Elsevier

Anesthesiology Clinics

Volume 26, Issue 4, December 2008, Pages 613-626
Anesthesiology Clinics

Is it Possible to Measure and Improve Patient Satisfaction with Anesthesia?

https://doi.org/10.1016/j.anclin.2008.07.008Get rights and content

Satisfaction cannot be considered as an objective indicator of the quality of anesthesia care, but it remains the best way to assess the outcome from the point of view of the patient. Patient satisfaction offers the opportunity for evaluating nontechnical aspects of medical care, in particular interpersonal relationships arising from specific episodes of care. Satisfaction is usually defined as the result of the comparison between expectations and perceived outcome. If improving patient satisfaction with anesthesia becomes one of the aims of a health service, anesthetists have to consider that when patients have an improved anesthesia experience, their expectations are exceeded, which in turn increases the expectations for subsequent anesthetics. A continuous quality improvement process is needed to maintain patient satisfaction at the highest level.

Section snippets

Methodologic aspects

At the end of the last century, Sitzia12 reported concerns about the validity or reliability of the instruments previously used to assess patient satisfaction. Subsequent reviews11, 12, 13, 14 emphasized that the foundation of any ad hoc instrument is the involvement of the patients in the identification of the items of the questionnaire, which should be psychometrically constructed and validated.

Method and timing of administration

Most of the instruments to assess patient satisfaction with anesthesia have been developed for self-administration, probably because this approach is easy and inexpensive. Questionnaires may be mailed or given to the patients during their hospital stay. Alternatively, administration by telephone, as done in studies on outpatients,21, 26 or face-to-face structured interview (where the interviewer administers the questionnaire) can be used. The method of administration of any instrument

Factors associated with patient satisfaction with anesthesia

Patient satisfaction with anesthesia is influenced by many factors, many of which may be unknown. Only by understanding which factors may be associated with patient satisfaction can one implement improvement strategies. Those factors can be classified as related to patient, surgery, and health care (Table 4).

The best known patient-related factors include gender and age. Young age is associated with lower satisfaction,5, 7, 9, 17, 19, 20, 31 as is female gender,6, 17, 19 and higher level of

How to improve patient satisfaction with anesthesia

To improve patient satisfaction with anesthesia, one can reduce the patient's baseline expectations or increase the level of perceived care. The first task can be very hard, because of the triumphalist tone used by the media (eg, newspapers and television), but sometimes also by some physicians, in talking about medicine. The only suggestion that can be given is that physicians avoid providing high patient expectations when preparing the patient at the time of preoperative anesthetic

Summary

Satisfaction cannot be considered as an objective indicator of the quality of anesthesia care, but it remains the best way to assess the outcome from the point of view of the patient. Patient satisfaction offers the opportunity for evaluating nontechnical aspects of medical care, in particular interpersonal relationships arising from specific episodes of care. Satisfaction is usually defined as the result of the comparison between expectations and perceived outcome. Instruments used to assess

Acknowledgments

The authors thank Silvia Zannoli and Lucia Farabegoli for their cooperation, and Susan Paris for the diligent linguistic revision.

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