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PubMed2001

Re-examining the general positivity model of subjective well-being: the discrepancy between specific and global domain satisfaction.

Three studies were conducted to examine the role of global life satisfaction in the discrepancy between specific and global domain satisfaction. Participants rated both global (e.g., education) and the corresponding, specific domain (e.g., professors, textbooks) satisfactions. In 3 studies, we found that individuals with higher life satisfaction evaluated global domain as a whole as more satisfying than those with lower life satisfaction, given the same level of satisfaction with specific domains. In Study 3, we also found that, given the same level of satisfaction during the previous 2 weeks, individuals with higher life satisfaction rated the global domains in general as more satisfying than those with lower life satisfaction. Overall, the association between globallife satisfaction and evaluative enhancement of global domains was most consistent in "self" and "social relationships." Finally, the effect of global life satisfaction on evaluative enhancement remained significant, controlling for extraversion and neuroticism.

Adaptation, Psychological↗
PubMed2004

Race/ethnicity and patient satisfaction. Using the appropriate method to test for perceived differences in care.

OBJECTIVE: To determine whether an established patient satisfaction scale commonly used in the primary care setting is sufficiently sensitive to identify racial/ethnic differences in satisfaction that may exist; to compare a composite indicator of overall patient satisfaction with a 4-item satisfaction scale that measures only the quality of the direct physician-patient interaction. DESIGN: Real-time survey of patients during a primary care office visit. SETTING: Private medical offices in a generally affluent area of northern California. PARTICIPANTS: Five hundred thirty-seven primary care patients selected at random from those entering a medical office. MAIN OUTCOME MEASURES: Patient satisfaction using 1) a composite, 9-item satisfaction scale (VSQ-9); and 2) a 4-item subset of that scale that measures only satisfaction with direct physician care. RESULTS: The 9-item, composite scale identified no significant difference in patient satisfaction between white and nonwhite patients, after controlling for patient demographics and other aspects of the visit. The 4-item, physician-specific scale indicated that nonwhite patients were less satisfied than white patients with their direct interaction with the physicians included in the study (P </=.01). CONCLUSIONS: Measurements of patient satisfaction that use multi-item, composite indicators should also include focused comparisons of satisfaction directly with the care provided by the physician. In measurements of patient satisfaction, patient race/ethnicity should be included as an explanatory variable. The results also confirm earlier findings that factors external to the direct physician-patient interaction can have substantial effects on patients' perceptions of that interaction.

Adult↗
PubMed2001

Patient satisfaction, use of services, and one-year outcomes in publicly funded substance abuse treatment.

OBJECTIVE: This longitudinal study examined the relationships among patient satisfaction with substance abuse services, service use, and clinical and employment outcomes. METHODS: Interviews were conducted with 502 adults who were beginning outpatient or residential treatment for substance abuse in a managed care plan in Oregon or in fee-for-service plans in Washington State. The participants were reinterviewed after six months and after one year. Measures of satisfaction and use of services were assessed at six months and clinical outcomes at one year with the Addiction Severity Index. Multivariate regression analyses were used to estimate the relationship between satisfaction and service use and the relationships among satisfaction, use, and one-year outcomes when baseline characteristics were held constant. RESULTS: The final sample included 310 individuals (62 percent) who completed interviews at the three time points. Compared with those who were excluded because of missing data, the patients in the final sample were more likely to be white, to be better educated, to be in outpatient treatment, and to live in Oregon and less likely to be homeless. No significant differences were observed in baseline symptoms between the two groups. Satisfaction with access and effectiveness of services predicted service use at six months. Service use, satisfaction with access, and satisfaction with effectiveness were significantly associated with abstinence from substance use at one year. Neither patient satisfaction nor use of services was related to other outcomes, including employment and the presence of psychiatric symptoms. CONCLUSIONS: Although causation cannot be determined, the results of this study suggest that patient satisfaction is related to both use of services and abstinence from substance use. Longitudinal research using more detailed measures of satisfaction is needed to sort out the complex relationship between satisfaction and service use and the direct and indirect influences of these variables on outcomes.

