Improving Patient Satisfaction in a Mid-Size Pediatric Hematology-Oncology Outpatient Clinic

Background: The study of patient satisfaction is a rapidly growing area of importance within healthcare. High levels of patient satisfaction are associated with exceptional doctor-patient communication (Williams S, et al., 1998), improved patient compliance (Zolnierek K and DiMatteo M, 2005), and reduced likelihood of medical malpractice (Stelfox H, et al., 2005). Furthermore, physician reimbursement and pay-for-performance measures will imminently be tied to patient satisfaction metrics. Despite its emerging significance within the medical community, a relative paucity of data exists with regards to improving patient satisfaction, and no reports have evaluated methods to improve the patient experience for the unique population served by the pediatric hematology-oncology (PHO) outpatient clinic.

Aim: To improve the PHO outpatient clinic overall patient satisfaction score to an institutional goal of 75^th percentile nationally, and improve collective provider score to the 90^th percentile nationally by the end of year 2014.

Methods: Patient satisfaction was measured using returned Press-Ganey® surveys at Blank Children’s Hospital PHO outpatient clinic (UnityPoint Health, Des Moines, Iowa), a mid-size practice consisting of 4 physicians and approximately 50-60 new oncology patients per year. Scores from year 2013 were analyzed and several provider and staff-initiated interventions were implemented in January 2014, including:

1) Distribution of published written strategies to address areas most likely to drive improvement in 2014

2) Weekly review of all returned surveys by physicians and clinic personnel

3) Review of year-to-date patient satisfaction results, goals, and progress at monthly staff meetings

4) Transparency of scores among providers

5) Devotion of additional efforts to address less-satisfied demographics (first-time patients)

6) Implementation of service recovery modalities

7) Offering of optional web-based patient satisfaction training modules to all providers

Results: Comparing pre-intervention patient satisfaction data from the year 2013 (n= 132) to year-to-date post-intervention data from year 2014 (n=58), overall patient satisfaction improved from 61^st to 92^nd percentile (all scores are national percentile rank). Collective provider scores improved from 73^rd to 94^th percentile. Among patients at their first appointment in the clinic, overall satisfaction improved from 41^st to 81^st percentile, and satisfaction with providers improved from 26^th to 89^th percentile.

Conclusions: Patient satisfaction can be improved in a mid-size PHO clinic through implementation of multiple strategic provider and staff-driven initiatives. It is unclear which interventions are most associated with improvement or if progress will be sustained as further post-intervention data is acquired. As the importance of patient satisfaction continues to grow within the medical and economic communities, further study is necessary to better address the needs of the distinctive PHO patient population.