title: Patient experience in the pediatric otolaryngology clinic: does the teaching setting influence parent satisfaction?
abstract: OBJECTIVE
  Patient experience scores are now recognized as a chief indicator of healthcare quality. This report compares outpatient pediatric otolaryngology patient satisfaction in the teaching and non-teaching settings.
  
  
  METHODS
  Cross-sectional, multi-site, patient-level analysis of satisfaction surveys (Press Ganey™ Medical Practice©) completed by parents of pediatric otolaryngology patients in FY2010.
  
  
  METHODS
  Surveys were stratified by teaching/non-teaching affiliation. The survey has 29 Likert-scaled questions which comprise an overall score and subscores in 6 domains: access, visit, nursing, provider, personal issues, and assessment. The item likelihood-to-recommend was measured to indicate practice loyalty. Mean scores were compared by Kruskal-Wallis rank test. Multivariate logistic regression was performed to evaluate the association of teaching status with receipt of highest scores (HI-SCORES).
  
  
  RESULTS
  4704 pediatric surveys were analyzed, with 1984 (42%) from the teaching setting. For the teaching setting, mean scores were lower overall (88.1 vs. 89.0; p<0.001) and in domains of access (includes scheduling ease, promptness in returning calls; 86.7 vs. 89.4; p<0.001) and personal issues (includes office hour convenience, sensitivity to needs; 87.0 vs. 88.5; p<0.001). Differences in access scores were largest for young children (0-<6 years; 86.0 vs. 89.5; p<0.001). Children in the teaching setting were less likely to have HI-SCORES overall (OR 0.78; 95%CI 0.65-0.95; p=0.011) and for access (OR 0.8; 95%CI 0.67-0.95; p=0.012); probability of HI-SCORES was similar for the two settings for all other domains.
  
  
  CONCLUSIONS
  Parents of pediatric otolaryngology patients evaluated in the teaching setting report lower satisfaction related to access, but similar scores for care providers and practice loyalty. Academic otolaryngology practices might focus on access issues to improve the overall care experience for children and families.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, United States. erudnic2@jhmi.edu
authors.forename: Emily F
authors.initials: EF
authors.lastname: Boss
authors.forename: Richard E
authors.initials: RE
authors.lastname: Thompson
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000553:Ambulatory Care / Q000592:standards* / Q000639:trends; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010036:Otolaryngology / Q000379:methods* / Q000639:trends; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000592:standards / Q000639:trends; D017149:Private Sector; D011785:Quality Assurance, Health Care; D014481:United States