title: Do some trusts deliver a consistently better experience for patients? An analysis of patient experience across acute care surveys in English NHS trusts.
abstract: BACKGROUND
  Data were used from inpatient, outpatient and accident and emergency surveys in acute trusts in England to examine consistency in patient-reported experience across services, and factors associated with systematic variations in performance.
  
  
  METHODS
  Standardised mean scores for six domains of patient experience were constructed for each survey for 145 non-specialist acute trusts. Hierarchical cluster analysis was used to investigate whether and how trust performance clusters. Multilevel regression analysis was used to determine trust characteristics associated with performance.
  
  
  RESULTS
  Cluster analysis identified three groups: trusts that performed consistently above (30 trusts) or below (six trusts) average, and those with mixed performance. All the poor performing trusts were in London, none were foundation trusts or teaching hospitals, and they had the highest mean deprivation score and the lowest proportion of white inpatients and response rates. Foundation and teaching status, and the proportion of white inpatients, were positively associated with performance; deprivation and response rates showed less consistent positive associations. No regional effects were apparent after adjusting for independent variables.
  
  
  CONCLUSIONS
  The results have significant implications for quality improvement in the NHS. The finding that some NHS providers consistently perform better than others suggests that there are system-wide determinants of patient experience and the potential for learning from innovators. However, there is room for improvement overall. Given the large samples of these surveys, the messages could also have relevance for healthcare systems elsewhere.
authors.affiliation: Policy, The King's Fund, London W1G 0AN, UK. v.raleigh@kingsfund.org.uk
authors.forename: Veena S
authors.initials: VS
authors.lastname: Raleigh
authors.forename: Francesca
authors.initials: F
authors.lastname: Frosini
authors.forename: Steve
authors.initials: S
authors.lastname: Sizmur
authors.forename: Chris
authors.initials: C
authors.lastname: Graham
mesh_terms: D016000:Cluster Analysis; D004739:England; D006305:Health Status Indicators; D006306:Health Surveys; D015285:Hospital-Patient Relations; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D009313:National Health Programs; D009936:Organizational Innovation; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards; D058996:Quality Improvement / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires