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A Retrospective Review of Plastic Surgery Consultations to Evaluate the Effect of Web-Based Education on Patient Satisfaction and Consultation Time.
David Boudreault, MD1, Chin-Shang Li, MD, PhD2, Michael S. Wong, MD1.
1UC Davis Medical Center, Sacramento, CA, USA, 2University of California, Davis, CA, USA.
To evaluate 1) patient satisfaction and 2) consultation times in those who viewed versus those who did not view online patient education material prior to their consult. Patients expect a healthcare system that is both efficient and provides the highest quality of care. Through an independent survey published by Grote in The McKinsey Quarterly 2007, patients report the quality of education they received regarding their procedure or treatment was the most influential factor in their decision of which hospital or physician they ultimately chose. The implications of an “excellent” versus a “very good” rating had significant affects on this choice. After reviewing 176,000 surveys performed through Physician Research Consultants, a significant decrease in patients’ willingness to recommend the service to family and friends was found between those rating their experience as “excellent” vs “very good” (86% vs 23%). Thus, it is important patients rate their experience as excellent. Many healthcare systems have targeted improved patient education through the use of various educational tools. Developers of the program used by our hospital report improved satisfaction and decreased consultation time by better preparing patients for consultation.
In this retrospective review, 767 new patient consultations were seen by 4 university based plastic surgeons, between May 2012 and August 2013, and were evaluated to determine the effect of a web-based educational program covering abdominoplasty, breast augmentation, breast reduction, breast reconstruction, blepharoplasty and liposuction on patient satisfaction and consultation time. A standard 5-point Likert scale survey completed at the end of the consultation was used to assess satisfaction with their experience. A score of 1 was excellent and 5 was poor. Consult times were obtained from the electronic medical record by taking the difference between the time vital signs were entered and when an after visit summary was printed. This was compared to actual consult times recorded by one surgeon. All analyses were done with Statistical Analysis Software (SAS) version 9.2 (SAS Inc., Cary, NC). A p-value < 0.05 was considered statistically significant.
Those who viewed the program prior to their consultation were more satisfied with their experience compared to those who did not (satisfaction scores, mean ± SD: 1.13 ± 0.44 vs. 1.36 ± 0.74; p=0.02) and more likely to rate their experience as excellent (92% vs. 75%; p=0.02). Patients who viewed the educational program prior to consultation trended towards longer visits compared to those who did not (mean time ± SD: 54 ± 26 vs. 50 ± 35 mins; p=0.10).
Viewing web-based educational programs significantly improved plastic surgery patients’ satisfaction with their consultation, but also trended towards longer consultation times. Our surgeons report that patients who use web-based educational tools appear to have an increased understanding of their procedure and thus engage in higher-level conversations, which may contribute to additional time spent with patients.
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