R. N. Willis1, B. Edwards1, R. G. Sawyer1, M. D. Williams1 1University Of Virginia,Dept. Of Surgery,Charlottesville, VA, USA
Introduction:
Physicians and hospitals are frequently subject to performance measurements that are increasingly linked to reimbursement. Not least among these is Patient Satisfaction (PS). Previous reports have shown that PS is driven less by clinical outcome, and more by hospital and post-operative experiences of care. Ironically, research has shown that increased PS is correlated with better clinical outcomes and more appropriate use of the health care system. The aim of this study was to determine if the patient and surgeon expectations of recovery from surgery to are aligned.
Methods:
A 15-question Likert-style survey given to the patient and surgeon was deployed prospectively immediately following the conclusion of the pre-operative clinic visit. The survey encompassed multiple aspects of the patient’s recovery from perception of health and wellness to anticipated pain medication requirements, to length of expected recovery. All patients were 18 years of age or older.
Results:
Statistical analyses were conducted using Wilcoxon Signed Rank test and McNemar’s test as appropriate. The results were predominately non-parametric using a Likert Survey. Surgeons expected patients to feel more prepared for surgery (p=0.001), be more likely to walk the day after surgery (p=0.01) have better tolerance of surgery (p=0.03) and a more likely ultimate return to activities of daily living (p=0.002) than patients did. Whereas patients expected both more pain (p=0.006), less/ no need for narcotics (p=0.05) than surgeons.
Conclusion:
Our study demonstrates that in our sample population, surgeons and patients have significantly different expectations of important outcomes immediately after the conversation that should ideally set those targets. There is an opportunity to educate both patients and surgeons as to expectation and goal setting related to elective surgery.