Melanie S. Brodnik

Patient satisfaction: how do qualitative comments relate to quantitative scores on a satisfaction survey?

Objective This study was designed to determine whether there are differences in how patients quantitatively rate their inpatient service in a given section of a patient satisfaction survey based on the types of qualitative comments they make about that given section. Methods The population under study was patients discharged from The James Cancer Hospital and Solove Research Institute at Ohio State University from April 1 to June 30, 2006. A sample of 1468 questionnaires was mailed. A total of 446 completed questionnaires were returned for a response rate of 30%, and 1068 comments were offered by the respondents. Results An analysis of variance determined statistically significant differences between the ratings and the comment types in all 10 sections of the survey. A Bonferroni post hoc test revealed that the scale ratings were higher for patients who made positive comments than for patients who made negative comments for 8 of the 10 survey sections. A positive comment produced a higher mean score than did a negative comment. Conclusion The study results offer empirical evidence that there are differences in how patients quantitatively rate the services received in a hospital based on patient comment types. Hospital staff interpreting patient satisfaction survey results could say that negative comments produce lower quantitative ratings than do positive comments.

Registered nurses' judgments of the classification and risk level of patient care errors.

As frontline clinicians, nurses play a critical role in mitigating patient harm, recovery from health care errors, and overall improvement of patient safety. This cross-sectional study asked nurse respondents to make judgments about the classification and severity of errors in 4 clinical vignettes. Our results showed that agreement about error classification and associated risk among registered nurses is less than optimal. Further research is needed to advance our understanding of how nurses working in complex patient care situations can improve their ability to recognize subtle cues to facilitate early recognition of potential errors.

Dietitians Roles in the Interdisciplinary Health Care Team

Abstract The role of the dietitian is evolving as contemporary health care systems change. In particular, the increasing usage of interdisciplinary and transdisciplinary teams for health care delivery is providing opportunities for dietitians to expand current roles. Dietitians must strategize and position themselves to continue to be an influential presence on these teams. To assess present roles, potential barriers to these roles, and potential strategies for success in these roles, eight focus groups were conducted at the 1997 Annual Meeting of the American Dietetic Association. A total of 41 dietitians varying in age, experience, and location of employment participated in the study. The views expressed during the discussions were diverse, however general themes developed. The participants did not describe many team roles for a general staff dietitian. Most roles and responsibilities were specific to specialized teams such as nutrition support or rehabilitation. Overall, the participants agreed their roles are changing or will change, but were uncertain of the outcomes. Dietitians felt their current roles are multi-faceted and commonly function as educators, leaders, and subject-matter experts. The participants concluded to remain an integral part of the team, dietitians need to become more proactive, increase the marketing of their skills, acquire new skills, expand responsibilities, and take more risks. Ultimately, dietitians may use this information to better position themselves in health care teams.

Access and Disclosure of Personal Health Information: A Challenging Privacy Landscape in 2016-2018

Summary Objectives:  To assess the current health data access and disclosure environment for potential privacy-protecting mechanisms that enable legitimate use of personal health information while preserving the rights of individuals. To identify the gaps and challenges between increasing requests and expanding uses of such information and the regulations, technologies, and management practices that permit appropriate access and disclosure while guarding against harmful misuse of such information. Methods:  A scoping literature review focused on (1) regulations affecting access and disclosure of personal health information, (2) the uses of health information that challenge access and disclosure boundaries, and (3) privacy management practices that may help mitigate gaps in protecting patient privacy. Results:  Countries and jurisdictions are developing laws, regulations, and public policies to balance the privacy rights of individuals and the unprecedented opportunities to advance health and health care through expanded uses of health data. Regulations and guidance are evolving, but they are outpaced by the increasing demand for and the challenges of managing access and disclosure. Mechanisms such as consent and authorization may not always be adequate. Mechanisms that advance principled stewardship are more important than ever. Conclusions:  Access and disclosure management are important dimensions of privacy management practices. This is a volatile period in which diverging public policies may reveal how best to balance access and disclosure of personal health information by individuals and by institutional custodians of the information. Approaches to access and disclosure management, including the roles of individuals, should be a focus for research and study in the years ahead.