We want to know: patient comfort speaking up about breakdowns in care and patient experience.
We want to know: patient comfort speaking up about breakdowns in care and patient experience.
- 2019
CONCLUSIONS: Patients frequently experience problems in care during hospitalisation and many do not feel comfortable speaking up. Creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience. Such efforts should consider the impact of health literacy and mental health on patient engagement in patient-safety activities. Copyright (c) Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ. DESIGN: Cross-sectional study. MAIN OUTCOME MEASURES: Response to the question 'How often did you feel comfortable speaking up if you had any problems in your care?' grouped as: (1) no problems during hospitalisation, (2) always felt comfortable speaking up and (3) usually/sometimes/never felt comfortable speaking up. OBJECTIVE: To assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up. PARTICIPANTS: Patients hospitalised at one of eight hospitals who completed the Hospital Consumer Assessment of Healthcare Providers and Systems survey postdischarge. RESULTS: Of 10 212 patients who provided valid responses, 4958 (48.6%) indicated they had experienced a problem during hospitalisation. Of these, 1514 (30.5%) did not always feel comfortable speaking up. Predictors of having a problem during hospitalisation included age, health status and education level. Patients who were older, reported worse overall and mental health, were admitted via the Emergency Department and did not speak English at home were less likely to always feel comfortable speaking up. Patients who were not always comfortable speaking up provided lower ratings of nurse communication (47.8 vs 80.4; p<0.01), physician communication (57.2 vs 82.6; p<0.01) and overall hospital ratings (7.1 vs 8.7; p<0.01). They were significantly less likely to definitely recommend the hospital (36.7% vs 71.7 %; p<0.01) than patients who were always comfortable speaking up. SETTING: Eight hospitals in Maryland and Washington, District of Columbia.
English
2044-5415
*Patient Comfort
*Patient Satisfaction
*Quality of Health Care
Adult
Aged
Communication
Cross-Sectional Studies
District of Columbia
Female
Health Care Surveys
Hospitals
Humans
Male
Maryland
Middle Aged
Patient Safety
Retrospective Studies
MedStar Health
MedStar Health Research Institute
Market Research
Journal Article
CONCLUSIONS: Patients frequently experience problems in care during hospitalisation and many do not feel comfortable speaking up. Creating conditions for patients to be comfortable speaking up may result in service recovery opportunities and improved patient experience. Such efforts should consider the impact of health literacy and mental health on patient engagement in patient-safety activities. Copyright (c) Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ. DESIGN: Cross-sectional study. MAIN OUTCOME MEASURES: Response to the question 'How often did you feel comfortable speaking up if you had any problems in your care?' grouped as: (1) no problems during hospitalisation, (2) always felt comfortable speaking up and (3) usually/sometimes/never felt comfortable speaking up. OBJECTIVE: To assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up. PARTICIPANTS: Patients hospitalised at one of eight hospitals who completed the Hospital Consumer Assessment of Healthcare Providers and Systems survey postdischarge. RESULTS: Of 10 212 patients who provided valid responses, 4958 (48.6%) indicated they had experienced a problem during hospitalisation. Of these, 1514 (30.5%) did not always feel comfortable speaking up. Predictors of having a problem during hospitalisation included age, health status and education level. Patients who were older, reported worse overall and mental health, were admitted via the Emergency Department and did not speak English at home were less likely to always feel comfortable speaking up. Patients who were not always comfortable speaking up provided lower ratings of nurse communication (47.8 vs 80.4; p<0.01), physician communication (57.2 vs 82.6; p<0.01) and overall hospital ratings (7.1 vs 8.7; p<0.01). They were significantly less likely to definitely recommend the hospital (36.7% vs 71.7 %; p<0.01) than patients who were always comfortable speaking up. SETTING: Eight hospitals in Maryland and Washington, District of Columbia.
English
2044-5415
*Patient Comfort
*Patient Satisfaction
*Quality of Health Care
Adult
Aged
Communication
Cross-Sectional Studies
District of Columbia
Female
Health Care Surveys
Hospitals
Humans
Male
Maryland
Middle Aged
Patient Safety
Retrospective Studies
MedStar Health
MedStar Health Research Institute
Market Research
Journal Article