Using patient evaluations to empirically assess medicaid programs for social justice.

The Medicaid program serves a social justice function in the United States. The program's effectiveness in achieving this aim is traditionally evaluated in terms of resource allocation and distribution using measures and concepts such as financing, access, and enrollment. The patient's perspective in ascertaining the quality of actual care delivery has not been utilized to ascertain social justice.

Customer convergence: patients, physicians, and employees share in the experience and evaluation of healthcare quality.

This article explores the interrelationships between three categories of service quality in healthcare delivery organizations: patient, employee, and physician satisfaction. Using the largest and most representative national databases available, the study compares the evaluations of hospital care by more than 2 million patients, 150,000 employees, and 40,000 physicians. The results confirm the relationship connecting employees' satisfaction and loyalty to their patients' satisfaction and loyalty.

Intensive care patients' evaluations of the informed consent process.

This study examines the informed consent process from the perspective of intensive care patients. Using the largest single-method database of patient-derived information in the United States, we systematically outlined and tested several key factors that influence patient evaluations of the intensive care unit (ICU) informed consent process. Measures of information, understanding, and decision-making involvement were found to predict overall patient satisfaction and patient loyalty intentions.

Hospital-level correlation between clinical and service quality performance for heart failure treatment.

A national cross-sectional study correlates the satisfaction ratings of heart failure patients (diagnosis related group 127) and the Centers for Medicare & Medicaid Services' process-based quality measures for heart failure treatment for 32 hospitals during the first and second quarters of 2004. Two of the four measures of clinical quality showed statistically significant, moderately strong, positive correlations with a global measure of satisfaction and with, respectively, 5 and 7 subscales of the 10 subscales of satisfaction under examination (Pearson's r ranged between .40 and .

State nursing shortages and patient satisfaction: more RNs--better patient experiences.

This study of 827,430 patients, 733 hospitals, and 25 states compares state performance in patient satisfaction with the supply of registered nurses. A significant, positive relationship exists between a state's supply of registered nurses and patients' evaluations of their care experiences. Hospitals in states with nursing shortages may be challenged by national comparisons of patient satisfaction and should take these results into account when devising their quality improvement strategy.

Patient perceptions of quality in discharge instruction.

The present study investigates patient perceptions of the quality of discharge instruction by assessing inpatients' ratings of care and service in the United States over the past 5 years (1997-2001) (n = 4,901,178). As expected, patients' ratings of "instructions given about how to care for yourself at home" showed a strong, consistent positive relationship with overall patient satisfaction from 1997 through 2001. Nevertheless, patient satisfaction with discharge instructions decreased significantly each year (p < 0.

Your patient--my child: seven priorities for improving pediatric care from the parent's perspective.

Parents and professional caregivers, although united in their shared goal of returning a sick child to health, do not always view the caregiving situation from the same frame of reference. This article describes the perspectives of more than 50,000 parents whose child experienced a hospitalization. It outlines the greatest opportunities for improving the pediatric inpatient experience from the parent's perspective.

Inpatient heart failure treatment from the patient's perspective.

Objective: The objective of this study was 2-fold: (1) to identify particular opportunities for improvement in patient-centered care of heart failure patients and (2) to suggest strategies for service quality improvement focusing on those areas.

Sample: A national cross-sectional sample of survey data from diagnostic-related group 127 patients was collected between December 1, 2001, and November 30, 2003. Data were split into two 12-month samples to compare results over time.

Elderly inpatients' priorities for acute care service quality.

This study examines elderly and advanced elderly inpatients' perceptions of acute care service quality, prioritises opportunities for quality improvement, and assesses variation in patients' satisfaction with care. Psychometrically-validated postal questionnaires were sent to random samplings of patients discharged from the US acute care facilities in 2002 (n = 2,057,164). Quality improvement priorities among non-elderly (< 65 years), elderly (65-74 years), and advanced elderly (> 74 years) were similar but substantial variation was found comparing single items between age groups.

Addressing patients' emotional and spiritual needs.

Background: A comprehensive, systematic literature review and original research were conducted to ascertain whether patients' emotional and spiritual needs are important, whether hospitals are effective in addressing these needs, and what strategies should guide improvement.

Methods: The literature review was conducted in August 2002. Patient satisfaction data were derived from the Press Ganey Associates' 2001 National Inpatient Database; survey data were collected from 1,732,562 patients between January 2001 and December 2001.

Medical practices' sensitivity to patients' needs. Opportunities and practices for improvement.

This article presents the results of a national study of medical practices' patient satisfaction using data collected from January to December 2001 with Press Ganey Associates' Medical Practice Survey (n = 503,407). The question, "Our sensitivity to your needs" (r = 0.85), most highly correlated with overall patient satisfaction.