Table 3 Multilevel regression of determinants of patient satisfaction (37 440 patients in 68 organizations)
Nurses & doctors | Patient-centered care | Admission process | Availability of staff | Communication with patient | Communication with family | Discharge transition | Pain management | |
|---|---|---|---|---|---|---|---|---|
Number of respondents | 37231 | 37339 | 33267 | 19993 | 33700 | 21719 | 24832 | 24108 |
Fixed effects | Coef (s.e.) | Coef (s.e.) | Coef (s.e.) | Coef (s.e.) | Coef (s.e.) | Coef (s.e.) | Coef (s.e.) | Coef (s.e.) |
Patient level | ||||||||
Constant | 62.2 (6.4) | 55.9 (4.8) | 72.7 (8.1) | 86.4 (6.8) | 74.6 (5.2) | 56.8 (6.7) | 59.7 (8.3) | 65.3 (3.6) |
Age in decade | 0.9 (0.1) | 1.1 (0.1) | 1.3 (0.1) | 0.8 (0.1) | 1 (0.1) | 1.9 (0.1) | 0 (0.1) | 1.2 (0.1) |
Male | 2.4 (0.2) | 2.7 (0.2) | 2.3 (0.3) | 3.6 (0.3) | 1.5 (0.2) | 3.6 (0.3) | 7.1 (0.4) | 1.6 (0.2) |
Length of stay | -0.03 (0.01) | -0.06 (0.01) | 0 (0.01) | -0.14 (0.01) | -0.08 (0.01) | -0.04 (0.02) | -0.17 (0.02) | -0.03 (0.01) |
Hospital stay (ref = Only this time) | ||||||||
This time and one other time | 0.7 (0.4) | 1 (0.3) | 1.7 (0.5) | 1.9 (0.5) | 1.8 (0.4) | 1 (0.6) | 1 (0.7) | 1.9 (0.4) |
This time and more than one other | 1.3 (0.3) | 1.6 (0.3) | 3.4 (0.4) | 3.4 (0.4) | 3.1 (0.3) | 1.3 (0.5) | 1.3 (0.6) | 2.6 (0.3) |
Education level (ref = Public or high school) | ||||||||
College, trade, or technical school | -2 (0.2) | -2 (0.2) | -1 (0.3) | -2.2 (0.3) | -1.1 (0.2) | -3 (0.4) | -3.8 (0.5) | -1.7 (0.2) |
University | -4.1 (0.3) | -3.6 (0.2) | -2.6 (0.4) | -4.8 (0.4) | -2.4 (0.3) | -5.1 (0.5) | -7.1 (0.5) | -2.6 (0.3) |
Someone else filled the questionnaire (ref = Patient) | -5.8 (0.3) | -3.7 (0.2) | -6.3 (0.4) | -7.4 (0.4) | -5.3 (0.3) | -2.9 (0.5) | -2.4 (0.6) | -3.4 (0.3) |
Perceived health (ref = Poor) | ||||||||
Good | 3.7 (0.3) | 2.8 (0.2) | 3.2 (0.3) | 3 (0.4) | 3.4 (0.2) | 3.5 (0.4) | 5.4 (0.5) | 2.7 (0.3) |
Very Good | 9.9 (0.3) | 6.7 (0.2) | 5.5 (0.4) | 5.8 (0.4) | 7 (0.3) | 7.6 (0.5) | 10.1 (0.6) | 4.5 (0.3) |
Excellent | 12.9 (0.4) | 8.1 (0.3) | 6.4 (0.6) | 4.9 (0.6) | 7.7 (0.4) | 8.5 (0.7) | 10.6 (0.8) | 4.4 (0.4) |
Admission (ref = Emergency) | ||||||||
Planned admission | 5.6 (0.2) | 2.5 (0.2) | 20.3 (0.3) | 2.3 (0.3) | 5.5 (0.2) | 5.8 (0.4) | 9.3 (0.4) | 3.8 (0.2) |
Transferred from another facility | 5.3 (0.4) | 4 (0.3) | 19.6 (0.6) | 3.5 (0.6) | 3.5 (0.4) | 1.6 (0.7) | 3.6 (0.8) | 3.6 (0.4) |
Other unplanned | 4.5 (0.5) | 2.1 (0.4) | 10.5 (0.6) | 3.4 (0.7) | 3.1 (0.5) | 5.2 (0.8) | 7.4 (0.9) | 2.8 (0.5) |