Adolescent↗
PubMedDate not supplied

A patient satisfaction theory and its robustness across gender in emergency departments: a multigroup structural equation modeling investigation.

This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction across gender in national random samples of emergency patients. Using multigroup structural equation modeling, the results supported the model's robustness. Physician service, waiting time, and nursing satisfaction explained 48%, 41%, and 11% of overall satisfaction plus 92% and 93% of female and male satisfaction, respectively. Unit increases in physician service satisfaction increased waiting time, nursing, and overall satisfaction by 0.991, 0.844, and 1.031 units, respectively. Unit increases in waiting time satisfaction increased nursing and overall satisfaction by 0.417 and 0.685 units, respectively. A unit increase in nursing satisfaction increased overall service satisfaction by 0.221 units. The investigation offers an alternative paradigm for measuring and achieving emergency department satisfaction, hierarchically related to patient expectations, where the primary provider has the greatest clinical utility to patients, followed by waiting for the primary provider, and then by nursing service.

Adult↗
PubMed2003

Assessing satisfaction with desloratadine and fexofenadine in allergy patients who report dissatisfaction with loratadine.

BACKGROUND: The FDA recently moved loratadine (Claritin) from prescription only status to over-the-counter (OTC). In response to the availability of an OTC non-sedating antihistamine, many managed care organizations are reevaluating which if any prescription antihistamines should remain on formulary. From a managed care perspective, determining which of the remaining prescription antihistamines results in the greatest patient satisfaction with allergy treatment would be informative. METHODS: We report on a weighted cross sectional survey (n = 10,023) delivered online to a sample of allergy sufferers in the U.S. during the month of December 2002. Two segments were identified for analysis: patient who were dissatisfied with loratadine and converted to desloratadine (Clarinex; n = 61), and patients who were dissatisfied with loratadine and converted to fexofenadine (Allegra; n = 211). The two segments were compared along a series of measures that the literature suggests are related to treatment satisfaction. RESULTS: The survey found that two of the satisfaction measures differentiated desloratadine converters from fexofenadine converters (p <.05): mean sum of self-reported adverse events and nighttime awakening due to allergy symptoms. For the remainder of satisfaction measures though, patients who were dissatisfied with loratadine reported equal duration of coverage and satisfaction with desloratadine as fexofenadine. When severity of disease was controlled for in the analysis, a pattern emerged suggesting greater levels of satisfaction amongst loratadine dissatisfied patients who converted to desloratadine. Point estimates suggest a consistent pattern favoring desloratadine patient satisfaction, with statistically significant results reported for sum of adverse effects, nighttime awakening due to symptoms, symptom severity just prior to the next dose, and overall satisfaction (p < 0.05). CONCLUSIONS: On average, patients who were dissatisfied with loratadine reported equal or better satisfaction with desloratadine as fexofenadine. Patients with severe allergic rhinitis reported greater satisfaction when converted from loratadine to desloratadine than fexofenadine for select satisfaction measures. These results suggest that if managed care intends to position prescription antihistamines as second line for OTC loratadine treatment dissatisfaction, desloratadine is a useful treatment alternative. These findings, while informative to formulary decision-makers, must be interpreted with caution. Only through head-to-head controlled clinical trials can differences in efficacy and safety be established.

Histamine H1 Antagonists↗
PubMed2006

Reduction in psychotic symptoms as a predictor of patient satisfaction with antipsychotic medication in schizophrenia: data from a randomized double-blind trial.

