Patients' concerns about medical errors during hospitalization.

Background: A clear understanding of patients' understanding and perceived risk of medical errors is needed. Multiwave telephone interviews were conducted in 2002 with 1,656 inpatients from 12 Midwestern hospitals regarding patients' conceptualization of medical errors and perceived risk of seven types of medical errors.

Results: Patients defined medical errors to include not only clinical mistakes but also falls, communication problems, and responsiveness.

Do on-site patient satisfaction surveys bias results?

Background: Response rates, patient sample characteristics, and patient satisfaction ratings were compared between two surveying methods: (1) surveys completed at the physician office site (on-site surveying), and (2) surveys mailed to patient homes following the encounter (mail-out/mail-back).

Methods: Surveying was completed at three physician practices within a 214-physician medical practice. Patients with physician appointments during four-hour time blocks were randomly split to receive either on-site or mail-based satisfaction surveys.

Patient concerns about medical errors in emergency departments.

Objective: Despite large numbers of emergency encounters, little is known about how emergency department (ED) patients conceptualize their risk of medical errors. This study examines how safe ED patients feel from medical errors, which errors are of greatest concern, how concerns differ by patient and hospital characteristics, and the relationship between concerns and willingness to return for future care.

Methods: Multiwave telephone interviews of 767 patients from 12 EDs were conducted.

Patient satisfaction measurement strategies: a comparison of phone and mail methods.

Background: In 1998 the BJC Health System (St Louis) made the decision to migrate its patient satisfaction measurement system from a mail-out/mail-back method to a phone interview method. Out of concern that results obtained by phone would not be comparable with the 4 years of mail-based data, a controlled study was undertaken to directly compare mail and phone responses and to evaluate response rates, patient sample demographics, and patient satisfaction ratings.

Methods: Mail and phone responses obtained from parallel random samples selected from inpatient, outpatient test/treatment, outpatient surgery, and emergency service patient populations were compared.

Using root cause analysis to address patient satisfaction and other improvement opportunities.

Background: Despite the considerable attention that health care organizations are devoting to the measurement of patient satisfaction, there is often confusion about how to systematically use these data to improve an organization's performance. A model to use in applying traditional quality improvement methods and tools to patient satisfaction problems includes five primary steps: (1) identifying opportunities, (2) prioritizing opportunities, (3) conducting root cause analysis, (4) designing and testing potential solutions, and (5) implementing the proposed solution.

Patient Satisfaction Surveys: A satisfaction survey serves best as a high-level screening device, not as a tool to provide highly detailed information about the root causes of patient dissatisfaction.