Improving Patient Satisfaction Improving Patient Satisfaction

• Sponsor: Vanderbilt University (Other)
• Overall Status: Completed
• CT.gov ID: NCT01263639
• Collaborator: (none)
• Enrollment: 228
• Location: 1
• Arms: 2
• Duration (Months): 12
• Patients Per Site Per Month: 19

Study Details

Study Description

Brief Summary

Objectives: Patient satisfaction is a key determinant of the quality of care and an important component of pay for performance metrics. The purpose of this study was to evaluate the impact of a simple intervention aimed to increase patients' understanding of their orthopaedic trauma surgeon and improve patient satisfaction with the overall quality of inpatient care delivered by the attending surgeon.

Design: Prospective quality improvement initiative using a randomized intervention.

Setting: Level 1 academic trauma center.

Patients/Participants: Two hundred twelve patients were eligible; 100 patients were randomized to the intervention group, and 112 patients were randomized to the control group. Overall, 76 patients could be reached for follow-up satisfaction survey, including 34 patients in the intervention group and 42 patients in the control group.

Intervention: Patients randomized to the intervention group received an attending biosketch card, which included a picture of the attending orthopaedic surgeon with a brief synopsis of his educational background, specialty, surgical interests, and research interests.

Main Outcome Measures: Our primary outcome measure was a patient satisfaction survey assessing patients' rating of the overall quality of inpatient care delivered by the attending surgeon.

Condition or Disease	Intervention/Treatment	Phase
Satisfaction; Trauma	Other: Orthopaedic Attending Biosketch Card; Other: Standard of care - No biosketch card	N/A

Detailed Description

Patient satisfaction is a key determinant of the quality of care and an important component of pay for performance metrics. The Centers for Medicare & Medicaid Services (CMS) Hospital Inpatient Value-Based Purchasing Program implemented value-based incentive payments that link Medicare reimbursements to patient satisfaction and physician surveys completed by patients.1 There is a paucity of data in the orthopaedic literature assessing patient satisfaction, especially regarding patients with orthopaedic trauma. Surprisingly, up to 90% of medical inpatients are unable to correctly name their treating physician when asked to identify the physician in charge of his or her care at the time of discharge.2-4 The orthopaedic trauma patient population is even more challenging due to traumatic injuries warranting inpatient surgery in the acute setting as opposed to elective surgeries or medical admissions. Admissions from the emergency department have been associated with a decreased ability of patients to identify their treating physician. 3 Furthermore, the acuity of these injuries does not always permit patients and surgeons to establish a strong patient-physician relationship before the surgery. Patient-physician communication is integral to improving clinical relationships and improving patient satisfaction.5,6 Surgeons exhibit a tendency to focus on operative quality and outcomes, whereas patients place greater value on the surgeon-patient interaction.7,8 Establishing rapport and a strong patient-physician relationship in the acute trauma setting is challenging but being able to recognize the name and face of the attending orthopaedic surgeon is a critical step in the communication chain. The presence of attending physician photographs in patient rooms has been associated with a significant improvement in the ability to correctly identify the attending physician and is associated with improved patient satisfaction.4,9 The purpose of this prospective quality improvement study was to evaluate the impact of a simple intervention aimed to increase patient recognition of the attending orthopaedic trauma surgeon and improve patient satisfaction with the overall quality of care delivered by the attending surgeon during the inpatient stay. Patients randomized to intervention group received an attending biosketch card, whereas patients randomized to the control group did not receive a card. Our hypothesis was that the patients in the intervention group (received attending biosketch card) would have higher patient satisfaction scores regarding the overall care provided by his or her attending orthopaedic trauma surgeon.

Study Design

• Study Type: Interventional
• Actual Enrollment: 228 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Triple (Participant, Investigator, Outcomes Assessor)
• Official Title: Improving Patient Satisfaction in the Orthopaedic Trauma Population
• Study Start Date: Jan 1, 2011
• Actual Primary Completion Date: Dec 1, 2011
• Actual Study Completion Date: Jan 1, 2012

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention Group, biosketch card The investigators aim to improve the patient-physician relationship and improve patient satisfaction by providing a biosketch card of the attending orthopaedic trauma surgeon to the patient. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.	Other: Orthopaedic Attending Biosketch Card; The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.
Active Comparator: Control group, standard care The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The control group will receive the usual/standard care as provided to all orthopaedic trauma admission patients without receiving a biosketch card.	Other: Standard of care - No biosketch card; Standard of care

Outcome Measures

Primary Outcome Measures

1. Patient Satisfaction as Measured by Giving an "Excellent" Score on a 5-point Rating [within 2 weeks of discharge and before first clinic appointment]

   Within 2 weeks of discharge from the hospital, but before the patient's first clinic visit, each group will be called by the Professional Resource Group as part of regular quality improvement by the Vanderbilt Medical Center Department of Strategic Development. The patients will be asked a series of questions aimed at determining overall patient satisfaction based on interactions with the attending orthopaedic trauma surgeon.

