2003 OPEN FORUM Abstracts
IMPACT OF A PATIENT INFORMATION PROGRAM ON UTILIZATION AND SATISFACTION WITH HOME RESPIRATORY CARE SERVICES.
E. Hoisington, RRT., Dale Miller RRT, Cheryl Adams, RN, BA, CPHQ, J.K. Stoller, MD, MS, FAARC, The Cleveland Clinic Foundation, Cleveland, Ohio
Background: When contractual arrangements between hospitals and durable medical equipment (DME) providers change, home-going patients may experience differing choices in selecting DME companies for their home respiratory care needs. When various providers are available, we hypothesized that patients' utilization would change and that satisfaction with providers would be enhanced by providing patients with information about the providers. To test whether an organized patient informational program altered utilization and satisfaction, we assessed patterns of utilization and patient satisfaction with DME providers before and we are currently assessing responses after implementing the informational program.
Methods: The patient informational program consisted of offering detailed descriptions of the many available providers to home-going patients before patients chose one. To characterize available providers, we administered a questionnaire to all DME providers known to the investigators in our area. Information about the scope of services, the number and types of providers, the geographic range of service, and contact information given by the providers was assembled on a one-page patient information sheet that was given to all home-going patients. Case managers, who routinely help patients make such DME arrangements, were oriented about the questionnaire and given the patient information sheets to distribute.
To gather baseline information, consecutive patients discharged from the Cleveland Clinic Hospital (between August 11, 2002 and December 31, 2002) were contacted by phone at least 2 weeks after discharge. Questionnaires invited responses about which DME provider was chosen and about the patient's level of satisfaction (using a 5-point Likert scale) with the service. Post-intervention data are currently being collected after submitting the same questionnaire to a separate group of 75 home-going patients who had been instructed regarding DME choices and given the information sheet. By comparing the scores, we propose to determine if patient satisfaction is enhanced by the information program handout.
The study was approved by the Cleveland Clinic Foundation Investigational Review Board. Statistical analysis was performed using SAS 8.2.
RESULTS: Baseline responses were available from 75 of the 94 consecutive eligible patients (80%); one patient declined to participate in the study, and 18 could not be reached. Of the 12 DME providers who responded (of 12 approached), 9 (75%) were chosen by at least one patient; 3 non-responders to the DME questionnaire also had patients discharged with oxygen.
Before the informational program was implemented, the mean level of satisfaction with the DME company was 1.15, where 1 indicated the highest degree of satisfaction and 5 the lowest. Other baseline mean ratings were as follows: (1) Level of satisfaction with equipment explanation - 1.20; (2) Response to "Were you able to operate the equipment?" - 1.15, (3) Level of satisfaction with equipment performance - 1.24, (4) Timeliness of equipment delivery - 1.34, and (5) How soon a therapist visited the patient - 2.31, where a score of 1 was given to a visit within 24 hours, and a score of 5 to "no visit within the first two weeks of discharge."
Conclusions: Baseline assessments in this before-after study examining the impact of a patient informational program on the use and satisfaction with DME respiratory care providers indicate a generally high level of baseline satisfaction, but poor ratings for the timeliness of therapists' home visits. Assessment of responses after implementing the informational program should indicate whether, as hypothesized, a patient informational program changes the pattern of DME provider use and enhances satisfaction with service.