BACKGROUND: Patient satisfaction with antipsychotic treatment is important. Limited evidence suggests that satisfaction is associated with symptom improvement and compliance. Predictors of patient satisfaction with antipsychotic medication were examined in a study of patients with a recent exacerbation of schizophrenia. METHODS: Data are from a randomized, double-blind trial comparing risperidone (n = 152), quetiapine (n = 156), and placebo (n = 73). Medication Satisfaction Questionnaire (MSQ) was completed after 14 days of treatment and after 6 weeks at last study visit. RESULTS: Medication satisfaction at both time points was significantly associated in multiple regression analysis with improvement on 3 Positive and Negative Syndrome Scale (PANSS) factor scores (positive symptoms p < .01; uncontrolled hostility/excitement, p < .0005; anxiety/depression, p < .04) and treatment with risperidone (p < .03); at day 14, significant association was also found with older age (p = .01). At both time points, predictor variables explained over 30% of the variance in medication satisfaction. Change in Hamilton Depression Scale, prolactin levels, sex, and reported adverse events of extrapyramidal symptoms, sedation, and movement disorders were not significant predictors of satisfaction. Lower level of medication satisfaction at day 14 was associated with earlier discontinuation in the trial at week 6 end point. A focused principal components analysis of PANSS factors and MSQ suggested that medication satisfaction relates to 3 groups of factors in descending order of magnitude: lower levels of (a) uncontrolled hostility/excitement, (b) positive symptoms, and (c) negative symptoms, disorganized thoughts, and anxiety/depression. CONCLUSION: Results give further support that treatment satisfaction is positively associated with symptom improvement, particularly psychotic symptoms, and suggest that satisfaction may also be related to compliance, as those who were more satisfied remained in the trial for a longer period of time.

Adolescent↗
PubMed2003

Life satisfaction several years after severe multiple trauma--a retrospective investigation.

OBJECTIVES: To describe the prevalence of self-reported changes in life satisfaction after multiple trauma, to analyse associations between satisfaction with life as a whole and with domains in life, and to identify important contributors for satisfaction with life. DESIGN: Retrospective follow-up study. SETTING: Rehabilitation hospital three years after multiple trauma. SUBJECTS: Sixty-nine subjects with severe multiple trauma (ISS > or = 16). MAIN OUTCOME MEASURES: Clinical examinations to reveal prevalences of impairments and disabilities. Questionnaires about satisfaction with life as a whole and eight domains of life, both for the time before trauma, and for the actual situation; sense of coherence (SOC-13); social network. RESULTS: A total of 87% experienced a decrease in at least one of the nine life satisfaction items from before to after trauma (six-graded scale). After trauma significantly fewer subjects reported to be satisfied with life as a whole, as well as the domains sexual life, ADL, contact with friends, leisure, vocational and financial situation. Satisfaction with family life and partner relationship did not decrease significantly. The most important domains after trauma were satisfaction with leisure, family life and vocation. Vocational and leisure disability after trauma were important determinants for satisfaction with life as a whole. A strong sense of coherence and sufficient social network quality had significant impact on satisfaction with life as a whole and some of the domain-specific satisfactions. CONCLUSIONS: Both personal resources (a strong sense of coherence) and the presence of a qualitatively sufficient social network can buffer the negative influence of disabilities on life satisfaction after trauma.

Activities of Daily Living↗
PubMed2004

Predictors of emergency department patient satisfaction: stability over 17 months.

OBJECTIVES: The contradictory findings reported in the emergency department (ED) patient satisfaction literature may be due to methodologic differences between studies, as well as actual differences in predictors. The authors examined the stability of predictors of ED patient satisfaction across multiple assessments over 17 months. METHODS: All patients who presented for emergency care to the authors' hospital during four designated time periods spanning 17 months were eligible. The participants were contacted by telephone and the following were assessed: demographics, visit characteristics, perceived waiting times, subjective quality of care indicators, and overall satisfaction. The authors computed logistic regressions to predict overall satisfaction for each of the four periods. They compared the results across the assessments, both visually and using an aggregated logistic regression, to determine the consistency of the final equations. Interpretations based on traditional p-value cut-offs and odds ratios (ORs) were compared. RESULTS: When using a p-value cut-off strategy of p < 0.05, notable discrepancies in the predictors of overall satisfaction were common. Six indicators, including age, perceived wait before bed placement, perceived wait before physician evaluation, physician care, discharge instructions, and waiting time satisfaction, were statistically associated with satisfaction for only one of the four assessments. In contrast, examining the size of the ORs associated with each predictor showed far fewer discrepancies. Only physician care appeared to have large differences in the strength of its relation to overall satisfaction. This trend was confirmed by the aggregated logistic regression analysis. CONCLUSIONS: Using p-value cut-offs as the sole criterion for interpreting which variables are most important in determining ED patient satisfaction is ill-advised, and may lead to spurious conclusions of discrepant findings. Nevertheless, some determinants of ED satisfaction likely differ meaningfully based on the cohort that is being examined. Overgeneralizing conclusions derived from a single ED patient satisfaction study should be avoided, especially those studies that are cross-sectional and use a single site.

