CMO Brief: Continuity and Patient Satisfaction

Nursing workloads could use a fix

Last time, we began to talk about continuity of care and the lessons we as hospitalists may be able to learn from the outpatient world.  We’re going to continue to talk about the outpatient world to see what we glean from it today, focusing on patient and provider satisfaction.

When we consider the patient perspective, they clearly prefer seeing physicians that they have seen in the past.  Hjortdahl and Laerum found that when evaluating satisfaction with a primary care consultation, “an overall personal patient-doctor relationship increased the odds of the patient being satisfied with the consultation sevenfold (95% confidence interval 4.9 to 9.9) as compared with consultations where no such relationships existed.” While this was in the outpatient setting, at a higher stress time (like in the hospital), one could imagine this is even more important to patients.

In fact, Mainous III, Goodwin, and Strange found that it’s not the length of the relationship that matters most to patients, but the depth.  Shared experiences increase the importance of continuity to the patient.

“Patients who have medical problems requiring substantial intervention on the part of the physician are more likely to exhibit a desire for continuity.”

The hospital is likely the place where patients will require the highest degree of intervention, thus making continuity even more important.

It’s not just the patients that have higher levels of satisfaction when there is greater continuity of care.  Blankfield et al. found that both residents and faculty highly value continuity, and that rates of continuity were highly correlated with physician satisfaction.

While we’re still talking about the outpatient setting, there seem to be further lessons we can take and apply to our work as hospitalists.  Next time, we’ll talk about costs and outcomes.