No pain (ref = Yes) | 3 (0.2) | 3.1 (0.2) | 1.7 (0.3) | 3 (0.3) | 2.7 (0.2) | 2.7 (0.4) | 1.6 (0.4) | N/A |
Hospital level | ||||||||
Peer group (ref = Community) | ||||||||
Small | 1.8 (2.4) | 4.3 (1.8) | 6.1 (3) | -0.4 (2.6) | 0.7 (2) | 4.2 (2.7) | 2.9 (3.2) | 1.5 (1.4) |
Teaching | 2.1 (1.4) | 1.6 (1) | 1.6 (1.8) | 1.8 (1.4) | 1.1 (1.1) | 1.6 (1.4) | 2.6 (1.7) | 0.5 (0.7) |
Medical nurse-sensitive adverse events (%) | -1.7 (0.9) | -1.5 (0.6) | -2.1 (1.1) | -2.1 (0.9) | -1.3 (0.7) | -0.5 (0.9) | -1.6 (1.1) | -0.4 (0.5) |
Medical readmissions (%) | 0.2 (0.2) | 0.1 (0.2) | 0.3 (0.3) | 0.2 (0.2) | 0.1 (0.2) | 0.3 (0.3) | 0.3 (0.3) | -0.1 (0.1) |
Total margin | -0.3 (0.2) | -0.1 (0.2) | -0.3 (0.3) | -0.1 (0.2) | -0.1 (0.2) | -0.1 (0.2) | -0.3 (0.3) | 0.1 (0.1) |
Equipment expenses | 0.4 (0.4) | 0.7 (0.3) | 0.8 (0.6) | 0.1 (0.5) | 0.1 (0.4) | 0.5 (0.5) | 0.4 (0.6) | 0 (0.3) |
Registered nurses (%) | -0.1 (0.1) | -0.1 (0.1) | -0.2 (0.1) | -0.2 (0.1) | -0.1 (0.1) | 0 (0.1) | 0 (0.1) | 0 (0) |
Percentage of sick time | -1.5 (0.7) | -1.6 (0.6) | -1.6 (0.9) | -1.3 (0.8) | -0.8 (0.6) | -0.7 (0.8) | -0.9 (1) | -0.4 (0.4) |
Number of permanent staff roles | -0.1 (0.2) | -0.1 (0.2) | -0.3 (0.3) | -0.1 (0.2) | -0.1 (0.2) | -0.1 (0.2) | -0.3 (0.3) | -0.1 (0.1) |
Continuing education about quality | 1.3 (1.1) | 1.1 (0.8) | 0.7 (1.4) | -1.1 (1.2) | 0.5 (0.9) | 2.1 (1.2) | 1 (1.4) | -0.3 (0.6) |
# areas where e-records and data are used | 0.7 (0.4) | 0.6 (0.3) | 0.7 (0.5) | 0.6 (0.5) | 0.4 (0.4) | 0.5 (0.4) | 0.8 (0.5) | 0.1 (0.2) |
# areas where data are collected and shared | 0.2 (0.2) | 0.1 (0.2) | 0.3 (0.3) | 0.2 (0.3) | 0 (0.2) | -0.2 (0.3) | -0.2 (0.3) | 0.2 (0.1) |
Policy for hand hygiene | 4 (1.9) | 2 (1.4) | 1.1 (2.4) | 3.2 (2) | 2.8 (1.6) | 1 (2) | 1.4 (2.4) | 1.4 (1) |
Patient safety as a written, strategic priority. | 1 (1.7) | 1.4 (1.3) | -0.4 (2.2) | 3.2 (1.9) | 0.7 (1.4) | 1.5 (1.9) | 1 (2.3) | 0 (1) |
Formal policy and process of disclosure of adverse events to patients/families | 0.6 (1.1) | 0.7 (0.8) | 2.2 (1.4) | 1.7 (1.1) | 0.6 (0.9) | 0 (1.1) | 1.6 (1.4) | 1.3 (0.6) |
Patient’s current medications reconciled on admission and with patient’s involvement. | -0.5 (1.4) | -0.3 (1.1) | -1.9 (1.8) | -2.2 (1.5) | -0.7 (1.2) | 1.8 (1.5) | 0 (1.8) | -1 (0.8) |
Patient's medications reconciled and communicated to next provider | 2.3 (1.4) | 2.3 (1.1) | 3.3 (1.8) | 3.5 (1.5) | 2.3 (1.2) | 0.7 (1.5) | 2.2 (1.9) | 1.7 (0.8) |