The purpose of this paper is to gain an understanding of Patient Satisfaction Research in health care. By understanding the definition of patient satisfaction as well the use of patient satisfaction surveys in health care, others will be able to comprehend how managers of Health Care Organizations use the scores to improve the quality of care in their organization.

After defining patient satisfaction research, then the question will be answered on how patient satisfaction surveys are used in health care, what influences patient satisfaction, how these surveys and research influence health service organizations, how the quality of health care is influenced by patient satisfaction as well as how health care organizations make improvements in quality within their organizations because of patient satisfaction research. Introduction Patient satisfaction is one of the ways that health care organizations understand how patients feel when they visit a Health Service Organization (HSO).

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Many patients who come into a hospital setting or urgent care facility will normally be asked to fill out a patient satisfaction survey either before they leave the facility or within a few days after discharge. Just like when someone goes to a retail store and gets randomly selected to take a survey online about their customer satisfaction, patient satisfaction is viewed the same way in health care. Sometimes patients receive phone calls from the nurse that took care of them to make sure everything was fine with them as well as to get an idea of how satisfied they were with the service.

It is up to the patient whether or not the facility or care provider has met that person’s expectations and preferences. The fact that 50% of Americans believe that the US Health Care system is worsening can cause health care administrators to worry about their health care companies’ performance. Given the publics wide spread concern for health care, patient satisfaction research can play an important part in how health care companies can improve their services.

Patient satisfaction research can show health care organizations what departments are getting high grades from patients and which departments are lacking in quality health care. This research will discuss the definition of patient satisfaction and research as well as the use of patient satisfaction surveys in health care. The research on patient satisfaction will also show what influences patient satisfaction, how the quality of health care affects patient satisfaction. Finally this research will explain different types of patient satisfaction research companies and quality improvement in health care organizations.

Definition of Patient Satisfaction Research One of the fastest growing industries in the United States is healthcare. With the growth of healthcare becoming a defining standard in the U. S. , patient satisfaction research has become a standard for the healthcare industry. To gain a competitive edge against other healthcare companies, so they can increase their profits, companies started using patient satisfaction research to understand how each patient views the service they received. Patient satisfaction main focus is on the patients’ perception of care delivery.

When a patient comes into the hospital for treatment, that patient is going to know whether or not the delivery of their care was adequate enough for them to want to continue to come to that particular hospital for treatment. Patients are being considered more like consumers. Healthcare organizations want to provide the best care and consideration for a patient just like a retail store wants to provide the best customer satisfaction during their shopping experience. Linder-Pelz (1982) defined patient satisfaction theory as an “attitude and is based on the summation of the very subjective assessments of the dimensions of the care experience”.

Therefore, the definition of patient satisfaction research would be the idea that the patient is satisfied with the quality of care they receive by a healthcare provider or organization and the idea that health service organizations can gain from the patient’s experience. Patient satisfaction surveys have become the main way that healthcare providers and organizations obtain a patient’s view of their healthcare experience. Use of Patient Satisfaction Surveys in Health Care Patient satisfaction surveys serve as one of the ways HSO’s see how their quality of care is provided to patients on a daily basis.

Many use the patient satisfaction survey for quality assurance purposes in order to assess how well the HSO is providing services. To be able to satisfy the patient/customer is the best business practice for any HSO. There are many statistical measures that are used to evaluate health care quality. Statistical data from patient satisfaction research is used within HSO’s in order to show improvement in departments that handle patient care. There has been some difference in opinion when it comes to how patient satisfaction research is handled.

Some believe that this type of research isn’t valid due to different types of questioning that can be asked in a survey. Many researchers depend on different characteristics in a survey. For example, in the case study done by Hasin (2001), they identified the patient’s characteristics, the critical factors that affect the intention of patients coming to the hospital again in future needs, analysis of the patients satisfaction about service and fee, classification of patients whether they were satisfied or dissatisfied, analysis of the level of expected service quality and identifying the reasons for problems and suggestions to the hospital.

By using these statistical measures in his survey Hasin was able to identify weak areas in the hospital with his statistics. Hasin (2001) believed that the reasons for poor satisfaction from the hospital were due to doctors and nurses who didn’t pay enough attention and take care of patients, be more fair-spoken, communicate more efficiently, and have more interaction with specialist doctors. These statistics all depended on how Hasin constructed his questionnaire. Construct validity and sensitivity of a questionnaire must be thought out as well when creating a patient satisfaction survey.

