Improving Patient Satisfaction Improving Patient Satisfaction

June 30, 2014 updated by: Brent Joseph Morris, Vanderbilt University

Improving Patient Satisfaction in the Orthopaedic Trauma Population

Objectives: Patient satisfaction is a key determinant of the quality of care and an important component of pay for performance metrics. The purpose of this study was to evaluate the impact of a simple intervention aimed to increase patients' understanding of their orthopaedic trauma surgeon and improve patient satisfaction with the overall quality of inpatient care delivered by the attending surgeon.

Design: Prospective quality improvement initiative using a randomized intervention.

Setting: Level 1 academic trauma center.

Patients/Participants: Two hundred twelve patients were eligible; 100 patients were randomized to the intervention group, and 112 patients were randomized to the control group. Overall, 76 patients could be reached for follow-up satisfaction survey, including 34 patients in the intervention group and 42 patients in the control group.

Intervention: Patients randomized to the intervention group received an attending biosketch card, which included a picture of the attending orthopaedic surgeon with a brief synopsis of his educational background, specialty, surgical interests, and research interests.

Main Outcome Measures: Our primary outcome measure was a patient satisfaction survey assessing patients' rating of the overall quality of inpatient care delivered by the attending surgeon.

Study Overview

Detailed Description

Patient satisfaction is a key determinant of the quality of care and an important component of pay for performance metrics. The Centers for Medicare & Medicaid Services (CMS) Hospital Inpatient Value-Based Purchasing Program implemented value-based incentive payments that link Medicare reimbursements to patient satisfaction and physician surveys completed by patients.1 There is a paucity of data in the orthopaedic literature assessing patient satisfaction, especially regarding patients with orthopaedic trauma. Surprisingly, up to 90% of medical inpatients are unable to correctly name their treating physician when asked to identify the physician in charge of his or her care at the time of discharge.2-4 The orthopaedic trauma patient population is even more challenging due to traumatic injuries warranting inpatient surgery in the acute setting as opposed to elective surgeries or medical admissions. Admissions from the emergency department have been associated with a decreased ability of patients to identify their treating physician. 3 Furthermore, the acuity of these injuries does not always permit patients and surgeons to establish a strong patient-physician relationship before the surgery. Patient-physician communication is integral to improving clinical relationships and improving patient satisfaction.5,6 Surgeons exhibit a tendency to focus on operative quality and outcomes, whereas patients place greater value on the surgeon-patient interaction.7,8 Establishing rapport and a strong patient-physician relationship in the acute trauma setting is challenging but being able to recognize the name and face of the attending orthopaedic surgeon is a critical step in the communication chain. The presence of attending physician photographs in patient rooms has been associated with a significant improvement in the ability to correctly identify the attending physician and is associated with improved patient satisfaction.4,9 The purpose of this prospective quality improvement study was to evaluate the impact of a simple intervention aimed to increase patient recognition of the attending orthopaedic trauma surgeon and improve patient satisfaction with the overall quality of care delivered by the attending surgeon during the inpatient stay. Patients randomized to intervention group received an attending biosketch card, whereas patients randomized to the control group did not receive a card. Our hypothesis was that the patients in the intervention group (received attending biosketch card) would have higher patient satisfaction scores regarding the overall care provided by his or her attending orthopaedic trauma surgeon.

Study Type

Interventional

Enrollment (Actual)

228

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Tennessee
      • Nashville, Tennessee, United States, 37212
        • Vanderiblt University Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age 18-100 year old patients
  • English speaking
  • Admitted to the orthopaedic trauma surgery service
  • Isolated orthopaedic injury requiring orthopaedic surgery on the same admission

Exclusion Criteria:

  • <18 years old
  • traumatic brain injury
  • Admission greater than 7 days
  • patients with prior orthopaedic trauma injuries treated at Vanderbilt University Medical Center (VUMC)
  • patients with prior patient patient-physician relationship with orthopaedic trauma attending
  • visually impaired patients
  • intubated/sedated patients
  • intoxicated patients

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group, biosketch card
The investigators aim to improve the patient-physician relationship and improve patient satisfaction by providing a biosketch card of the attending orthopaedic trauma surgeon to the patient. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.
The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.
Active Comparator: Control group, standard care
The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The control group will receive the usual/standard care as provided to all orthopaedic trauma admission patients without receiving a biosketch card.
Standard of care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient Satisfaction as Measured by Giving an "Excellent" Score on a 5-point Rating
Time Frame: within 2 weeks of discharge and before first clinic appointment
Within 2 weeks of discharge from the hospital, but before the patient's first clinic visit, each group will be called by the Professional Resource Group as part of regular quality improvement by the Vanderbilt Medical Center Department of Strategic Development. The patients will be asked a series of questions aimed at determining overall patient satisfaction based on interactions with the attending orthopaedic trauma surgeon.
within 2 weeks of discharge and before first clinic appointment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Brent J Morris, MD, Vanderbilt University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2011

Primary Completion (Actual)

December 1, 2011

Study Completion (Actual)

January 1, 2012

Study Registration Dates

First Submitted

December 16, 2010

First Submitted That Met QC Criteria

December 20, 2010

First Posted (Estimate)

December 21, 2010

Study Record Updates

Last Update Posted (Estimate)

July 28, 2014

Last Update Submitted That Met QC Criteria

June 30, 2014

Last Verified

June 1, 2014

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • patient satisfaction
  • clinical trial (Baxter)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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