The Value and Challenge of Patient Satisfaction Surveys

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By Eric Schwelke CPO/L, Director

Satisfaction surveys. I'm sure you've seen them, and answered them or perhaps thrown them in the round file. They are ubiquitous; we get them via email and websites, by mail, phone, and fax. Almost every progressive organization in all lines of business conduct them to gather data from their customer base, to measure performance metrics, and to gauge their standing against a benchmark. Though the results can be useful and meaningful in improving care and services, convincing people to complete them can be challenging.

My experience with patient satisfaction surveys began in the late 1980s as I negotiated contracts with hospital networks in New York City for my private practice. The contracts required my company to have quality assurance programs in place and provide quarterly reports showing how my practice was rated by patients. It was the beginning of evidence-based care coming to health professions, but I found little information about what to do with the results. What was I supposed to do about the small number of surveys that were returned? Who would break down the responses to illuminate what was happening in my practice? Back then, computers were almost non-existent in O&P and paper records were the norm. What ended up happening was that the returned surveys were put in a file in the event our referral sources asked for them.

Today, O&P patient satisfaction surveys are a tool of performance management required by Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Standards and accrediting organizations. At Kessler O&P Services, we outsourced our survey processes to a service that has produced a core set of questions for our services and devices that satisfy Medicare and accreditation quality standards. In addition, the service parses the data and allows us to benchmark our results against a national database of O&P providers. Using the data, which we can break down in many ways, we can look at individual clinician performance. For example, examining the responses to the survey question, "How would you rate the knowledge, care, and attention that the practitioner provided to you during your visit?" can help us see if our clinicians are providing the highest level of treatment to our patients and correct poor results or acknowledge good ones. Over the past ten years, that question has been answered over 200,000 times nationally, making us confident we are using a valid process.

Surveys are delivered to all our patients at device or service delivery and that is tracked as well. Our survey process is integrated with our electronic medical records software, which eases the survey production/provision and return. We typically print and provide them to our patients with a postage-paid business reply envelope, or the software can automatically email the survey to the patient with instructions about how to complete it and mail or digitally return it. However, we consistently receive less than ten percent return of the surveys, making it difficult to produce statistically significant results. We are working to increase the response rate by signage in our reception area; verbal encouragement throughout the episode of care; and explaining to the patient how essential their input is for our organization to improve the healthcare we provide.

In this evolving healthcare climate and its focus on evidence-based care, the patient satisfaction survey is an effective tool that can help us understand how O&P practices provide value to our patients and other stakeholders. I would be interested to know how other practices encourage survey completion and how successful they have been.

Eric Schwelke, CPO/L, Director, Kessler O&P Services, Livingston, New Jersey, can be reached at