Adolescent↗
PubMed2003

[Satisfaction with life overall and with specific life domains among elderly persons with a lower limb amputation].

OBJECTIVE: To examine a group of elderly persons who had had a lower limb amputation and who were receiving care at the outpatient clinic of a teaching hospital in Campinas, São Paulo, Brazil, in order to: 1) identify relationships between their perceived overall life satisfaction and their functional capacity; 2) assess their perceived satisfaction with the domains of health, physical functioning/dependence, mental health, and social integration/involvement; and 3) identify relationships between overall life satisfaction and satisfaction with the specific domains. METHODS: An assessment was done of a group of 40 elderly persons (30 men and 10 women) who had had an amputation above the malleolus at least 1 year earlier and who were undergoing rehabilitation between June 1994 and June 1999. Their mean age was 74.5 years (range, 60 to 79 years). A questionnaire was used for data collection to assess: 1) functional capacity (Barthel index); 2) general life satisfaction (Cantrill model); and 3) satisfaction with the domains of health, physical functioning/dependence, mental health, and social integration/involvement, with the 40 elderly persons assessing themselves both in individual terms and in comparison to other persons of the same age group. RESULTS: Among the 40 elderly persons, the level of general life satisfaction was high. Measured on a scale of 1 to 10, the mean was 7.1 and the median 7.5, with a standard deviation of 2.73. There was no correlation between overall life satisfaction and functional capacity. There was no significant difference between individual perceived satisfaction with the specific domains and the perception of these domains in comparison to other persons of the same age group; in both of these cases, the elderly persons who had had an amputation reported a high degree of satisfaction. A positive correlation was found only between overall life satisfaction and the domains of health (individual and comparative) and of physical functioning (comparative). CONCLUSIONS: These results suggest that this group of elderly persons who had had an amputation tended to assess their situation positively. This finding provides new insights into the rehabilitation of elderly persons with lower limb amputations. Taken together with the dearth of studies concerning the subject, this finding also indicates the need for additional research focusing on the subjective well-being of the elderly.

Aged↗
PubMed1996

Patient satisfaction with time use in audiological consultations.

An analysis of how time was used in and around 60 consultations was carried out for the purpose of exploring the relationship of time use to patient satisfaction. Sixty patients across two practice settings were surveyed, immediately following their interaction with the audiologist, regarding satisfaction with the consultation. Satisfaction was measured via: (1) a four-point scale, which yielded a satisfaction rating; and (2) a check list of satisfaction with 11 aspects of the consultation, which yielded a satisfaction score. Satisfaction ratings and scores were correlated significantly (rs = 0.76 corrected for ties, P = 0.0001). The majority of patients were either 'very satisfied' (63%) or 'satisfied' (31.6%) with the consultation experience. Temporal pictures of the consultations of 'very satisfied', 'satisfied' and 'dissatisfied' patients were clearly different. For the present sample it appeared that patient satisfaction ensued when the total consultation time was equal to or exceeded 0.6 of the sum of total consultation time and the time spent waiting at the clinic immediately prior to the consultation. Regression analyses showed that of the temporal variables studied, total consultation time (TCT) and the amount of time waiting immediately pre consultation (WT) contributed most to the variation in patient satisfaction ratings and scores. Forty-two per cent of the variance in satisfaction ratings and 36% of the variance in satisfaction scores could be explained by TCT/(WT + TCT).

Adult↗
PubMedDate not supplied

Factors associated with changes in satisfaction with care.

