May 22, 2012 | | Comments 1
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Perception versus practice in quality of care

Patients’ perceived quality of care varied greatly from the actual quality of care as defined by adherence to guidelines, according to a study published in the Journal of Clinical Oncology last month. Researchers surveyed 374 women receiving treatment for early stage breast cancer at New York City hospitals and asked the patients to rate the care they received. Only 55% of women indicated that they received excellent care, despite the fact that 88% of the women received care that is considered in line with the best treatment guidelines. The findings of the study could have huge implications for hospitals and other healthcare organizations, particularly as insurers use performance and quality metrics to determine reimbursement.

Several factors influenced the women’s perception of care and patient satisfaction. The ease or difficulty of obtaining initial treatment correlated to the rating of quality: 60% of women who said they received excellent care also said the process of getting care was excellent, but only 16% of women who rated care as less-than-excellent said that the process of receiving care was excellent. Race also contributed to perceptions of quality. The survey found that African-American women were less likely to report excellent care and less likely to trust their doctor than Caucasian or Hispanic women, and were more likely to say they experienced racism during the treatment process, despite the fact that there was no difference in the actual quality of medical care the women received.

Communication and interactions with medical personnel also made a difference in the perception of quality. Women who reported having good communication with their physician, a clear understanding of which staff member to turn to with questions, and generally excellent  treatment from the medical staff were more likely to rate their overall quality of care as excellent. The same group of women also felt less mistrust of the medical system.

Although this study examined only a small sample of patients, its findings can be applicable at most institutions. The researchers on the study conclude that healthcare organizations should improve the perceived quality of care by making it easier for patients to obtain care and by establishing trust between patients and healthcare staff. In both instances, clear and detailed communication could aid in improving patient perceptions.

Has your organization noticed a difference in the actual quality of care patients receive and patients’ perceptions of quality? What have you done to align the two? Post a comment below.

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Filed Under: nurse educationpatient satisfaction

About the Author: Katrina Gravel is an editor for the Education division of HCPro.

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