ED opioid prescribing is not associated with higher patient satisfaction scores

2016 ◽  
Vol 34 (10) ◽  
pp. 2032-2034 ◽  
Author(s):  
Howard S. Kim ◽  
Patrick M. Lank ◽  
Peter S. Pang ◽  
D. Mark Courtney ◽  
Bruce L. Lambert ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Opioid Prescribing ◽  
Patient Satisfaction Scores

scholarly journals 3038 Examining the association between inpatient opioid prescribing and patient satisfaction.

2019 ◽  
Vol 3 (s1) ◽  
pp. 121-122
Author(s):  
Olena Mazurenko ◽  
Justin Blackburn ◽  
Matthew Bair ◽  
Areeba Kara ◽  
Christopher A. Harle
Keyword(s):  
Patient Satisfaction ◽  
Hospital Stay ◽  
Healthcare System ◽  
Prescribing Practices ◽  
Patient Centered ◽  
Opioid Prescribing ◽  
Patient Satisfaction Scores ◽  
Centered Care ◽  
Willingness To Recommend ◽  
Pain Care

OBJECTIVES/SPECIFIC AIMS: Research overview: Providing patient-centered care is increasingly a top priority in the U.S. healthcare system.1,2 Hospitals are required to publicly report patient-centered assessments, including results from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction surveys.3 Furthermore, clinician and hospital reimbursements are partially determined by performance on patient satisfaction measures.3 Consequently, hospitals and clinicians may be incentivized to improve patient satisfaction scores over other important outcomes.4 Paradoxically then, the pursuit of patient-centered care may lead clinicians to fulfill patient requests for unnecessary and potentially harmful treatments.5 Opioid prescribing during hospitalizations may be particularly affected by clinicians’ seeking to optimize patient satisfaction scores.6,7 Satisfaction with pain care is an important predictor of overall patient satisfaction in the HCAHPS surveys,8,9 and clinicians report increased pressure to fulfill patient requests for immediate pain-relief.10,11 Therefore, clinicians may prescribe opioids to avoid receiving lower patient satisfaction scores.12,13 Furthermore, clinicians lack clear guidance on opioid prescribing for some populations, including non-surgical inpatients, who represent almost half of all hospitalizations.14 To reduce clinicians’ incentive to prescribe opioids as a means of achieving patient satisfaction, the Center for Medicare and Medicaid Services (CMS) temporarily removed questions related to patient satisfaction with pain care from the clinician and hospital reimbursement formulas beginning in 2018.15 Importantly, prior research16-20 has not rigorously tested the hypothesis implied by the CMS policy change: that certain opioid prescribing practices in inpatient pain care are associated with higher patient satisfaction. Objectives: The purpose of this study was to evaluate the association between the receipt/dose of opioids during non-surgical hospitalizations and patient satisfaction measured by the HCAHPS survey. METHODS/STUDY POPULATION: Methods/Study Population: We conducted a pooled cross-sectional study of adults (18 and older) with non-surgical hospitalizations within the 11-hospital healthcare system in a Midwestern state from 2011-2016. Data were extracted from electronic health records and linked to HCAHPS patient satisfaction surveys. We estimated the propensity score for receipt of any opioids during hospitalization and separately the receipt of high dose opioids (≥100 morphine milligram equivalent [MME]) based on patient, encounter, and facility characteristics for all hospitalizations with complete data. We used nearest neighbor matching to construct two matched samples to minimize selection bias and confounding by indication. We used a standardized difference threshold of < 0.1 as an indication of the balance between matched groups. Outcomes were compared with a test on the equality of proportions using large-sample statistics. All analysis was performed in STATA 14.0 analytical software. Main outcomes: We analyzed four dependent variables. Two pain-specific patient satisfaction variables were derived from the responses to the following survey questions: 1) “During this hospital stay, how often your pain was well controlled? (pain control)” and 2) “During this hospital stay, how often did the hospital staff do everything they could to help you with your pain? (pain help)”, with 4-point Likert scale responses ranging from “Never” to “Always.” We also used two global satisfaction measures derived from the responses to the following survey questions: 1) “Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay (overall patient satisfaction)?” and 2) “Would you recommend this hospital to your friends and family (willingness to recommend a hospital)? (4-point scale of “Definitely Yes” to “Definitely No”). Because the responses are not normally distributed, and the response options are truncated, we dichotomized each of these questions following previously published approaches8 and CMS methodology3 (e.g. “always” vs. all other responses or “9 or 10 rating” vs. all others). RESULTS/ANTICIPATED RESULTS: Results: Among 17,691 patients who reported that they needed pain medications during hospitalization in their HCAHPS survey, 43.7% (n=7,735) received opioids. Among the matched sample (n=8,848), 55% were female, 90% were white, 9% were black, 74% were emergency admissions, 29% had a circulatory diagnosis, 92% were discharged home, and the average pain score ranged from 0.2 to 7.1 during the hospital stay. Compared to matched patients hospitalized but did not receiving opioids, those who received opioids did not significantly differ in their rating of pain help (75% of patients without opioids rated that they always received help for their pain versus 75% of patients with opioids; p=.78), pain control (55% of patients without opioids reported that their pain was well controlled versus 54% on opioids; p=.93), willingness to recommend the hospital (69% of patients without opioids reported that they would definitely recommend a hospital versus 71% with opioids; p=.16) and overall rating of their care (47% of patients without opioids rated their hospitalization as 10 versus 46% on opioids; p=.22). DISCUSSION/SIGNIFICANCE OF IMPACT: Discussion: We found no evidence that receipt of opioids is associated with patient satisfaction, including at doses. To our knowledge, this is the first study that used propensity score matching to examine the association between inpatient opioid prescribing practices and patient satisfaction. Furthermore, our sample is unique in the inclusion of patients hospitalized for non-surgical indicators over a five year period in the multi-hospital healthcare system in a Midwestern state. Our findings add to the existing literature which has shown contradictory associations between opioid prescribing and patient satisfaction.16-22 Specifically, few studies that looked at surgical inpatients showed a lack of association between patient satisfaction16,18 and opioid prescribing, whereas others showed that receipt of opioids was associated with lower patient satisfaction.17-20 Our findings may imply that satisfaction with pain care may be achieved without administering opioids to non-surgical inpatients. Alternatively, satisfaction with pain care may not be influenced by opioid prescribing for non-surgical inpatients. Future research should further examine the association between opioid prescribing and patient satisfaction among non-surgical inpatients on a national scale to get a better understanding of the relationship between certain pain care practices and patient satisfaction.

