J. L. Liao2, L. Z. Chehab1, S. L. Pink3, D. Patel1, K. Neville3, A. Sammann1 1University Of California – San Francisco,San Francisco, CA, USA 2George Washington University School Of Medicine And Health Sciences,Washington, DC, USA 3Stanford University,Palo Alto, CA, USA
Introduction: Patient satisfaction is an important measure of the quality of care. Hospitals, providers and payers are struggling to accurately quantify the patient experience. There is significant debate in the literature regarding which metrics or tools most accurately capture the patient perspective. While the CG-CAHPS surveys are the most commonly used tools and often tied to reimbursement, the Net Promoter Score (NPS) has emerged from management research as a potential reliable measure of the patient experience. Wait times have also been shown to significantly contribute to satisfaction outcomes. This study measures patient satisfaction using three different methods in a trauma and general surgery clinic at an urban, level-one trauma center and safety-net hospital.
Methods: This study uses a two-tiered quantitative methodology to compare patient wait times, NPS scores and overall patient satisfaction as measured through the CG-CAHPS survey. We performed 111 time-tracked patient observations at a trauma and general surgery clinic. The duration of activities from clinic arrival to departure were measured using a custom data collection tool in Excel. A survey was administered to all patients at the end of their clinic visit which included the NPS measure ‘how likely are you to recommend a loved one to care in the general surgery clinic?’ and the overall satisfaction with the clinic survey question in CG-CAHPS. Data was analyzed using R.
Results: Patients spent an average of 74% of their total clinic visit waiting to see a provider. While the average visit was 93 minutes, almost a quarter of visits (23%) were over 2 hours. Patients waited an average of 15.7 minutes in the waiting room and 38.6 minutes in the exam room. The survey found a significant negative correlation between wait time and overall satisfaction (r = -.43, p < .001), no significant correlation between wait time and NPS (r = -0.21, p = 0.12), and a significant positive correlation between NPS and overall satisfaction (r = 0.58, p< .001).
Conclusion: As expected, patients who had longer wait times reported lower overall satisfaction, but surprisingly, there was no significant decrease in their NPS. These findings demonstrate the complexity of measuring patient experience in a surgical clinic for a safety net population. Rather than continuing to use summative quantitative measures that fail to capture patients’ complex, unmet needs, the health care community needs to focus more time and resources to develop a deeper understanding of the variables that influence patient experience in order to more accurately track and improve patient satisfaction.