Typically, outpatient surgery is the most highly rated healthcare service area when it comes to patient satisfaction. According to Gallup's aggregated healthcare database, more than 7 in 10 outpatient surgery patients report they are "very satisfied" with their experiences, and this high level of satisfaction has been fairly consistent over the last four years. So it's troubling that outpatient surgery was the only one of the four hospital departments for which Gallup tracks satisfaction (inpatient, outpatient, outpatient surgery, and outpatient test and treatment) to experience a decline in mean satisfaction in the 2004 database. The decline was small (a mean score drop of -.01), but it's enough to raise an early warning flag after three years of steady performance.
What caused this decline in satisfaction among outpatient surgery patients? Between 2003 and 2004, two of the core items Gallup uses to measure outpatient surgery satisfaction dropped more than the .01 mean score decline. These two items, each of which dropped by .02, are:
- satisfaction with the staff making you feel safe and secure
- satisfaction with the concern shown by the staff
Staff Making You Feel Safe and Secure
The 2004 decline on the safety and security item brings it below its 2001 level -- the first year Gallup began keeping an annually updated database. Safety and security has been an area of emphasis in most healthcare organizations since a 1999 Institute of Medicine (IOM) report showed medical errors are rampant in the U.S. healthcare system. So why are scores on this item decreasing rather than increasing?
One possible explanation is patients have become more sensitive to the potential for medical errors in recent years, because of the extensive publicity generated by the IOM report. Also, many hospitals and physician groups are beginning to establish off-campus ambulatory surgery facilities, separate from hospitals; some patients may feel less secure about having outpatient surgery performed in these smaller facilities. Or the explanation may be simpler, that outpatient surgery staff members simply aren't doing enough to quell patients' anxieties about their surgeries.
Concern Shown by the Staff
The decline on the "concern shown by staff" item reinforces the idea that outpatient surgery staff members are not doing enough to make their patients feel comfortable. This past year, we've observed staff members and physicians expressing concerns about reimbursement for outpatient surgery -- and these concerns have been echoed throughout the industry in general. Some physicians were considering establishing their own outpatient surgery facilities, and staff members felt threatened by these potential changes. This insecurity among outpatient surgery staff members could be affecting their performance at work, and patients may be picking up on these signals.
Bottom Line
Outpatient surgery is the flagship area when it comes to patient satisfaction. The decline in the 2004 database, although slight, is a warning because it was driven by perceptions of staff member performance -- the bedrock of patient satisfaction. Healthcare organizations need to address potential problems with the engagement of outpatient surgery employees or more significant declines in outpatient surgery satisfaction could occur in the future.
