Patients enjoy spiffy surroundings but care most about care: Johns Hopkins

Hospital patients appreciate it when facilities have been prettied up for eye appeal and ambience. However, when they feel dissatisfied with the care they receive, even the nicest amenities won’t sway their overall opinion of the place.

That’s according to a new study of 5,663 recent inpatients published in the March edition of the Journal of Hospital Medicine.

Johns Hopkins hospitalist Zishan Siddiqui, MD, led the research, which compared satisfaction surveys filled out by inpatients treated in Hopkins’ old facilities, parts of which are more than 100 years old, with identical surveys returned by inpatients treated in the institution’s gleaming, $1.1 billion Sheikh Zayed Tower.

Johns Hopkins opened the tower in 2012 with all sorts of niceties, including a meditation garden, hundreds of works of art and a modern library offering books, games, music and more.

Patients in the older buildings, which had remained open, functioned as the control group. The authors noted that a hospital’s satisfaction scores tend to fluctuate even when the physical site doesn’t change.  

“The move to a new building had significant impact on only 1 of 4 measures of overall patient satisfaction, as clinical care is likely to be the most important determinant of this outcome,” they concluded. “Hospital administrators should not use outdated facilities as an excuse for suboptimal provider satisfaction scores.”

In explaining the importance of their study, the authors pointed to the trend of hospitals being refurbished or rebuilt with patient-centered, and often hotel-like, touches. 

Satisfaction scores from Press Ganey surveys and the CAHPS survey provided the data, on which the researchers performed logistic regression to identify predictors of “top-box”—i.e., most positive—scores.

The data were categorized into facility-related, nonfacility-related or overall satisfaction-related domains. Data were also adjusted for age, sex, length of stay, insurance type and illness complexity to ensure results were not affected by those variables, according to the study abstract.

This new study adds a distinctly clinical wrinkle to the conclusions of a 2012 J.D. Power and Associates survey of more than 10,200 patients who received care in inpatient, emergency or outpatient facilities in the U.S.

“In an era in when hospitals compete for patients by boasting the latest clinical technology, the most prestigious physicians and impressive amenities,” reported the Power organization, “patient satisfaction is most influenced by human factors, especially superior service-related communication skills between hospital staff and patients.”

In prepared remarks, Siddiqui was more pointed. “Hospital leaders,” he said, “will have to stop blaming poor patient satisfaction scores on aging buildings and units.”