OBJECTIVE: Satisfaction with care is an important outcome for evaluating the effectiveness of medical care. Many factors can influence satisfaction, including disease state, healthcare utilization, and health-status changes. However, few studies have investigated the association between these factors and changes in satisfaction. DESIGN: This study examined the influence of personal characteristics, type of health plan, disease states, and healthcare utilization on changes in satisfaction with care in a prospective cohort over a 12-month period through two surveys, baseline and follow-up. PARTICIPANTS: Enrollees in one of three different commercial health plans: point-of-service product, an unrestricted fee-for-service product, and a preferred-provider organization product. MEASUREMENTS AND MAIN RESULTS: Two multivariate logistic regression models were constructed. The first model evaluated factors that predicted increased satisfaction with care between the two surveys. Compared with respondents who reported no change in health status, both those with improved health status (odds ratio [OR], 1.29, 95% confidence interval [CI95], 1.03-1.61) and those with declines in health (OR, 1.29, CI95, 1.03-1.61) were significantly more likely to report an increase in satisfaction with care. Those with a history of hospitalization were also more likely to report an increase in satisfaction with care (OR, 1.27, CI95, 1.01-1.59). The second multivariate logit model evaluated factors that predicted decreases in satisfaction with care from the baseline survey. Those with reported declines in health status were more likely to report decreases in satisfaction with medical care (OR, 1.43, CI95, 1.13-1.79). Neither age, gender, race, type of health plan, disease state, nor doctor's office visits were related to observed changes in satisfaction with medical care. CONCLUSION: Changes in satisfaction with care appear to be related to changes in health status. However, the relation between these two attributes is not intuitively apparent.

Adult↗
PubMed2000

Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses.

BACKGROUND: High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. OBJECTIVE: To explore the influences of nurses' attributes, unit characteristics, and elements of the work environment on the job satisfaction of nurses in pediatric critical care units and to determine stressors that are unique to nurses working in pediatric critical care. METHOD: A cross-sectional survey design was used. The sample consisted of 1973 staff nurses in pediatric critical care units in 65 institutions in the United States and Canada. The following variables were measured: nurses' perceptions of group cohesion, job stress, nurse-physician collaboration, nursing leadership, professional job satisfaction, and organizational work satisfaction. RESULTS: Significant associations (r = -0.37 to r = -0.56) were found between job stress and group cohesion, professional job satisfaction, nurse-physician collaboration, nursing leadership behaviors, and organizational work satisfaction. Organizational work satisfaction was positively correlated (r = 0.35 to r = 0.56) with group cohesion, professional job satisfaction, nurse-physician collaboration, and nursing leadership behaviors. Job stress, group cohesion, job satisfaction, nurse-physician collaboration, and nursing leadership behaviors explained 52% of the variance in organizational work satisfaction. Dealing with patients' families was the most frequently cited job stressor. CONCLUSIONS: Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted.

Adult↗
PubMed2003

Stress, satisfaction and burnout among Dutch medical specialists.

BACKGROUND: Stress and stress-related illnesses are increasing among medical specialists. This threatens the quality of patient care. In this study we investigated (a) levels of job stress and job satisfaction among medical specialists, (b) factors contributing to stress and satisfaction and (c) the effect of stress and satisfaction on burnout. METHODS: A questionnaire was mailed to a random sample of 2400 Dutch medical specialists. Measures included job stress, job satisfaction, burnout, personal characteristics, job characteristics and perceived working conditions. RESULTS: The final response rate was 63%. Of the respondents, 55% acknowledged high levels of stress, and 81% reported high job satisfaction. Personal and job characteristics explained 2%-6% of the variance in job stress and satisfaction. Perceived working conditions were more important, explaining 24% of the variance in job stress and 34% of the variance in job satisfaction. Among perceived working conditions, the interference of work on home life (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.35-1.76) and not being able to live up to one's professional standards (OR 1.57, 95% CI 1.37-1.80) were most related to stress. Feeling poorly managed and resourced (OR 2.07, 95% CI 1.76-2.43) diminished job satisfaction. Burnout was explained by both high stress and low satisfaction (41% of variance explained) rather than by stress alone. INTERPRETATION: Our study showed a protective effect of job satisfaction against the negative consequences of work stress as well as the importance of organizational rather than personal factors in managing both stress and satisfaction.

Adult↗
PubMed2004

[The level of anxiety, depression and aggression in nurses and their life and job satisfaction].

