Humble C, Meterko M, Gilman SC, Graber M, Aron DC, Zeiss A; AcademyHealth. Meeting (2003 : Nashville, Tenn.).
Abstr AcademyHealth Meet. 2003; 20: abstract no. 742.
Dept of Veterans Affairs, Performance Analysis Center for Excellence, 615 Davis Drive, Ste 800, Morrisville, NC 27560 Tel. (919) 993-3035 x224 Fax (919) 993-3053
RESEARCH OBJECTIVE: How patients perceive the quality of their medical care has become an important measure of overall quality. The purpose of our study was to compare both inpatient and outpatient perceptions of their medical care with the perceptions of medical residents of their training at the same Department of Veterans Affairs healthcare centers. STUDY DESIGN: Trainee satisfaction with training and aspects of patient care was measured in the 2001 Learners Perception Survey. Trainees answered specific questions in 4 domains: Faculty; and Work, Learning, and Physical Environment. In the same year, patient satisfaction (i.e., overall rating of the quality of their healthcare) was assessed via the VA's annual system wide patient survey. Group level comparisons between patient and trainee satisfaction were limited to the 83 VA medical centers with at least 5 trainee responses. Bonferoni adjustment for multiple comparisons was used to screen out marginal associations in the initial correlations. Associations of specific drivers for significant overall correlates with patient satisfaction were assessed via bivariate correlation and multiple regression modeling. POPULATION STUDIED: Surveys were sent to 3269 physician trainees and data from the 1702 respondents (52%) were analyzed. Patient surveys were sent to stratified random samples of 10,816 discharged inpatients (57% response) and 77,917 outpatients (74% response). PRINCIPAL FINDINGS: Both outpatient satisfaction and inpatient satisfaction were significantly correlated (i.e., at p < 0.01) with residents' overall ratings of the Learning Environment. Neither outpatient nor inpatient satisfaction was associated with trainees' overall satisfaction with the domains of Faculty, Work Environment or the Physical Environments for their VA training. Outpatient satisfaction was also correlated with the numeric score residents gave their current VA training experience. Thirteen factors were identified as key aspects of the Learning Environment during the piloting of the trainee survey. In descending order of significance, the seven factors correlated at p < 0.10 with outpatient satisfaction with care were trainee satisfaction with quality of care, amount of scut work, culture of patient safety, time working with patients, degree of supervision, teaching conferences, and interdisciplinary approach. When these 7 factors were included in an ordinary least squares model, only trainee satisfaction with quality of care remained a significant predictor (p = 0.017) of outpatient satisfaction. Four of the 13 factors were associated with inpatient satisfaction: degree of supervision, quality of care, amount of scut work and culture of patient safety. When these 4 terms were included in a regression model, only trainee satisfaction with degree of supervision had even a marginally significant association (p= 0.0509) with patient satisfaction with care. CONCLUSIONS: Centers where outpatients rate the quality of care more highly also have greater satisfaction with training among residents. Also, there is commonality in how both patients and medical trainees perceive the overall quality of medical care. This tends to validate the use of satisfaction surveys as a measurement of quality. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The observed associations suggest that common factors contribute to both patient and trainee satisfaction, and that emphasis on quality of patient care may enhance the educational mission.
Publication Types:
Keywords:
- Data Collection
- Delivery of Health Care
- Education, Medical, Graduate
- Hospitals, Veterans
- Humans
- Internship and Residency
- Patient Satisfaction
- Personal Satisfaction
- Research
- Research Design
- Teaching
- Veterans
- education
- hsrmtgs
Other ID:
UI: 102275710
From Meeting Abstracts