showed a strong, consistent positive relationship with overall patient satisfaction from 1997 through 2001. Nevertheless, patient satisfaction with discharge instructions decreased significantly each year (p < 0.001). Patients gave lower ratings to the quality of discharge instruction than to the overall quality of their hospital stay which indicates a failure to match the quality delivered among other services within the hospital. Patient assessments of discharge instruction quality varied systematically among conditions. Patients with musculoskeletal diseases and disorders (MDC-8) rated discharge instruction considerably lower than all other patient groups. Patients' age, sex, self-described health status and length of stay did not predict patients' evaluations of discharge instructions. U.S. hospitals may not be meeting existing AMA and JCAHO standards for patient education and discharge.

Cross-Sectional Studies↗

PubMedDate not supplied

Identifying priority actions for improving patient satisfaction with outpatient cancer care.

In parallel to developing new cancer therapies, the healthcare community has the responsibility of creating positive treatment experiences for patients. Data from 5907 cancer outpatients treated at 23 hospitals across the United States were analyzed to identify the top priorities for service improvement in outpatient cancer treatment facilities. They included meeting patients' emotional needs, providing information to patients and family members, reducing waiting times, and providing convenience and coordinated care among physicians and other care providers.

Ambulatory Care↗

PubMedDate not supplied

Improving assisted living care.

In the absence of a national measurement system, private vendors of satisfaction measurement and improvement services have played a crucial role in the quality movement in the assisted living industry. Survey responses from 175 resident-family dyads at 20 facilities were analyzed to identify priorities for service improvement from the customers' perspective. They include improving care provided by aides and management, meal service, and activities. Practical solutions for addressing these issues are presented.

Aged↗

PubMedDate not supplied

Inpatient heart failure treatment from the patient's perspective.

OBJECTIVE: The objective of this study was 2-fold: (1) to identify particular opportunities for improvement in patient-centered care of heart failure patients and (2) to suggest strategies for service quality improvement focusing on those areas. SAMPLE: A national cross-sectional sample of survey data from diagnostic-related group 127 patients was collected between December 1, 2001, and November 30, 2003. Data were split into two 12-month samples to compare results over time. The 2002 sample included 5224 patients treated at 220 hospitals; the 2003 sample included 6531 patients treated at 269 hospitals. METHOD: A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. RESULTS: For both samples, the ranking of service issues was highly similar, with the same 4 areas emerging as the foremost priorities: patient involvement in decision making, staff response to concerns voiced during the hospital stay, staff sensitivity to the inconvenience of heart failure and hospitalization, and emotional/spiritual support. Improvement in these 4 service areas should be associated with the greatest increases in patient satisfaction and quality of care for heart failure patients. CONCLUSIONS: Adequately addressing these patient needs should increase patient satisfaction and quality of care for heart failure patients.

Adolescent↗

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

A patient satisfaction theory and its robustness across gender in emergency departments: a multigroup structural equation modeling investigation.

This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction across gender in national random samples of emergency patients. Using multigroup structural equation modeling, the results supported the model's robustness. Physician service, waiting time, and nursing satisfaction explained 48%, 41%, and 11% of overall satisfaction plus 92% and 93% of female and male satisfaction, respectively. Unit increases in physician service satisfaction increased waiting time, nursing, and overall satisfaction by 0.991, 0.844, and 1.031 units, respectively. Unit increases in waiting time satisfaction increased nursing and overall satisfaction by 0.417 and 0.685 units, respectively. A unit increase in nursing satisfaction increased overall service satisfaction by 0.221 units. The investigation offers an alternative paradigm for measuring and achieving emergency department satisfaction, hierarchically related to patient expectations, where the primary provider has the greatest clinical utility to patients, followed by waiting for the primary provider, and then by nursing service.

Adult↗