scholarly journals Institutional Reductions in Opioid Prescribing Following Hip Arthroscopy Do Not Change Patient Satisfaction Scores

2021 ◽  
Vol 3 (2) ◽  
pp. e463-e469
Author(s):  
David A. Bloom ◽  
Amit K. Manjunath ◽  
Charles Wang ◽  
Alexander J. Egol ◽  
Robert J. Meislin ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hip Arthroscopy ◽  
Opioid Prescribing ◽  
Patient Satisfaction Scores

scholarly journals Development of a combined paediatric emergency department and observation unit

2020 ◽  
Vol 9 (1) ◽  
pp. e000688
Author(s):  
Czer Anthoney Enriquez Lim ◽  
Julie Oh ◽  
Erick Eiting ◽  
Catherine Coughlin ◽  
Yvette Calderon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Patient Satisfaction ◽  
Patient Outcomes ◽  
Close Monitoring ◽  
Observation Unit ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Patient Satisfaction Scores ◽  
Conversion Rates

BackgroundRecent trends towards more cost-efficient and patient-centred treatment are converging to provide opportunities to improve the care of children. Observation units are hospital areas dedicated to the ongoing evaluation and management of patients for a brief period of time for well-defined conditions. We describe the implementation of a paediatric observation unit (POU) adjacent to a paediatric emergency department (PED) in an urban, academic, community hospital.MethodsStaffing models were designed to provide paediatric services to patients in both the PED and POU. Admission criteria, workflow and transfer guidelines were developed. Quality improvement initiatives were undertaken and evaluated. Unit throughput, patient outcomes and patient satisfaction data were collected and analysed.ResultsOver a 2-year period, there were 24 038 patient visits to the PED. Of these, 1215 (5.1%) patients required admission. Seven hundred and seventy-seven (64.0%) of these children were admitted to the POU. One hundred and nineteen (15.3%) of these patients were subsequently converted to inpatient hospitalisation. The average length of stay (LOS) was 25.7 hours in 2017 and 26.5 hours in 2018. Ten patients returned to the PED within 72 hours of discharge from the POU and four were readmitted. Patient satisfaction scores regarding ‘likelihood to recommend’ improved from the 36th to the 92nd percentile rank over a 1-year period. Close monitoring of patient outcomes allowed for the adjustment of admission guidelines, increased unit census and optimised utilisation.ConclusionA combined PED-POU has been successful at our institution in meeting benchmark goals set for LOS and conversion rates. In addition, quality improvement interventions increased patient census and improved patient satisfaction scores while reducing the inpatient burden on the referring children’s hospital.

Patient Satisfaction After Total Hip Arthroplasty Is Not Influenced by Reductions in Opioid Prescribing

2021 ◽  
Author(s):  
David A. Bloom ◽  
Amit K. Manjunath ◽  
Anthony P. Gualtieri ◽  
Jordan W. Fried ◽  
Ran M. Schwarzkopf ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Opioid Prescribing

scholarly journals Patient Satisfaction Scores and Their Relationship to Hospital Website Quality Measures

2013 ◽  
Vol 30 (4) ◽  
pp. 334-348 ◽  
Author(s):  
Eric W. Ford ◽  
Timothy R. Huerta ◽  
Mark L. Diana ◽  
Abby Swanson Kazley ◽  
Nir Menachemi
Keyword(s):  
Patient Satisfaction ◽  
Quality Measures ◽  
Website Quality ◽  
Patient Satisfaction Scores

The effect of periodic monitoring and feedback on screening colonoscopy withdrawal times, polyp detection rates, and patient satisfaction scores

2010 ◽  
Vol 71 (7) ◽  
pp. 1253-1259 ◽  
Author(s):  
Otto S. Lin ◽  
Richard A. Kozarek ◽  
Andrew Arai ◽  
Michael Gluck ◽  
Geoffrey C. Jiranek ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Screening Colonoscopy ◽  
Polyp Detection ◽  
Detection Rates ◽  
Patient Satisfaction Scores ◽  
Periodic Monitoring

Factors impacting Press Ganey patient satisfaction scores in orthopedic surgery spine clinic

2016 ◽  
Vol 16 (11) ◽  
pp. 1285-1289 ◽  
Author(s):  
Brian E. Etier ◽  
Scott P. Orr ◽  
Jonathan Antonetti ◽  
Scott B. Thomas ◽  
Steven M. Theiss
Keyword(s):  
Patient Satisfaction ◽  
Orthopedic Surgery ◽  
Patient Satisfaction Scores
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