Advertisement

Patient Satisfaction in the Hand Surgery Clinic: An Analysis of Factors That Impact the Press Ganey Survey

      Purpose

      Our purpose was to test the null hypothesis that no patient or clinic visit characteristics affect satisfaction of hand surgery outpatients, as measured by the Press Ganey Outpatient Medical Practice Survey (PGOMPS).

      Methods

      Adult patients (≥ 18 years) evaluated by 5 fellowship-trained hand surgeons between January 2014 and December 2016 for a new patient clinic visit at a single tertiary academic medical center, were included. Prospectively collected PGOMPS data were reviewed retrospectively for each visit. Chart review was performed to collect demographic and visit characteristics data. Satisfaction was defined a priori as achieving a PGOMPS score above the 33rd percentile. Both the PGOMPS Total Score (primary outcome) and Provider Subscore (secondary outcome) were analyzed using univariate and multivariable logistic regression.

      Results

      Of 748 included patients, the mean age was 51.7 ± 15.5 years, and 64% were women. Leading diagnoses included tendinitis (19%), neuropathy (19%), arthritis (16%), and fracture-dislocation (13%). Multivariable modelling of the PGOMPS Total Score revealed that older age, shorter wait times, and scheduling surgery were significantly associated with greater satisfaction. The PGOMPS Provider Sub-Score multivariable modelling revealed that older age, shorter wait times, scheduling surgery, and administering injections were significantly associated with greater satisfaction. Diagnostic category and insurance status did not affect satisfaction.

      Conclusions

      Increasing patient age, decreased wait time, and receiving an intervention (scheduling of surgery or receiving an injection) are associated with increased satisfaction among newly presenting hand surgery clinic patients as measured by the Press Ganey Outpatient Medical Practice Survey. Diagnosis and access to health care (insurance status and distance to clinic) did not influence patient satisfaction.

