[Patient satisfaction--a potential cornerstone of hospital management]

[Better patient orientation through certified cancer centres in oncological care? Patient satisfaction in breast cancer patients in certified breast cancer centres and noncertified hospitals]

OBJECTIVES

We investigated whether patient satisfaction (including its subdimensions) among breast cancer patients depends on the place of the treatment (certified breast cancer centre vs. noncertified clinics). Furthermore, we examined the impact of patient- and disease-related factors on patient satisfaction.

METHODS

652 breast cancer patients (n = 480 from certified breast cancer centres and n = 172 from noncertified clinics) took part in the study after their hospital stay and completed a questionnaire. Data on patient satisfaction (Hamburger Fragebogen zum Krankenhausaufenthalt, HFK), psychological distress (HADS), as well as sociodemographic and disease-related characteristics were collected.

RESULTS

Regardless of the place of cancer treatment, breast cancer patients reported a high level of satisfaction. There was only one significant difference between the two patient groups in the subdimension "overall judgement" (breast centre: 1.28 vs. noncertified clinic: 1.19; p = 0.017). In the multivariate analysis, the place of treatment had less explanatory power on patient satisfaction than other factors such as psychological distress.

CONCLUSIONS

In this study, there were only few differences in patient satisfaction between the two investigated groups of breast cancer patients. This result is discussed in the context of various moderating factors.

[Improvement of team competence in the operating room : Training programs from aviation]

Growing attention has been drawn to patient safety during recent months due to media reports of clinical errors. To date only clinical incident reporting systems have been implemented in acute care hospitals as instruments of risk management. However, these systems only have a limited impact on human factors which account for the majority of all errors in medicine. Crew resource management (CRM) starts here. For the commissioning of a new hospital in Minden, training programs were installed in order to maintain patient safety in a new complex environment. The training was planned in three parts: All relevant processes were defined as standard operating procedures (SOP), visualized and then simulated in the new building. In addition, staff members (trainers) in leading positions were trained in CRM in order to train the complete staff. The training programs were analyzed by questionnaires. Selection of topics, relevance for practice and mode of presentation were rated as very good by 73% of the participants. The staff members ranked the topics communication in crisis situations, individual errors and compensating measures as most important followed by case studies and teamwork. Employees improved in compliance to the SOP, team competence and communication. In high technology environments with escalating workloads and interdisciplinary organization, staff members are confronted with increasing demands in knowledge and skills. To reduce errors under such working conditions relevant processes should be standardized and trained for the emergency situation. Human performance can be supported by well-trained interpersonal skills which are evolved in CRM training. In combination these training programs make a significant contribution to maintaining patient safety.