RESUMO
BACKGROUND: There is a trend toward patient-centered care as a means of improving patient satisfaction. The Centers for Medicare and Medicaid Services (CMS) have made this concept more significant with plans to link reimbursement to patient satisfaction measures such as the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS). OBJECTIVES: To generate hypotheses for reasons underlying diminished HCAHPS patient satisfaction survey ratings, with reference to hospitalists. DESIGN, SETTING, PATIENTS: Observational study conducted using a cognitive interview (CI) technique in a 180-bed community hospital on adult medical, surgical, and critical care inpatients. MEASUREMENTS: Mixed qualitative and quantitative study using both standard responses and open-ended responses. The standard responses were compiled into raw numbers and percentages and the qualitative responses were evaluated for common themes and other useful information. RESULTS: Notable factors that may affect satisfaction of patients include ability to have all of their questions answered, incomplete discussion of medication side effects, and failure of physicians to listen and form personal connections with them. CONCLUSION: Cognitive interview techniques can be used to provide additional detail regarding patient satisfaction beyond that provided by standard surveys.