title: Postacute stroke guideline compliance is associated with greater patient satisfaction.
abstract: OBJECTIVE
  To determine if the structure of care or the process of stroke care, as measured by compliance with stroke guidelines published by the Agency for Healthcare Research and Quality (AHRQ), is associated with patient satisfaction.
  
  
  METHODS
  Prospective inception cohort study of new stroke admissions including postacute care with follow-up interviews at 6 months poststroke.
  
  
  METHODS
  Eleven Veterans Affairs medical centers (VAMCs).
  
  
  METHODS
  A total of 288 new stroke patients admitted to VAMCs.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Compliance with AHRQ stroke guidelines and patient satisfaction with care using a stroke-specific instrument.
  
  
  RESULTS
  Process of care was positively and significantly associated with greater patient satisfaction even after controlling for patient functional outcome. The most visible (to the patient) process of care dimensions correlated most highly with patient satisfaction. Sixty-four percent (73/115) of patients expressed some dissatisfaction with 1 or more survey items.
  
  
  CONCLUSIONS
  "What we do" and "how we do it" while providing postacute care to stroke patients was associated with patient satisfaction. This linkage of process to outcome is an important validation of satisfaction as a significant patient outcome. This linkage is further evidence that compliance with AHRQ stroke guidelines may be a valid quality of care indicator.
authors.affiliation: Kansas City VA Medical Center and Center on Aging, University of Kansas Medical Center, Kansas City, KS 64128, USA. dean.recker@med.va.gov
authors.forename: Dean M
authors.initials: DM
authors.lastname: Reker
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Duncan
authors.forename: Ronnie D
authors.initials: RD
authors.lastname: Horner
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Samsa
authors.forename: Byron B
authors.initials: BB
authors.lastname: Hamilton
authors.forename: Tara K
authors.initials: TK
authors.lastname: Dudley
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D000071939:Stroke Rehabilitation; D014481:United States