Harvard Researchers Evaluate Patient Satisfaction

Hospitals have long focused on providing adequate treatment, but a study released by the Harvard School of Public Health redirects their attention to keeping patients happy.

Researchers at the School of Public Health analyzed the first set of national data detailing patient satisfaction with hospital care. The findings, which were published in today’s issue of The New England Journal of Medicine, show that despite general satisfaction with patient care, hospitals across the nation are underperforming in a number of basic areas, including mitigating pain and giving clear discharge instructions.

Lead author Ashish K. Jha and his colleagues used data collected from over 2,400 hospitals—roughly 60 percent of the nation’s hospitals—to assess patient satisfaction with hospital experiences.

The survey was conducted by the Hospital Quality Alliance, a national organization that aims to improve the quality of hospital care.

The Harvard researchers focused on six areas of the survey responses including how well doctors and nurses communicate with patients about medication and how attentive they are to a patient’s needs.

The findings suggest that hospitals can and should provide both a high quality of clinical care and a positive experience for patients. Taking a step as simple as hiring more nurses may significantly improve the quality of patient care, Jha said.

“We spend $2.1 trillion on healthcare. That’s obviously an unbelievable amount of money,” Jha said. “But [healthcare providers] don’t value patients’ opinions as much as they should, and this data changes the ball game.”

Although 67 percent of patients were satisfied enough with the care they received to “definitely recommend” their hospital, Jha said the results show that there are many areas in which hospital performance is “still pretty suboptimal.”

According to the study, almost half of the patients said that their pain was not treated adequately in the hospital.

“In 2008, this is pretty disappointing,” Jha said. “We clearly have not prioritized this—we should be at 95 percent.”

Arnold M. Epstein, who is also a professor at the School of Public Health, said that he hopes making the data publicly available will shift the focus at hospitals to improving patients’ experiences during their stay.

Epstein added that the findings show that healthcare providers should be more attentive to patient’s needs. Alleviating pain or maintaining a quiet hospital environment, for example, are important issues doctors and nurses sometimes do not take into consideration, he said.

Although the study only revealed a modest direct relationship between levels of patient satisfaction and the quality of medical care, Jha said that hospitals should not choose one at the expense of the other.

“A lot of people have argued that we may not really focus on patient experiences because we’re trying to focus on getting the patient the right care,” Jha said. “But these two things go hand-in-hand.”

Jha said that he is confident that a hospital’s competitive streak will spur its efforts to beat “that hospital down the street.”

Boston hospitals are ranked sixth in the nation in terms of patient satisfaction, with over 71 percent of patients recommending their hospital.

—Staff Writer June Q. Wu can be reached at junewu@fas.harvard.edu.