The Effect of Length of Hospital Stay and Patient Factors on Patient Satisfaction in an Academic Hospital.

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a metric for patient satisfaction consisting of 19 questions divided into 10 domains. Scores affect hospital reimbursements and accreditation and may play a role in patient outcomes. It is unclear how length of stay and other factors affect each of the 10 domains. This retrospective review gathered data of 600 patients between December 2008 and January 2017 who completed the HCAHPS survey. The odds of complete satisfaction in each of the 10 domains was evaluated. The results suggest increased length of stay is associated with lower odds of patient satisfaction and decreased likelihood of recommending the hospital. The odds of being completely satisfied regarding communication with physicians, discharge information, and responsiveness of the hospital staff, as well as the odds of recommending the hospital to others, were lower if the care provider was younger than the patient. Obese patients were also more likely to be satisfied with responsiveness and care transition. Male patients were more satisfied with communication about medications (odds ratio [OR], 1.694), care transition (OR, 1.489), and cleanliness (OR, 2.120). Medicare and fewer consults were related to increased odds of patient satisfaction with care transition (OR, 1.748 and 0.573, respectively). Males, older patients, and White patients were more likely to recommend the hospital (OR, 1.476, 1.025, and 1.690, respectively). Length of stay affects patient satisfaction and likelihood of recommending the hospital to others. Other factors such as a younger provider age than the patient, lower body mass index, female sex, non-Medicare insurance, and higher number of consults are also associated with lower satisfaction in various domains. Hospital systems can bolster patient satisfaction by strategizing day-of-surgery and weekend staffing to reduce length of stay. [Orthopedics. 2020;43(6):373-379.].

Analysis of operating room efficiency between a hospital-owned ambulatory surgical center and hospital outpatient department.

BACKGROUND: Ambulatory surgery centers (ASCs) are frequently utilized; however some ambulatory procedures may be performed in hospital outpatient departments (HOPs). Our aim was to compare operating room efficiency between our ASC and HOP. METHODS: We reviewed outpatient general surgery procedures performed at our ASC and HOP. Total case time was divided into five components: ancillary time, procedure time, exit time, turnover time, and nonoperative time. RESULTS: Overall, 220 procedures were included (114 ASC, 106 HOP). Expressed in minutes, the mean turnover time (29.8 ±â€¯9.6 vs. 24.5 ±â€¯12.7; p < 0.01), ancillary time (32.2 ±â€¯7.0 vs. 22.2 ±â€¯4.5; p < 0.01), procedure time (77.4 ±â€¯44.9 vs. 56.2 ±â€¯23.0 p < 0.01), exit time (11.8 ±â€¯4.4 vs. 8.5 ±â€¯4.3; p < 0.01), and nonoperative time (62.9 ±â€¯21.9 vs. 48.7 ±â€¯15.0; p < 0.01) were longer at the HOP than at the ASC. CONCLUSION: ASC outpatient procedures are more efficient than those performed at our HOP. A system evaluation of our HOP operating room efficiency is necessary.