By Karen Sandrick
Source: October 2007 issue of Trustee Magazine

Clinical quality is obviously important to hospitalized patients. However, its construct and many specific quality indicators are difficult for patients to fathom.

Clinical quality also is often measured in terms of outcomes after patients have been discharged. Quality metrics, therefore, do not directly reflect patients’ actual experiences while they were hospitalized.

“Generally speaking, consumers are not able to distinguish quality in health care. That’s not to say they aren’t interested in quality. It’s to say that they often can’t differentiate good from bad quality. If they go in for treatment and there is no significant adverse outcome, they may perceive that they had a good clinical experience, when, in fact, they didn’t,” says Kent Jackson, director of children’s specialty services and behavior health at St. Luke’s Hospital, Cedar Rapids, Iowa.

Patients tend to be equally, if not more, concerned about the personal aspects of health care—how courteously and compassionately they were treated, how well they were instructed about what was happening to them, how quickly their concerns were addressed—and they value the opinions of other patients.

“There’s a saying you hear among highly technical clinicians who are apt to believe their job as a clinician is all that counts: ‘I’m here to save butts, not to kiss them.’ That’s a myth. What counts just as much is how patients and their families are treated, because ultimately their perception of their experience will decide whether they will want to come back or refer their friends and families,” Jackson says.

There are significant positive correlations between clinical quality and patient satisfaction, so a hospital providing high-quality care generally performs well in both areas. Patients usually have an easier time interpreting patient satisfaction data over quality data, says Deirdre Mylod, Ph.D., vice president of public policy for Press Ganey Associates, South Bend, Ind.

“When [prospective] patients see the percentage of [former] patients with a heart attack who got a beta blocker in a specific amount of time, they don’t always understand what that means and how it is linked with quality. Whereas the percentage of people who are likely to recommend a hospital is much more understandable,” Mylod says.

Vendors who conduct patient satisfaction surveys do not randomly select their clients, and none have more than a thousand hospitals as clients. Their databases are therefore suspect in terms of the degree to which they represent all hospitals in the United States, says Michael Everett, CEO of Avatar International, which conducts patient, employee and physician surveys.

The federal government’s new health care data collection and release initiative—Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)—is the first time data gathered from patients will be benchmarked.