Comments on: Patient Surveys and the Six Sources of Influence

By: Ryan Trimble

Ryan Trimble — Mon, 02 Jan 2023 20:28:29 +0000

In reply to Peter Clark. Thank you. 😊

By: Peter Clark

Peter Clark — Fri, 16 Dec 2022 11:11:23 +0000

Well written, Ryan! I’m don’t recall seeing your name before. Bravo, Crucial Skills, for your pantheon of contributors!

By: Bill F

Bill F — Thu, 15 Dec 2022 23:41:23 +0000

Surveys are surveys. Too many factors to consider regarding “feedback” from un-trained, unprofessional survey-takers, especially when the survey / response is voluntary. Perspectives on Feedback Results should only be used as a data point… and used with a huge grain of salt.
I used to work for a company who believed 0 events was the only acceptable safety rate – regardless of how many people were involved, or number of entries were made, or number of times the activity was performed. This is pretty much a ridiculous perspective or expectation. No one, or no thing is 100% perfect – ever.
Surveys …are only voluntary. Time and effort, attitudes and experiences will influence participation. With that I’d submit that a higher percentage of people that experienced a “less than perfect encounter” would be more likely to submit feedback/survey. Meaning the 100% satisfied would be less likely to respond to a survey – they’re happy. Eschewing results to trend lower automatically rather than higher (.e.g., 7 instead of 10). Also, people who respond to the visual 0-10 scale questions aren’t always going to respond to extremes, 0 or 10, but reasonably somewhere in between. How was the environment for your visit? And the one noisy kid in the waiting room (which is way beyond anyones control) results in a score of 7, and everything else about the environment was perfect. My advice would be don’t put too much weight on a survey, don’t use a 0-10 scale, consider face to face feedback with every client and if you must use a Survey, do what some of the people here say, ask the correct and reasonable questions.

By: Eric S Dickson

Eric S Dickson — Thu, 15 Dec 2022 21:23:57 +0000

Am I the only one who gets texts and emails from the car dealership after a service visit that tells me that “anything less than a 10 is considered a failure”? I have refused to provide feedback because that kind of statement just means that they don’t want honest feedback. I think the issue here is that if you are using a survey to judge someone’s performance, it will be biased and people will try to manipulate the results. But if you are genuinely looking for ways to improve, you spend the time and effort to try to remove bias and get honest feedback. The last thing you want when you are looking for ways to improve is people telling you that you are perfect!

By: Ed

Ed — Wed, 14 Dec 2022 23:31:51 +0000

The survey Seeking a Source is probably referring to is likely a CAHPS survey. CAHPS stands for Consumer Assessment of Healthcare Providers and Systems and conducted under strict rules established by AHRQ – Agency for Healthcare Research and Quality. A company that I used to work at administered millions of these surveys. We investigated many reports where they suspected a problem because a rating and a verbal comment seemed to disagree. Respondents/patients did give what appeared to be inconsistent ratings and responses. Now what?

You rightfully point the reader to the goal of getting good information rather than good scores. That’s great advice. Going a step further to say work on improving the survey is where the advice is less on point. The likelihood that a reader will be able to make any change to the survey is exceedingly unlikely. The uniformity of the survey is what gives it it’s power. Everyone is being assessed by the same yardstick. The CAHPS surveys do change in respond of suggestions but the process is long and involved and unlikely to address the issue of apparently inconsistent respondents.

Instead of focusing on the survey why not focus on improving customer/patient satisfaction? If you improve patent satisfaction you will likely improve scores. One way to improve scores is to look to institution that do satisfy their patients. As a patient at Johns Hopkins Hospital it was obvious I was at a place that took my satisfaction seriously. Everywhere you looked there were signs on the walls letting you know they wanted to hear from you if there was any problem. I had a colonoscopy there twenty years ago and I remember to this day receiving a card signed by all the people in the clinic thanking me for giving them the opportunity to care for me. Time well spent.

By: Ryan Trimble

Ryan Trimble — Wed, 14 Dec 2022 16:17:02 +0000

In reply to susanloucks. :)

By: Hanne

Hanne — Wed, 14 Dec 2022 15:38:49 +0000

When you look at the sources of influence, wanting to being nice/being liked (source 3, social motivation) could play a role and explain the discrepancy between a direct question during a live interaction and an anonymous filled out survey. Timing might play a role too: we humans want to reciprocate kindness after we’ve just been helped, but when we reflect on the overall care a while later, we might adjust our opinion.

By: susanloucks

susanloucks — Wed, 14 Dec 2022 15:22:29 +0000

I think this is a thoughtful reply with a laudable push towards integrity, which makes me grin a little because on more than one occasion I’ve been asked to fill out a survey from this group which seems to be angling for a particular press-worthy result about a problem they could address, as opposed to collecting unbiased data. Don’t get me wrong – I think Crucial Learning is great. But worth remembering, physician – heal thyself!

By: benzonit

benzonit — Wed, 14 Dec 2022 15:05:01 +0000

Several thoughts from nearly 4 decades of putting up with surveys:
1. You are not obligated to use a commercial survey service. Generic surveys aren’t very useful for specialized applications. Consider making a quality improvement project. For instance, on a six-month rotating basis you could query waiting time, phone courtesy, speed of getting follow-ups, adequacy of explanations and educational material, utility of consultants, structure of your place (comfort, furniture, parking lot, etc.)
2. From a statistics perspective, expecting or getting a 10 on all surveys makes the survey useless. It’s much better to have a survey that gives you a fairly Gaussian curve with the skewness to the right. Unfortunately, most of us in medicine aren’t accustomed to this; We think we always have to be 11 on a 10 scale. That makes scales useless.

By: Karl Beil

Karl Beil — Wed, 14 Dec 2022 13:36:46 +0000

I have often said, I can get the results I want from a survey I author by what questions are asked and how they are asked. This includes the order the questions are in. However, when doing a customer satisfaction survey, I don’t want to see the results I want. I want to see the results that are true and accurate. When designing a survey, ask yourself, what is my goal with this survey. Then write questions that ONLY work toward that goal. For example: If my goal is to improve customer satisfaction, I ask my self what comprises customer satisfaction? The answers may be response time on a call; how long customers wait to be served; did the service result in the customer receiving the products or services they need; etc. Then ask questions designed to get to these needs:
> How long did you wait before your call was answered? Was this time excessive?
> How long did you wait in the waiting room before your name was called? Was this time excessive?
> Did your agent answer your question?
Etc

Ryan mentioned hiring a agency to do your surveys. I agree with this, unless you are prepared to hire someone to your staff that is trained survey development and execution.