Patient Experience in Obstetrics in a Military Patient Satisfaction Survey: Findings and Recommendations for Improvement

Abstract

Introduction: This study examines the care experience of obstetric patients within the Military Health System and compares them to those of medical and surgical care patients. Specifically, the study seeks to (1) examine how obstetric inpatient experience ratings differ from medical and surgical inpatient experience ratings, (2) understand specific aspects of care that drive overall experience ratings within this population, (3) test whether adherence to nursing practices such as hourly rounding and nurse leader visits affect experience ratings, and (4) describe ways that patient experience information can be presented to healthcare providers to improve performance. Materials and Methods: Data for this study include Military Health System patient experience survey data (based on the Hospital Consumer Assessment of Healthcare Providers and Systems) collected from 2011 through 2019. Analysis includes data collected from 338,124 patients aged 18 years and older. Our analysis involved z-test comparisons of patient experience measure scores, trend analysis, logistic regression-based driver analysis, and correlations. Results: Obstetric ratings are generally lower than those of medical and surgical patients; however, they have been improving at a slightly faster rate year over year. Effective nurse communications with patients are a particularly strong driver for improving their overall care experiences, and practices like hourly nurse rounding, nurse leader visits, and nurse-patient shift change conversations are positively correlated with obstetric patient experience ratings. Conclusions: This study contextualizes how obstetric inpatient experience ratings differ from those of medical and surgical care patients. Healthcare administrators and policymakers should be aware that obstetric patients may have unique needs and expectations that lead to patient experience ratings differing from those of medical and surgical patients. Effective nurse-patient communications, hourly rounding, nurse leader visits, and nurse-patient shift change conversations could be strategies used to improve obstetric experience ratings.