Improving Patient Satisfaction Improving Patient Satisfaction

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.

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.

Eligibility Criteria:
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