Background: The need to improve patient satisfaction (or patient experience) is increasing dramatically. Patient satisfaction is not only a direct indicator of quality of care but it is also an important component of pay for performance metrics.
We started a standardized process of admitting patients by developing dedicated admission teams called Patient Centered Admission Teams (P-CAT). The main objective of this retrospective study was to analyze the effect of standardized admission process using P-CAT on patient satisfaction.
Methods: Each dedicated admission team called Patient Centered Admission Team (P-CAT) includes a physician (hospitalist), a clinical pharmacist, two nurses, one patient care technician, and a scribe. The teams are provided work space near the emergency room, from where most patients get admitted. After being notified of admission, team sees the patient quickly to reduce the waiting period. P-CAT team followed a standardized admission process starting with properly introducing themselves to the patient. Physician completes history taking and physical exam at bedside. Scribes are trained to enter history and exam findings in electronic health record at bedside itself as physician keeps on explaining findings to patient. Physician then comes back to workspace where he /she works on ordersstarts working on completing orders. In the meantime, clinical pharmacist gets details from patient and his/her pharmacy/primary care doctor/pill bottles/family to complete medication reconciliation. Once the orders are finalized by physician, pharmacist reviews all medication orders with the goal of preventing medication errors and reducing medication costs. On-site availability of clinical pharmacist helps patients understand their medications better. Nurses and patient care technician draw all labs and administer medication. Dedicated time for counseling and answering questions from patient and family is an integral part of this standardized admission process.
Data was gathered from HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey. Out of all received surveys from hospital patients discharged between 01/01/2013 to 09/08/2015, surveys for patients admitted by hospitalist group were filtered out. These were then grouped on the basis of whether patient was admitted by P-CAT or non-PCAT team of hospitalist group. HCAHPS survey question “rate hospital 0-10” in global rating was then analyzed in the both the groups. Only response where patients gave a score of 9-10 was considered “positive outcome”. All other scores ranging from zero to 8 were considered “negative outcome”. From the gathered data, 2 X 2 contingency table was made, Fisher’s exact test was applied and p value was calculated. P value was considered significant for value less than 0.05
Results: Retrospective data analysis showed that 309 patients in P-CAT group and 822 patients in non-non-P-CAT group returned the HCAHPS survey and rated the hospital on scale of 0-10. 215 patients (69.6%) in P-CAT group and 541 patients (65.8%) in non-PCAT group gave the score of 9-10 when rating the hospital (p value 0.26).
Conclusions: Initial data shows increase in patient satisfaction by standardized admission process using multidisciplinary patient centered admission team (P-CAT). More data is required to establish statistical significance of the improvement.