BACKGROUND: In professions aimed at helping other people such as nursing, an increased level of anxiety, depression and aggression caused by extremely stressful work environment is always possible. It can be hypothesized that these emotions influence nurses' life and job satisfaction, through its decreasing or increasing. MATERIALS AND METHODS: In all, 102 nurses, employed in hospitals, outpatient clinics, hospices and old people's homes, were administered three questionnaires: 1) the Hospital Anxiety and Depression Scale-Modified; 2) the Life Satisfaction Scale; and 3) the job Satisfaction Scale. The survey was a closing part of the course on psychology carried out under the postgraduate education program. RESULTS: The statistical analysis of the results showed the increased level of anxiety in the youngest group of nurses, whereas the level of depression and aggression ranged from medium to low in the whole sample. The nurses' level of job satisfaction was higher than that of their life satisfaction and the differences were statistically significant in each of the three seniority categories. The evaluation of the relationship between life and job satisfaction and anxiety, depression, aggression and job seniority showed: (a) the effect of anxiety and depression, as self-contained factors, on life satisfaction, regardless of job seniority; (b) the effect of aggression interrelated with job seniority on job satisfaction. CONCLUSIONS: Anxiety is the major factor affecting life satisfaction; job satisfaction is less prone to the influence of negative emotions than life satisfaction. Bearing in mind a tendency shown by nurses to suppress their emotions as well as their stressful work environment, they should receive psychological support in its broadest sense.

Adult↗
PubMed2005

Longitudinal continuity of care is associated with high patient satisfaction with physical therapy.

BACKGROUND AND PURPOSE: Recent literature has suggested that longitudinal continuity (ie, the patient is seen by the same practitioner for the entire course of treatment) may be linked to high degrees of patient satisfaction with medical care. The purpose of this study was to provide preliminary information regarding the association between longitudinal continuity and reports of patient satisfaction with physical therapy outpatient care. SUBJECTS AND METHODS: A sample of 1,502 adult subjects completed the MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care at the time of discharge from outpatient physical therapy. Relationships between satisfaction measures and the presence or absence of longitudinal continuity were assessed by use of binary logistic regression. RESULTS: Overall, 36.8% of the subjects reported complete satisfaction on the internal subscale (patient-therapist), and 47.9% of the subjects reported complete satisfaction on the external subscale (patient-support staff). Higher percentages of women (40.2% and 51.1% for internal and external subscales, respectively) than of men (31.9% and 43.3% for internal and external subscales, respectively) were completely satisfied with care. Of subjects who reported complete satisfaction on the internal subscale, 71.2% had longitudinal continuity of care, and 28.8% did not. A similar trend was noted for the external subscale (patient-support staff); 66.8% of subjects who reported complete satisfaction had longitudinal continuity, and 33.2% did not. Odds ratios describing the probability of complete satisfaction with care for subjects who had longitudinal continuity and for those who did not were significant and ranged from 2.7 to 3.5. DISCUSSION AND CONCLUSION: Subjects who received their entire course of outpatient physical therapy from only 1 provider were approximately 3 times more likely to report complete satisfaction with care than those who received care from more than 1 provider. These findings suggest that clinicians and managers should make efforts to preserve longitudinal continuity of care as a means of improving patient satisfaction with care.

Adult↗
PubMed1995

What type of general practice do patients prefer? Exploration of practice characteristics influencing patient satisfaction.

BACKGROUND: General practice is currently experiencing a large number of developments. Studies of patient satisfaction are required to guide the changes that many general practitioners are introducing. AIM: A study set out to examine the characteristics of general practices that influence patient satisfaction. METHOD: In 1991-92, a surgery satisfaction questionnaire of demonstrated reliability and validity was administered to 220 patients in each of 89 general practices. A further questionnaire completed by a member of practice staff collected information about practice characteristics including total list size, number, age and sex of practice partners, training status, fundholding status, presence of a practice manager and whether there was a personal list system. Stepwise multiple regression analyses were undertaken to identify those practice characteristics that influenced patient satisfaction. RESULTS: The mean of the response rates of patients completing questionnaires in each practice was 82%. An increasing total list size of patients registered with practices was associated with decreasing levels of general satisfaction and decreased satisfaction with accessibility, availability, continuity of care, medical care and premises. The presence of a personal list system was associated with increased levels of general satisfaction and increased satisfaction with accessibility, availability, continuity of care and medical care. Training practices were associated with decreased levels of general satisfaction and decreased satisfaction with availability and continuity of care. CONCLUSION: The patients of practices in this study preferred smaller practices, non-training practices and practices that had personal list systems. Practice organization should be reviewed in order to ensure that the trend towards larger practices that provide a wider range of services does not lead to a decline in patient satisfaction. General practitioners should have personal list systems and consider the creation of several personal teams within the practice consisting of small numbers of doctors, receptionists and practice nurses.