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Age 18-100 year old patients

• English speaking

• Admitted to the orthopaedic trauma surgery service

• Isolated orthopaedic injury requiring orthopaedic surgery on the same admission

Exclusion Criteria:

• <18 years old

• traumatic brain injury

• Admission greater than 7 days

• patients with prior orthopaedic trauma injuries treated at Vanderbilt University Medical Center (VUMC)

• patients with prior patient patient-physician relationship with orthopaedic trauma attending

• visually impaired patients

• intubated/sedated patients

• intoxicated patients

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Vanderiblt University Medical Center	Nashville	Tennessee	United States	37212

Sponsors and Collaborators

• Vanderbilt University

Investigators

• Principal Investigator: Brent J Morris, MD, Vanderbilt University

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Brent Joseph Morris, Orthopaedic Resident, Vanderbilt University
• ClinicalTrials.gov Identifier: NCT01263639
• Other Study ID Numbers: Patient Satisfaction; Clinical Trial
• First Posted: Dec 21, 2010
• Last Update Posted: Jul 28, 2014
• Last Verified: Jun 1, 2014

• Keywords provided by Brent Joseph Morris, Orthopaedic Resident, Vanderbilt University: patient satisfaction; patient-physician relationship; orthopaedic trauma
• Additional relevant MeSH terms: Wounds and Injuries

Study Results

Participant Flow

Recruitment Details	January 2011 to December 2011. All patients were admitted from the ER to the orthopaedic trauma service and had operative injuries requiring surgery on the same admission.

Arm/Group Title	Intervention Group, Biosketch Card	Control Group, Standard Care
Arm/Group Description	The investigators aim to improve the patient-physician relationship and improve patient satisfaction by providing a biosketch card of the attending orthopaedic trauma surgeon to the patient. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.	The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The control group will receive the usual/standard care as provided to all orthopaedic trauma admission patients without receiving a biosketch card.
Period Title: Overall Study
STARTED	107	121
COMPLETED	34	42
NOT COMPLETED	73	79

Baseline Characteristics

Arm/Group Title	Intervention Group, Biosketch Card	Control Group, Standard Care	Total
Arm/Group Description	The investigators aim to improve the patient-physician relationship and improve patient satisfaction by providing a biosketch card of the attending orthopaedic trauma surgeon to the patient. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.	The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The control group will receive the usual/standard care as provided to all orthopaedic trauma admission patients without receiving a biosketch card.	Total of all reporting groups
Overall Participants	107	121	228
Age (Count of Participants)
<=18 years	6 5.6%	6 5%	12 5.3%
Between 18 and 65 years	80 74.8%	88 72.7%	168 73.7%
>=65 years	21 19.6%	27 22.3%	48 21.1%
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	42.7 (17.3)	41.9 (17.1)	42.3 (15.8)
Sex: Female, Male (Count of Participants)
Female	43 40.2%	52 43%	95 41.7%
Male	64 59.8%	69 57%	133 58.3%
Region of Enrollment (participants) [Number]
United States	107 100%	121 100%	228 100%

Outcome Measures

1. Primary Outcome

Title	Patient Satisfaction as Measured by Giving an "Excellent" Score on a 5-point Rating
Description	Within 2 weeks of discharge from the hospital, but before the patient's first clinic visit, each group will be called by the Professional Resource Group as part of regular quality improvement by the Vanderbilt Medical Center Department of Strategic Development. The patients will be asked a series of questions aimed at determining overall patient satisfaction based on interactions with the attending orthopaedic trauma surgeon.
Time Frame	within 2 weeks of discharge and before first clinic appointment

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention Group, Biosketch Card	Control Group, Standard Care
Arm/Group Description	The investigators aim to improve the patient-physician relationship and improve patient satisfaction by providing a biosketch card of the attending orthopaedic trauma surgeon to the patient. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.	The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The control group will receive the usual/standard care as provided to all orthopaedic trauma admission patients without receiving a biosketch card.
Measure Participants	34	42
Number [participants]	25 23.4%	22 18.2%

Adverse Events

Arm/Group Title	Intervention Group, Biosketch Card		Control Group, Standard Care
Arm/Group Description	The investigators aim to improve the patient-physician relationship and improve patient satisfaction by providing a biosketch card of the attending orthopaedic trauma surgeon to the patient. The biosketch card will include a picture of the attending orthopaedic surgeon with a brief synopsis of his or her: education background, specialty, surgical interests, research interests, and other interests including hobbies.		The "intervention" group will receive an attending photo/biosketch card within 24 hours of admission while the control group will not. The control group will receive the usual/standard care as provided to all orthopaedic trauma admission patients without receiving a biosketch card.
All Cause Mortality
	Intervention Group, Biosketch Card		Control Group, Standard Care
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	/ (NaN)		/ (NaN)
Serious Adverse Events
	Intervention Group, Biosketch Card		Control Group, Standard Care
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/100 (0%)		0/112 (0%)
Other (Not Including Serious) Adverse Events
	Intervention Group, Biosketch Card		Control Group, Standard Care
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/100 (0%)		0/112 (0%)

Limitations/Caveats

No adverse events. Limitations included poor patient follow-up due to poor patient participation with telephone call surveys.

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.