Introduction: The concept of patient-centered care has become an important part of value-based payment. Unfortunately, there are few measures of patient satisfaction relevant to surgical treatment, and surgeons have the sense that they can do little to impact the patient's answers to survey questions. The American College of Surgeons has championed a surgical satisfaction survey (S-CAHPS), part of its paradigm for advanced payment models. Implementation of an additional survey often requires significant resources. Our purpose was to determine whether a selection of questions from the current CMS outpatient ambulatory surgery (OAS-CAHPS) and Press-Ganey surveys could be used to simulate the S-CAHPS
Methods: We integrated 3 S-CAHPS quesions into the PG survey, and matched S-CAPHS questions to existing OAS and PG questions. These added questions concerned offering alternatives, and discussing risks/benefits and treatment preferences. Six months of data were collected across an academic Department of Surgery.
Results: Data spanning 11 surgical divisions, including neurosurgery, will be presented. A significant variation in patient experience scores was found across this spectrum of activity, with clear room for improvement and shared learning across divisions. It was surprising to find significant variability in discussions of risks and benefits, and treatment options, and in sharing postoperative information regarding infection and bleeding. These deficiencies could be addressed with structured communication improvement plans. Disadvantages of using this survey method include a lack of scientific validation, which is true for most surveys, and a significant lag time between the consenting process and completion of the survey. Other practical issues regarding the timing of postoperative patient interactions are also discussed.
Conclusions: This study demonstrates how the ACS S-CAHPS can be simulated without additional resources and can offer an acceptable metric for improvement in patient satisfaction scores across a broad range of surgical service lines.
Patient Care: Identifying patients' perceptions of deficiencies in surgical care offers a pathway to improve satisfaction.
Learning Objectives: To understand the content of three current patient satisfaction surveys relevant to surgical practice
To understand the differences between S-CAHPS, AOS-CAHPS, and PG satisfaction surveys