      Type of study/level of evidence

      Diagnostic III.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • James J.
        Health Policy Brief: Pay-for-Performance.
        Health Affairs. October 2012; (Available at:) (Accessed April 16, 2019)
        • O'Leary K.J.
        • Darling T.A.
        • Rauworth J.
        • Williams M.V.
        Impact of hospitalist communication-skills training on patient-satisfaction scores.
        J Hosp Med. 2013; 8: 315-320
        • Bible J.E.
        • Kay H.F.
        • Shau D.N.
        • O'Neill K.R.
        • Segebarth P.B.
        • Devin C.J.
        What patient characteristics could potentially affect patient satisfaction scores during spine clinic?.
        Spine (Phila Pa 1976). 2015; 40: 1039-1044
        • Graham B.
        • Green A.
        • James M.
        • Katz J.
        • Swiontkowski M.
        Measuring patient satisfaction in orthopaedic surgery.
        J Bone Joint Surg Am. 2015; 97: 80-84
        • Anderson R.T.
        • Camacho F.T.
        • Balkrishnan R.
        Willing to wait?: the influence of patient wait time on satisfaction with primary care.
        BMC Health Serv Res. 2007; 7: 31
        • Bleustein C.
        • Rothschild D.B.
        • Valen A.
        • Valatis E.
        • Schweitzer L.
        • Jones R.
        Wait times, patient satisfaction scores, and the perception of care.
        Am J Manag Care. 2014; 20: 393-400
        • Kreitz T.M.
        • Winters B.S.
        • Pedowitz D.I.
        The influence of wait time on patient satisfaction in the orthopedic clinic.
        J Patient Exp. 2016; 3: 39-42
        • Thompson D.A.
        • Yarnold P.R.
        • Williams D.R.
        • Adams S.L.
        Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department.
        Ann Emerg Med. 1996; 28: 657-665
        • Patterson B.M.
        • Eskildsen S.M.
        • Clement R.C.
        • et al.
        Patient satisfaction is associated with time with provider but not clinic wait time among orthopedic patients.
        Orthopedics. 2017; 40: 43-48
        • Donahue R.
        • Russell D.
        • de Riese C.
        • Smith C.
        • de Riese W.T.W.
        • Medway A.
        Patients willing to wait: arrival time, wait time and patient satisfaction in an ambulatory urology clinic.
        Urol Pract. 2017; 4: 1-6
        • Bernard A.W.
        • Martin D.R.
        • Moseley M.G.
        • et al.
        The impact of medical student participation in emergency medicine patient care on departmental press ganey scores.
        West J Emerg Med. 2015; 16: 830-838
        • Hwang C.E.
        • Lipman G.S.
        • Kane M.
        Effect of an emergency department fast track on Press-Ganey patient satisfaction scores.
        West J Emerg Med. 2015; 16: 34-38
        • Schwartz T.M.
        • Tai M.
        • Babu K.M.
        • Merchant R.C.
        Lack of association between Press Ganey emergency department patient satisfaction scores and emergency department administration of analgesic medications.
        Ann Emerg Med. 2014; 64: 469-481
        • Presson A.P.
        • Zhang C.
        • Abtahi A.M.
        • Kean J.
        • Hung M.
        • Tyser A.R.
        Psychometric properties of the Press Ganey® outpatient medical practice survey.
        Health Qual Life Outcomes. 2017; 15: 32
        • Press Ganey Associates, Inc
        Medical Practice Survey Psychometrics Report.
        Press Ganey Associates, Inc, South Bend, IN2010
        • Abtahi A.M.
        • Presson A.P.
        • Zhang C.
        • Saltzman C.L.
        • Tyser A.R.
        Association between orthopaedic outpatient satisfaction and non-modifiable patient factors.
        J Bone Joint Surg Am. 2015; 97: 1041-1048
        • Nunnally J.
        Psychometric Theory.
        2nd ed. McGraw-Hill, New York1978
        • Vittinghoff E.
        • McCulloch C.E.
        Relaxing the rule of ten events per variable in logistic and cox regression.
        Am J Epidemiol. 2007; 165: 710-718
      1. Medicare program: hospital inpatient value-based purchasing program. Final rule. Centers for Medicare & Medicaid Services (CMS), HHS.
        Fed Regist. 2011; 76: 26490-26547
        • Jaipaul C.K.
        • Rosenthal G.E.
        Are older patients more satisfied with hospital care than younger patients?.
        J Gen Intern Med. 2003; 18: 23-30
        • Etier Jr., B.E.
        • Orr S.P.
        • Antonetti J.
        • Thomas S.B.
        • Theiss S.M.
        Factors impacting Press Ganey patient satisfaction scores in orthopedic surgery spine clinic.
        Spine J. 2016; 16: 1285-1289
        • Rogers F.
        • Horst M.
        • To T.
        • et al.
        Factors associated with patient satisfaction scores for physician care in trauma patients.
        J Trauma Acute Care Surg. 2013; 75: 110-114
        • Young G.J.
        • Meterko M.
        • Desai K.R.
        Patient satisfaction with hospital care.
        Med Care. 2000; 38: 325-334
        • Tyser A.R.
        • Abtahi A.M.
        • McFadden M.
        • Presson A.P.
        Evidence of non-response bias in the Press-Ganey patient satisfaction survey.
        BMC Health Serv Res. 2016; 16: 350
        • Lee V.S.
        • Miller T.
        • Daniels C.
        • Paine M.
        • Gresh B.
        • Betz A.L.
        Creating the exceptional patient experience in one academic health system.
        Acad Med. 2016; 91: 338-344
        • Elliott M.N.
        • Edwards C.
        • Angeles J.
        • Hambarsoomians K.
        • Hays R.D.
        Patterns of unit and item nonresponse in the CAHPS hospital survey.
        Health Serv Res. 2005; 40: 2096-2119
        • Chen A.Y.
        • Elliott M.N.
        • Spritzer K.L.
        • et al.
        Differences in CAHPS reports and ratings of health care provided to adults and children.
        Med Care. 2012; 50: S35-S39