Improving Patient Satisfaction Improving Patient Satisfaction

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Improving Patient Satisfaction in the Orthopaedic Trauma Population

Conditions
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Satisfaction, Trauma

Intervention / Treatment
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* Other: Orthopaedic Attending Biosketch Card
* Other: Standard of care - No biosketch card


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Group, biosketch card<br>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. | Other: Orthopaedic Attending Biosketch Card<br>* 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.<br>|
| Active Comparator: Control group, standard care<br>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. | Other: Standard of care - No biosketch card<br>* Standard of care<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Satisfaction as Measured by Giving an Excellent Score on a 5-point Rating | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patient satisfaction, patient-physician relationship, orthopaedic trauma