Use of a customer satisfaction survey by health care regulators: a tool for total quality management.
OBJECTIVE
To conduct a survey of health care providers to determine the quality of service provided by the staff of a regulatory agency; to collect information on provider needs and expectations; to identify perceived and potential problems that need improvement; and to make changes to improve regulatory services.


METHODS
The authors surveyed health care providers using a customer satisfaction questionnaire developed in collaboration with a group of providers and a research consultant. The questionnaire contained 20 declarative statements that fell into six quality domains: proficiency, judgment, responsiveness, communication, accommodation, and relevance. A 10% level of dissatisfaction was used as the acceptable performance standard.


RESULTS
The survey was mailed to 324 hospitals, nursing homes, home care agencies, hospices, ambulatory care centers, and health maintenance organizations. Fifty-six percent of provider agencies responded; more than half had written comments. The three highest levels of customer satisfaction were in courtesy of regulatory staff (90%), efficient use of onsite time (84%), and respect for provider employees (83%). The three lowest levels of satisfaction were in the judgment domain; only 44% felt that there was consistency among regulatory staff in the interpretation of regulations, only 45% felt that interpretations of regulations were flexible and reasonable, and only 49% felt that regulations were applied objectively. Nine of 20 quality indicators had dissatisfaction ratings of more than 10%; these were considered priorities for improvement.


CONCLUSIONS
Responses to the survey identified a number of specific areas of concern; these findings are being incorporated into the continuous quality improvement program of the office.
Andrzejewski
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New York State Department of Health, Syracuse 13202, USA. nsa01@health.state.ny.us
Lagua
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D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D003695:Delivery of Health Care / Q000592:standards*; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D009518:New York; D011634:Public Health; D011787:Quality of Health Care; D013219:State Government