Biering (2006) created a study aimed to understand construct validity and the sensitivity of a patient satisfaction questionnaire. There are many issues that surround this topic and can become debate in different HSO’s and how they want to develop a patient survey. Biering created a patient satisfaction questionnaire (PSQ) in order to understand the ideas behind this type of survey. In her conclusion, Biering (2006) believed that “to further develop valid and sensitivity of patient satisfaction questionnaires, studies are needed that would compare different instruments in controlled settings” (p. 56). How patients evaluate their healthcare is an important aspect in patient satisfaction research. After evaluating many studies on how patients evaluate their health care, Tucker and Adams (2001) concluded from the studies they examined that patients will make evaluation of their care whether they are medically qualified or not. If a patient will fill out a satisfaction survey, whether they feel qualified medically to or not, what influences their decision when they answer the questions given to them? Influences in Patient Satisfaction

It has become apparent that service quality and customer satisfaction are major purpose in modern organizations. A patient’s emotion can play a big influence on satisfaction in HSO’s. Another influence on patient satisfaction is service quality. Vinagre and Neves (2008) explore both these influences during their research examining the major factors affection patient satisfaction. Service quality can be broken down into the service quality measurement called SERVQUAL, developed in the early 1990’s, it covers five service quality dimensions; reliability, assurance, tangibles, empathy and responsiveness.

These types of dimensions can be used when dealing with patient satisfaction research as well. The five service qualities can help HSO’s better understand how a patient perceives the organization. According to Westbrook and Oliver (1991), “emotions refer to a set of responses occurring during consumer experience”. To fully understand how emotions play a factor in patient satisfaction, Vinagre and Neves (2008) examine positive and negative emotions separately and use a Differential Emotions Scale (DES) which is used to measure emotional experience or reactions perceived by an individual during a period of time.

Although by using DES, some emotions experienced are created in interpersonal relationships, and may be different from ones experienced during a consumer experience. When taking these factors into consideration for patient satisfaction research, developing a survey that involves patient emotions and service quality won’t be easy. It is up to the HSO how they want to handle these influences when developing a survey.

When patient care teams are developed in certain HSO’s, it becomes apparent that these teams are used to working with each other, know how to deal with situations together and have a cohesion that isn’t quite like others in the HSO that are not a part of a team. Teams are needed as a means to “coordinate the information and services needed to provide high quality patient care at a reasonable cost to the consumer and hospital” (Deeter-Schmelz and Kennedy, 2003). With the addition of a more cohesive team, it is more likely to create higher quality care and see less turnover and absenteeism within the team.

Moreover, this creates higher patient satisfaction scores. Information Technology also plays a key role in influencing and enhancing patient satisfaction. According to Roberts and Philp (1996) patient satisfaction is one of the three most important measures when it comes to health care service. Information Technology (IT) can help monitor and improve patient satisfaction. Sabada, Singh and Munchus (2001) believe that information parameters can be imputed into the health information system being used by the HSO in order to enhance patient satisfaction.

One example that Sabada, Singh and Munchus use in their research is the use of Telemedicine. One of the patients concerns is not having the same doctor during a patient stay in a hospital. Telemedicine is used to close the gap created by doctors when they are stretched too thin. Although it may be pricy for these HSO’s to create a more IT friendly work environment for their staff, it will help them in the long run, creating better patient satisfaction scores and make staff more efficient. Information Technology will play a key role in improving quality of care. Quality of Health Care in Patient Satisfaction

Is it a necessity to have quality of health care? Some HSO’s will put in their mission statement a promise of quality care for everyone that comes to them for service. It is up to that HSO to follow through with their promise of quality. Grol (2001) states, “patient assessment of the health services together with the views of staff in improving the level of quality is in fact respecting the consumer sovereignty”. In order to create quality care, quality improvement is important to the improvement in HSO’s. There is a link between quality improvement and patient satisfaction.

Due to the increased competition between healthcare providers, and the fact that patient satisfaction has become a quality indicator in the field, continuous quality improvements must be made in order to stay competitive in the highly needed field. Quality improvement programs have been put in place in many HSO’s in order to improve patient satisfaction and help providers succeed in an increasingly competitive environment (Torres and Guo, 2004). In order for patient satisfaction scores to improve, these programs can help HSO’s focus more on quality care and increase patient satisfaction.

There are other quality improvement techniques that can improve patient satisfaction. Torres and Guo (2004) describe several approaches to improve patient satisfaction. This will enable healthcare organizations to become more successful in an increased global competitive environment. These approaches include a community-wide effort, and the Six Sigma program. In order to use these approaches one must understand the three components of a patient’s view of health care. They include, preferences, evaluations and reports.

Preferences are defined as a “patients desires and expectations about what should occur in the health care setting” (Torres and Guo, 2004). In order to live up to patients’ expectations, there are several ways including Six Sigma. This concept began in the 1980’s, and is used to evaluate the capability of a process to perform defect free. In patient care, the Six Sigma will help meet the needs and expectations of customers in HSO’s as well as improve cash flow and profitability. It is important for this process to work, it must have the support of upper management.

When using a community-based program to help improve patient satisfaction, healthcare organizations can use the help of physicians and other health care professionals. This creates a collaborative unit of community leaders and health care providers to take advantage of having many different people involved with different perspectives and with levels of experience. This collaborative effort can help create more ideas about improving patient satisfaction from several perspectives, from doctors, nurses, to community leaders and the patients themselves.

