Improving patient satisfaction through physician education, feedback, and incentives

Background: Patient satisfaction has been associated with improved outcomes and become a focus of reimbursement.

Objective: Evaluate an intervention to improve patient satisfaction.

Design: Nonrandomized, pre-post study that took place from 2011 to 2012.

Setting: Large tertiary academic medical center.

Participants: Internal medicine (IM) resident physicians, non-IM resident physicians, and adult patients of the resident physicians.

Intervention: IM resident physicians were provided with patient satisfaction education through a conference, real-time individualized patient satisfaction score feedback, monthly recognition, and incentives for high patient-satisfaction scores.

Main measures: Patient satisfaction on physician-related and overall satisfaction questions on the HCAHPS survey. We conducted a difference-in-differences regression analysis comparing IM and non-IM patient responses, adjusting for differences in patient characteristics.

Key results: In our regression analysis, the percentage of patients who responded positively to all 3 physician-related Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions increased by 8.1% in the IM and 1.5% in the control cohorts (absolute difference 6.6%, P = 0.04). The percentage of patients who would definitely recommend this hospital to friends and family increased by 7.1% in the IM and 1.5% in the control cohorts (absolute difference 5.6%, P = 0.02). The national average for the HCAHPS outcomes studied improved by no more than 3.1%.

Limitations: This study was nonrandomized and was conducted at a single site.

Conclusion: To our knowledge, this is the first intervention associated with a significant improvement in HCAHPS scores. This may serve as a model to increase patient satisfaction, hospital revenue, and train resident physicians.