Adolescent↗
PubMedDate not supplied

Benchmarking surgeon satisfaction at academic health centers: a nationwide comparative survey.

BACKGROUND: Forty-six academic health centers (AHCs) belonging to the University HealthSystem consortium joined forces to compare the efficiency of their surgical services and to identify best practices. In addition to measures of operational performance, surgeon satisfaction with the surgical services provided was measured by using a standardized questionnaire. METHODS: From hospital records, indicators of the efficiency of surgical services were collected in three main areas: scheduling, preoperative testing and assessment, and the intraoperative process. Responding to a mail questionnaire, a sample of surgeons rated their satisfaction with key aspects of surgical services including scheduling, operating room staff, and equipment/supplies. On the basis of a review of the operational measures and the survey results, high performers were identified. Site visits were made to several of these high performers to uncover the critical factors responsible for their success. RESULTS: The survey revealed distinct variations in surgeon satisfaction across the participating institutions. Numerical benchmarks were obtained for surgeon satisfaction with each key component of surgical services. Scheduling was the most important component of overall surgeon satisfaction, explaining 71% of the variance in the rating of overall satisfaction with surgical services. High operational efficiency and high surgeon satisfaction were not incompatible. Several of the participating institutions were able to achieve both. These results were disseminated to all of the participants at a national meeting as well as in written form. CONCLUSIONS: The surgeon satisfaction survey allowed the participants to establish benchmarks for surgeon satisfaction for each key component of the surgical services they receive. The site visits revealed several common characteristics of highly efficient surgical services. Taken by themselves, the participating institutions might have been reluctant to consider adopting these best practices for fear of alienating the surgical staff. The availability of data on surgeon satisfaction showed the participants that these best practices can coexist with high levels of surgeon satisfaction. This has helped to promote their adoption by the other participating institutions.

Academic Medical Centers↗
PubMed1999

Satisfaction of women attending the Manitoba breast screening program.

BACKGROUND: This study evaluated the satisfaction of women who attended the Manitoba Breast Screening Program (MBSP) during the first 17 months of operation and examined differences in satisfaction by screening location and screening result. The setting was the province of Manitoba, Canada. METHODS: A breast screening program satisfaction questionnaire comprising six subscales was mailed to 1,331 randomly chosen women in five different categories who attended the MBSP. Four categories were based on location of screen (city of Brandon vs city of Winnipeg) and screen result (normal vs abnormal) and one category comprised women who were screened at a mobile unit. Eighty-eight percent of all questionnaires were returned. Data analyses included analyses of variance to examine the effect of location and result on satisfaction scores and logistic regression to explore the variables associated with reported satisfied and not satisfied responses to each satisfaction subscale. RESULTS: All satisfaction scores were above 80 of 100, indicating high levels of satisfaction. A significant difference in satisfaction scores between women in Winnipeg and women in Brandon was found for the convenience and accessibility (P = 0.0153) and the information transfer subscales (P = 0.0150). A significant difference was found between women with abnormal and women with normal screen results for all subscales (P < 0.01). Women were 4.5 times more likely to be dissatisfied on the general satisfaction subscale if they had an abnormal screen result (95% CI 1.9,10.4). CONCLUSIONS: High levels of satisfaction were reported for all aspects of screening at the MBSP. However, women were less likely to be satisfied with program convenience and accessibility. Women with an abnormal result reported lower levels of satisfaction on all subscales. Some women with an abnormal screening result were confused about what their results meant and why they were sent for additional diagnostic tests. As a result of these findings, numerous changes were made to the MBSP.

Aged↗