As a tool of continuous quality improvement, patient surveys do possess certain potential; they are useful for allocating various types of resources and evaluating allocative efficiency of specific medical programs. The problem is, however, in that patient surveys are usually characterised by a number of pitfalls. Researchers tend to suggest that the problem is in the lack of patient expertise and patients’ conscious refusal to reflect truthful information in survey reports (42% of patients reflect a different gender in written survey forms – Kahn et al 2006).
Others see the problem in that patient satisfaction surveys oversimplify complex clinical issues (Draper, Cohen & Buchan 2001, p. 464), and that patient surveys frequently use the wrong wording (Imam et al 2007). However, the truth is that physicians and clinical professionals lack sufficient knowledge, skills, and appropriate infrastructure needed to develop and implement improvement plans on the basis of patient survey results.
Patient satisfaction surveys are potentially strong and reliable tools of quality improvement, but unless health care facilities are able to promote usability and adaptability of survey results, they will hardly be able to form a new patient-based methodology of quality improvement in health care. Patient surveys vs. quality improvement To be honest, the current state of research does not provide sufficient evidence to assert that patient surveys are unilaterally negative or positive tools of continuous quality improvement.
Many studies however, suggest that patient survey results necessarily lead to the development and implementation of various action plans. For example, Stubbe, Brouwer and Delnoij (2007) used a CQI Cataract questionnaire to evaluate the reliability and validity of instruments of measuring patient experience with quality of care after a cataract operation. Similarly, a different study was conducted to prove the usefulness of patient surveys in QA programmes (Imam et al 2007); and only a few authors have expressed their true concern in terms of patient surveys usability as a tool of quality improvement.
Andrzejewski and Lagua (1997) were the first to suggest that beyond researching the problems which patients face when filling written survey forms, special attention needs to be paid to standardising statements of deficiency and survey protocols, making providers familiar with regulatory changes with regard to patient surveys, and holding regular meetings to discuss the emerging issues.
These findings go in line with Reeves and Seccombe’s (2008) statement that “just giving people the results doesn’t mean that will take action. They need direction to make them do things and the frameworks to help them”. As a result, beyond the mere fact that patients may not always wish to provide objective feedback, there is another significant concern on “whether a survey and its promise of corrective action would enhance our ability to do our job satisfactorily” (Andrzejewski & Lagua 1997, p.
210). In reality, a whole set of barriers needs to be overcome, before patient surveys become a reliable tool of quality improvement in health care. These barriers have been categorised by Davis and Cleary (2005) along the three different dimensions: organisational, data related barriers, and professional barriers. Although this categorisation finds its reasonable reflection in other researches, such evidence is mostly obscured from the reader.