Patient Satisfaction in the Preoperative Period, Preparing for Hand Surgery
William R Smith, MD1; Jeffrey Wera, MD1; Robert Takei, MD2; Greg Gallant, MD2; Fred Liss, MD2; Pedro Beredjiklian, MD2; Moody Kwok, MD2
1Temple University Hospital, Philadelphia, PA; 2Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA
Background: Within an outcomes-based healthcare environment patient satisfaction is used as a quality of care measure and is often publically available and incentivized by practices. Few reports focus on the potential impact of the preoperative period in overall satisfaction rates following elective surgical procedures, specifically the scheduling and medical clearance process.
Methods: Questionnaires investigating patient satisfaction with the surgical scheduling process were prospectively collected for 200 consecutive patients prior to elective hand surgery. The number of telephone, surgeon and medical office encounters were recorded, and a satisfaction level was determined for each encounter type based on a 5 point scale. Demographic data including age, sex, occupation, and the patient's perception of their health status were recorded. All patients over the age of 18 years old were included regardless of procedure, and only patients failing to complete the entire questionnaire were excluded. Outcome data was assessed for associations between different encounter types and satisfaction rates.
Results: Among 200 patients presenting for elective hand surgery, 197 completed the entire questionnaire and were included. Mean patient age was 57.9 years and 56.3% of the population was female. 86% of cases occurred at outpatient surgical centers, with the most common surgical procedure being carpal tunnel release (47.2%). Overall satisfaction with the scheduling process was 92.9% (extremely or somewhat satisfied), with only 3% of patients dissatisfied. There was a statistically significant association between patient satisfaction and the number of telephone and total encounters (combined telephone, surgeon, and medical). Patient satisfaction fell below 90% after 4 or more telephone calls (66.6% satisfaction, p = 0.005) and 5 or more total encounters (80% satisfaction, p = 0.008). There was no statistically significant association between patient satisfaction and the number of medical clearance encounters (p = 0.087) or perceived health status (p = 0.14).
Conclusion: Patient satisfaction with the elective hand surgery scheduling process is high (92.9%). Greater than 3 telephone calls from office staff or 4 total encounters (regardless of type) in the preoperative period significantly decrease patient satisfaction prior to their surgical procedure. This may negatively effect overall patient satisfaction postoperatively, highlighting the importance of efficient communication between surgeons, office staff, and medical clearance providers. Satisfaction rates are not associated with a patient's perception of their own health or whether a surgeon requests medical clearance visits prior to elective procedures.
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