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Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study.
BMJ Open. 2016 07 01; 6(7):e011242.BO

Abstract

OBJECTIVES

There remains concern regarding the use of survey data to assess aspects of healthcare quality. The relationship between patient experience and adverse events as documented by patient safety indicators (PSIs) is a timely research topic. The objectives were to document the association of PSIs and patient experience scores, and to determine risk-adjusted odds of high experience scores versus PSI presence.

SETTING AND PARTICIPANTS

From April 2011 to March 2014, 25 098 patients completed a telephone survey following discharge from 93 inpatient hospitals in Alberta, Canada.

RESEARCH DESIGN

A modified version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was used. Surveys were linked to inpatient records and PSI presence was documented using a validated algorithm.

MEASURES

Three questions about overall hospital, physician and nurse ratings were scored on an 11-point Likert scale from 0 (worst) to 10 (best). Experience was classified as high (9 or 10) versus low (0-8). Demographic/clinical differences between respondents with/without a PSI were assessed. Logistic regression examined the relationship between factors including PSI and experience ratings.

RESULTS

Overall, physician and nurse care was rated high by 61.9%, 73.7% and 66.2% of respondents. 1085 patients (4.3%) had a documented PSI. Most frequent PSIs were haemorrhagic events (n=502; 2.0% of sample), events relating to obstetrics (n=373; 1.5%) and surgical-related events (n=248; 1.0%). Risk-adjusted models showed patients with PSIs had decreased odds of having high overall (OR=0.86; 95% CI 0.75 to 0.97), physician (OR=0.76; 95% CI 0.66 to 0.87) and nurse (OR=0.83; 95% CI 0.73 to 0.94) ratings.

CONCLUSIONS

There is clear evidence that inpatient experience ratings are associated with PSIs, one element of quality of care. Future research, examining individual PSIs and patient experience questions, is warranted, as this may inform targeted quality improvement initiatives.

Authors+Show Affiliations

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Primary Data Support, Analytics (DIMR), Alberta Health Services, Calgary, Alberta, Canada.Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.Primary Data Support, Analytics (DIMR), Alberta Health Services, Calgary, Alberta, Canada.Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27371554

Citation

Kemp, Kyle A., et al. "Association of Inpatient Hospital Experience With Patient Safety Indicators: a Cross-sectional, Canadian Study." BMJ Open, vol. 6, no. 7, 2016, pp. e011242.
Kemp KA, Santana MJ, Southern DA, et al. Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study. BMJ Open. 2016;6(7):e011242.
Kemp, K. A., Santana, M. J., Southern, D. A., McCormack, B., & Quan, H. (2016). Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study. BMJ Open, 6(7), e011242. https://doi.org/10.1136/bmjopen-2016-011242
Kemp KA, et al. Association of Inpatient Hospital Experience With Patient Safety Indicators: a Cross-sectional, Canadian Study. BMJ Open. 2016 07 1;6(7):e011242. PubMed PMID: 27371554.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study. AU - Kemp,Kyle A, AU - Santana,Maria J, AU - Southern,Danielle A, AU - McCormack,Brandi, AU - Quan,Hude, Y1 - 2016/07/01/ PY - 2016/7/3/entrez PY - 2016/7/3/pubmed PY - 2017/12/5/medline KW - Acute care KW - HCAHPS KW - Patient experience KW - Patient safety SP - e011242 EP - e011242 JF - BMJ open JO - BMJ Open VL - 6 IS - 7 N2 - OBJECTIVES: There remains concern regarding the use of survey data to assess aspects of healthcare quality. The relationship between patient experience and adverse events as documented by patient safety indicators (PSIs) is a timely research topic. The objectives were to document the association of PSIs and patient experience scores, and to determine risk-adjusted odds of high experience scores versus PSI presence. SETTING AND PARTICIPANTS: From April 2011 to March 2014, 25 098 patients completed a telephone survey following discharge from 93 inpatient hospitals in Alberta, Canada. RESEARCH DESIGN: A modified version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was used. Surveys were linked to inpatient records and PSI presence was documented using a validated algorithm. MEASURES: Three questions about overall hospital, physician and nurse ratings were scored on an 11-point Likert scale from 0 (worst) to 10 (best). Experience was classified as high (9 or 10) versus low (0-8). Demographic/clinical differences between respondents with/without a PSI were assessed. Logistic regression examined the relationship between factors including PSI and experience ratings. RESULTS: Overall, physician and nurse care was rated high by 61.9%, 73.7% and 66.2% of respondents. 1085 patients (4.3%) had a documented PSI. Most frequent PSIs were haemorrhagic events (n=502; 2.0% of sample), events relating to obstetrics (n=373; 1.5%) and surgical-related events (n=248; 1.0%). Risk-adjusted models showed patients with PSIs had decreased odds of having high overall (OR=0.86; 95% CI 0.75 to 0.97), physician (OR=0.76; 95% CI 0.66 to 0.87) and nurse (OR=0.83; 95% CI 0.73 to 0.94) ratings. CONCLUSIONS: There is clear evidence that inpatient experience ratings are associated with PSIs, one element of quality of care. Future research, examining individual PSIs and patient experience questions, is warranted, as this may inform targeted quality improvement initiatives. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/27371554/Association_of_inpatient_hospital_experience_with_patient_safety_indicators:_a_cross_sectional_Canadian_study_ L2 - http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=27371554 DB - PRIME DP - Unbound Medicine ER -