REVIEWED BY JEANIE MAMULA
Patient Satisfaction: Understanding and Managing the Experience of Care, 2nd ed.
By Irwin Press
Health Administration Press, Chicago, 262 pp., 2006, $69 (paperback)
Irwin Press, Ph.D., is the cofounder of Press Ganey Associates. A cultural anthropologist, he has employed the tools of that discipline to explore and explain the "clashes" between traditional clinical medicine and alternative medicine. He was the first to promote patient satisfaction as an indicator of health care quality. In recent years, he has worked with hospitals across the nation to implement satisfaction measures and improvement strategies.
In this book, Press looks at patient satisfaction from a variety of perspectives, each of which is allotted a chapter, and he ends each chapter with a summary, conclusion, and recommended actions.
He begins the book by explaining why, in his opinion, measuring patient satisfaction works both as a gauge of quality measure and as an organizational effectiveness tool for improving the business of health care. The author demonstrates linkages between patient satisfaction and employee and physician satisfaction, as well as between patient satisfaction and competitive strength, profitability, public accountability, and risk management. He explains the concept of "cultural competence" and stresses its importance in improving satisfaction.
In his book, Press describes the basics of patient-satisfaction measurement and the management and understanding of the data obtained from it. Patient Satisfaction is written in a language and style that will make it compelling to the administrator or manager, and, at the same time, interesting to and comprehensible by the staff-level reader. Press not only makes the data analysis easy to understand; he also motivates the reader to take action, and provides him or her with usable tools for creating and prioritizing action plans.
Besides outlining the basic mechanics of patient satisfaction, Press describes the expectations that patients tend to bring with them to the health care world, and the ways those expectations influence their perception of the health care organization and its staff. He cites writers such as Arthur Kleinman, the eminent medical anthropologist who believes that culture shapes how different people view and react to illness. Echoing Kleinman, Press argues that if health care doesn't attempt to understand an individual's perception of his or her illness, it will never be able to satisfy that individual's opinion of the quality of care he or she has received.
Press also points out the biases that staff members may have — including their view of the "perfect patient" — and the ways those biases will influence their treatment of patients.
The author devotes an entire chapter to emergency departments (EDs), highlighting the differences — from both the staff and patient viewpoints — between the ED and the inpatient setting. He offers numerous examples of "good practices" in the ED that are both simple to perform and likely to improve patient satisfaction.
This new edition of Patient Satisfaction includes a chapter that offers "fifty nifty ideas" for improving satisfaction, each of them a practical suggestion that a hospital striving to change its overall performance should be able to implement with relative ease.
Press's book has four major themes:
- "Justification for the Effort," which makes the case for expending time and resources on trying to fully assess patients' experiences in the hospital
- "The Basics of Patient Satisfaction," which discusses the factors that make a patient satisfied with his or her hospital experience, how the patient's background and culture influence his or her view of the experience, and how the staff's background influences their treatment of the patient
- "The Measurement and Analysis of Patient Satisfaction," which describes the mechanics involved in assessing patient satisfaction, including the analysis and interpretation of the data
- "Practical Application," which explains to the reader how he or she can take the information from the previous sections and turn it into positive action
Patient Satisfaction is written in language that will make it useful for administrators and managers — but also for frontline caregivers such as nurses, physicians, technologists, and therapists. It is intended to help all staff understand the importance of their role in positively influencing the patient's view of his or her hospital experience. Its last chapters are particularly directed toward those responsible for leading improvement initiatives.
Press's book could have as easily been titled "Person-Centered Care 101" because of its focus on the importance of understanding the person in order to provide the best care and the most satisfying experience. I found the book compelling and would recommend it strongly to any hospital focused on changing its practices. Patient Satisfaction both motivates the reader to act and provides a map with which he or she can get started on the journey.
Jeanie Mamula
Director, Clinical Quality Improvement
Catholic Health Initiatives
Denver
Copyright © 2007 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.