In health care, patient satisfaction is an important metric for judging the quality of service provided. Patient satisfaction affects not only clinical outcomes but also the acquisition and retention of patients as well as malpractice claims (Xesfingi & Vozokis, 2016; Thornton et al., 2017). Adeline Herzog Memorial Hospital in Castle Rock, Colorado, had a patient satisfaction problem in 2012. It's third-floor nursing unit that receives 70% of the total patients admitted to the hospital rated in the 15 th percentile in a Press-Ganey test. Furthermore, the floor's HCAHPS score for inpatients was below the state average. Different interventions have been implemented by the director of medical, surgical, and intensive care services, Jeri Tinsley. However, they have had little to no effect. If no effective measures are taken, the patients will start going to competing hospitals.
To understand what is wrong with the third floor, surveys were conducted where the patients provided comments on different factors that impacted both the quality of health care delivered and patient satisfaction. However, Tinsley has little expertise in data analysis. This paper is a report documenting the results of a data analysis conducted using patient survey data. Its purpose is to make recommendations the hospital should implement in the next four to eight weeks.
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Analysis
Negative Comments for all Ten Categories
After plotting the Pareto chart, it was clear that 80% of all negative comments were about the room and visitors and family. For instance, the patients complained that sharing a room with another patient made them uncomfortable, especially with regard to privacy concerns and solitude. Furthermore, sharing was complicated by unclean bathrooms. The nurses who would take and return patients for special services, like dialysis, made a lot of noise.
On the other hand, the patients required privacy and solitude when recovery. However, the visitors were very noisy, especially in shared rooms. Given that the roommates were strangers, there was little consideration to the welfare of the others. Furthermore, the rooms were too small, with no chairs or space to physically or mentally stretch out. According to Foye (2017) and Hu & Coulter (2017), living in small spaces has negative effects on an individual's mental health. These are the items that need immediate attention. The chart below visualizes the results of data analysis with regards to all negative comments.
Figure 1 . Negative comments Pareto chart
Three interventions are recommended. First, the hospital should train its staff to be sensitive to patient concerns, especially with noise levels. Secondly, the hospital should institute rules that will limit the amount of noise in the facility, especially from visitors and family. Before going in to see a patient, every visitor should be reminded of the rules, including the consequences of breaking them. Lastly, the hospitals should add chairs in the rooms so that the recuperating patients can choose the most comfortable means of rest.
Positive Comments for All Ten Categories
Figure 2 below visualizes the positive comments that the patients provided in the survey. It is clear that most of the patient satisfaction was from the meals and nurses.
Figure 2 . Positive comments from survey data
The results of positive comments inform on two approaches that could be used to boost patient satisfaction. First, patient satisfaction could be boosted by improving the areas where the patients commented positively. For instance, apart from preparing delicious meals, the hospital could train the ordering and delivery personnel to be very polite and helpful in making healthy meal suggestions for the patients. Furthermore, satisfaction can be improved if apart from meeting the dietary needs of the patients, they could be allowed a variety of meals to choose from. Giving the patients a choice in what they like to have is also beneficial because it opens the avenue for patient education about the importance of dietary changes. For patients with chronic conditions requiring lifestyle and behavioural changes, the dietary choice is an excellent education tool.
Secondly, patient satisfaction can be improved by shoring up on some of the weaknesses pointed out by the survey. Though no large changes should be made, the following improvements are necessary as they need immediate attention. First, patient complaints (negative comments) about physicians, personal issues, and admission should be addressed immediately. Secondly, visitors and family interventions were addressed in the previous section. However, the hospital needs to address the issues related to discharge as it received the least positive comments next to visitors and family. For instance, potential issues to resolve would be to make the discharge process as efficient as possible, take as little time as possible, and understand patient attitudes at discharge. Most of these issues are solvable in two steps. In the first step, the discharge process should be started at least 24 hours before the patient is released. The result would be that the patients would not have to wait for extended periods. The second step is communicating with the patient, especially about the discharge process, what to expect, and how long it would take. Additionally, the patient should be updated on the process regularly to they feel a sense of progress.
Negative Patient Comments, Affinity Diagram, and Interpretation
The figure below is an affinity diagram of the most serious negative patient comments that require immediate attention. The affinity diagram was used to create the Pareto chart in figure 4.
Figure 3 . Affinity diagram of patient comments
Figure 4 . Negative comments about the room derived from the affinity diagram
From figure 4 above, it is clear that negative comments about the room need immediate attention if patient satisfaction is to be improved. It is also clear that noise, untidy rooms and bathrooms, and uncomfortable conditions are the biggest contributors to the negative comments. Several actions are recommended. First, hospital hygiene should be improved. The cleaning staff should be investigated to discover the root cause of their laxity or dereliction of duty. Once solved, improved hygiene will even impact negative comments on dirty beddings. Secondly, patient levels of comfort with regards to noise should be observed. For instance, visitors and families should keep their interactions as quiet as possible, especially in shared rooms. Nurses and other staff should also be retrained on patient service, especially how to perform their duties with minimum disturbance to patient comfort. Lastly, the rooms should be made as comfortable as possible. While it is impossible to increase the room sizes in the short-term, other interventions can be taken. For instance, painting the rooms in bright colours and proper lighting design would improve patient moods. Furthermore, installing reflective surfaces, like mirrors, would improve room conditions. Similar to how they are used in cramped spaces like elevators, reflective surfaces provide the illusion of a larger space, thus minimizing the complaints on room size (Giancoli, 2016; Böhme, 2017) . These strategies need to be implemented immediately.
Conclusion
In summary, this paper set out to analyze the data from patient satisfaction surveys and recommend actions that need to be taken in the near term (four to eight weeks). Several recommendations were made along with four major areas. To improve patient satisfaction, the hospital would have to reduce noise, improve hospital and room hygiene, patient comfort, and factors contributed to by nurses. For instance, in the newly proposed discharge plan, the nurses would not only have to start the discharge process early (at least 24 hours) and keep updating the patient on the progress. Other patient complaints, like room size, cannot be fixed in the near term. However, proper room lighting and installing reflective surfaces would solve the problem.
References
Böhme, G. (2017). Atmospheric architectures: The aesthetics of felt spaces . Bloomsbury Publishing.
Foye, C. (2017). The relationship between size of living space and subjective well-being. Journal of Happiness Studies , 18 (2), 427-461.
Giancoli, D. C. (2016). Physics: principles with applications . Boston: Pearson,.
Hu, Y., & Coulter, R. (2017). Living space and psychological well-being in urban China: Differentiated relationships across socio-economic gradients. Environment and Planning A , 49 (4), 911-929.
Thornton, R. D., Nurse, N., Snavely, L., Hackett-Zahler, S., Frank, K., & DiTomasso, R. A. (2017). Influences on patient satisfaction in healthcare centers: a semi-quantitative study over 5 years. BMC health services research , 17 (1), 361.
Xesfingi, S., & Vozikis, A. (2016). Patient satisfaction with the healthcare system: assessing the impact of socio-economic and healthcare provision factors. BMC health services research , 16 (1), 1-7.