Quality Improvement based on Patient Satisfaction Research Volume flexible strategies can be used to improve customer satisfaction and performance in health care services. Powers and Jack (2008) define volume flexible strategies as a way to improve patient satisfaction and organizational performance while dealing with fluctuating patterns in health care. “Health care organizations face changing demand patters as well as cost pressures that increase the need to understand the processes and performance outcomes related to managing volume uncertainty” (Powers and Jack, 2008).

Depending on how healthcare administrators effectively manage the volume uncertainty, can or cannot create enhanced patient satisfaction. Powers and Jack’s findings concluded that there is a relationship between volume flexible strategies, volume flexible capability, patient satisfaction, and organizational performance. In order to increase patient satisfaction, the healthcare administrator must properly manage the strategies and capability of volume flexibility. As Information Technology grows to be more advanced in healthcare, more patients will become educated about healthcare itself.

Lesley, Oermann and Vander Wal (2004) developed an Internet intervention that included five web documents that were informative and educational about quality care, provided guides for decision making, and directed consumers to take an active role in preventing medical errors. The examined the effectiveness of this Internet intervention and compared consumer definitions of quality from prior to using the intervention and after, as well as compared the knowledge between consumers who completed the intervention and ones who completed the intervention and had interactions with a nurse.

They concluded “the internet can be an effective medium for teaching consumers about quality of health care particularly when combined with a discussion with a nurse” (Lesley, Oermann, Vander Wal, 2004). By using the internet as a medium, we see that ideas like disease management and health risk assessment that are used online can help patients understand more about their condition and needs.

Disease management programs combine education from online websites and one-on-one education sessions with a nurse either in person or on the phone can help patients understand what is going on with them and what to do bout it. Therefore, HSO’s use these types of IT programs to improve quality of care and overall improve patient satisfaction. There is also a link to nurse retention, quality of care and patient satisfaction. For every one nurse recruited, the healthcare industry loses two qualified nurses. A study done in 1998 which surveyed 6,011 nurses asking them for the reason for leaving the profession included, inadequate pay, decreased opportunities to develop skills, inadequate promotion prospects, excessive workload, minimal career structure and inflexible working hours (Smith and Seccombe, 1998).

If health care organizations become able to retain nurses and decrease the shortage of nurses in the industry, there would be a significant increase in patient satisfaction and quality care. Newman, Maylor and Chansarkar’s (2001) research concluded that government initiatives such as major recruitment advertising campaign, and increase in the starting salary for newly qualified nurses by 12 percent could increase retention for nurses in healthcare. These initiatives could certainly improve patient satisfaction.

Government promises to improve working conditions and improve training and education in order to enhance nursing skills, could improve the quality of care and satisfaction. It is simple to see that the equation for increased patient satisfaction equals nurse satisfaction plus quality of care. When these two things are in order they can help a healthcare organization improve greatly. Patient Satisfaction Companies There are many companies that go to healthcare organizations to do patient satisfaction research.

Press Ganey® is one of the major companies that do patient satisfaction research. They have over twenty years of experience in health care performance measurement and improvement solutions. They offer many products that help with patient satisfaction that include, surveys and reports, consultation, online reporting, workshops and training, and resources that is continually updated for clients to have the latest data. Press Ganey® focus’s mainly on health care which is a big advantage for HSO’s who use their product to gain knowledge about their patient satisfaction scores.

They create custom surveys for their clients instead of using one survey for every client. This gives HSO’s an opportunity to properly see how they are comparing to competitors in their area, state or region. Jackson Organization Research now known as HealthStream©. They provide patient satisfaction consulting to over 1,100 healthcare facilities across the nation. By integrating products such as internet-based learning center, training solutions, quality healthcare education, and quality and satisfaction surveys.

In order to increase quality care to these health care facilities, HealthStream© uses the quality and satisfaction surveys to see what are the areas of improvement for the facility and create education plans for the staff to use to improve upon their scores in the future. HealthStream Research©, a company closely similar to HealthStream© strictly uses quality and satisfaction research to identify key issues in healthcare facilities. Using these companies is a great way to take the facility out of the equation when patient satisfaction scores are being calculated.

If a healthcare facility were to generate their own patient satisfaction research, they could potentially become bias in their question choosing and create questions that make more positive answers than negative answers. Using companies like the ones talked about create an environment successfully takes away the facilities bias opinions and generates genuine outcomes in their research. Conclusion In reality, HSO’s are only as good as what people think of them. Even if a HSO has quality staffing, there might be other problems that the patient understands and can decrease the patient’s satisfaction.

Using patient satisfaction research not only develops a way to see how HSO’s are doing in the eyes of their customers but also gives perspective on what areas need improvement. As HSO’s move into the future with patient satisfaction research, they must understand that IT and many other variables will be a necessity to stay competitive with other HSO’s. They need to be able to set aside emotions from patients that may affect scores, and turn to improving quality of care by using ideas given such as quality improvement programs, community-based programs, nurse retention, IT, and Six Sigma.