1. Improving Inpatient Patient Satisfaction: Role of a Resident
Pierre El Hachem MD, Youssef Yaacoub MD, Luna Elias MS and Yelena Galumyan MD
Department of Medicine, Englewood Hospital and Medical Center
Background
Objectives
Methods Results Cont. Conclusion
References
Patient satisfaction with their care delivery
experience has become an almost universal
parameter tracked in health care systems. It has
become an increasingly important and commonly
used indicator for measuring the quality of
healthcare provided as well as the success of
doctors and hospitals. Many studies have
suggested a correlation between patient
satisfaction and level of communication between
patient and provider. The AIDET tool demonstrated
a great efficacy in improving those communication
skills. Also, studies have shown that making a
post-discharge follow-up phone call by the hospital
staff increases the patients’ satisfaction through
reducing their complaints and anxiety and
reinforcing their perception that they have been
cared about as a person.
Over a period of eight months, PGYIs and PGYIIs on
two separate teams were sent an email explaining the
study. Laminated pocket cards were circulated to
educate the residents on the effective use of AIDET
tool. An online dataset was maintained by the PGY1
including patients’ demographics and contact
information. PGY2s were instructed to do a phone call
within 24 to 72 hours of discharge during which
he/she will use a standardized question template that
addresses queries regarding the discharge
medications, establishing a follow-up appointment,
other concerns, and whether the patient needs a call
back from the hospitalist or not. A maximum of three
calls are done and the PGYII has to document on the
same data sheet the date and time of the call attempts
and any pertinent comments. Patients discharged to
rehabilitation center, hospice care, or another hospital
are to be excluded from the study. Patient satisfaction
score on the care provided by his doctor is based on
the HCAHPS Data Collection and Public Reporting
system.
Data for 630 patients was collected during 8 months.
The age ranged from 18 to 99 year old with a median
of 61 years old. 345 were males (54.76%) and 285
were females (45.23%). The primary reason for
admission was divided as follows: 106 patients
(16.82%) infectious disease, 113 (17.93%) cardiac, 42
(6.66%) pulmonary, 24 (3.8%) renal, 114 (18.09%)
neurologic, 12 (1.9%) endocrinology, 123 (19.52%)
gastroenterology, 10 (1.58%) hematology, 19 (3%)
oncology and 67 (10.63%) for other miscellaneous
causes.
Of the 630 patients, 203 (32.22%) had no primary
medical doctor. Of the 630 patients, 236 (37.46%) were
successfully contacted, 139 (22.06%) did not answer,
158 (25.07%) no call attempt was done, 8 (1.26%) were
readmitted before trying to call, and for 89 patients
(14.12%) there was fail of call. Out of the 236 patients
who answered, only 7 patients (2.96%) requested a call
back from the hospitalist. Satisfaction score results
came back as the following: 85.50% for the first three
months, 73.21% for the second three months, and
89.74% for the last two months.
Increasing patient satisfaction poses a major
challenge to the health care system since it is
affected by multiple factors; starting with the health
care provider’s effort and ending with the patient’s
subjective perception of the care he/she is provided
with and the overall hospital experience. This study
demonstrates the important role of the residents in
providing care to the patients and how vital it is to
integrate the communication skill techniques as part
of their teaching process. The study revealed a
significant number of gaps where there is a
considerable room for improvement. Residents
should be educated that a post-discharge phone call
will not only improve patient satisfaction but will also
prevent unnecessary readmissions to the hospital,
provide continuity care and most importantly it will
offer an opportunity to harvest reward and
recognition for their efforts.
1. Care Improve Patient Satisfaction? A Systematic Review of
Randomized Controlled Trials. PLoS ONE 9(7):e100603 doi: 10.
1371 /journal .pone
2. Studer Q. Discharge phone calls deliver quality care, higher
patient satisfaction. May 2006. Studergroup.com
3. Stephanie J. Baker. “Post-visit Phone Calls Save Lives, Improve
Clinical Outcomes, and Reduce Readmissions 2011”. J Emerg
Nurs 2010;36:256-9
4. Regina Shupe. “Post-visit phone calls: Reducing preventable
readmissions and improving the patient experience”. Journal of
Nursing Education and Practice, 2014, Vol. 4, No. 4
Results
To determine whether, using the AIDET
communication tool by the internal medicine
residents followed by a telephone call to
the patient after discharge from the hospital, is
associated with improved patient satisfaction or
not.
0
10
20
30
40
50
60
70
80
90
100
First Three Months Second Three Months Last Two Months
Satisfaction score
Primary cause of Hospitalisation
GI
Neurology
Cardiology
ID
Pulmonary
Nephrology
Oncology
Endocrinology
Hematology
Misc
Patients Contacted
Successfully
Contacted
No answer
No call
attempt
Readmitted
Fail to call