title: The patient satisfaction chasm: the gap between hospital management and frontline clinicians.
abstract: BACKGROUND
  Achieving high levels of patient satisfaction requires hospital management to be proactive in patient-centred care improvement initiatives and to engage frontline clinicians in this process.
  
  
  METHODS
  We developed a survey to assess the attitudes of clinicians towards hospital management activities with respect to improving patient satisfaction and surveyed clinicians in four academic hospitals located in Denmark, Israel, the UK and the USA.
  
  
  RESULTS
  We collected 1004 questionnaires (79.9% response rate) from four hospitals in four countries on three continents. Overall, 90.4% of clinicians believed that improving patient satisfaction during hospitalisation was achievable, but only 9.2% of clinicians thought their department had a structured plan to do so, with significant differences between the countries (p<0.0001). Among responders, only 38% remembered targeted actions to improve patient satisfaction and just 34% stated having received feedback from hospital management regarding patient satisfaction status in their department during the past year. In multivariate analyses, clinicians who received feedback from hospital management and remembered targeted actions to improve patient satisfaction were more likely to state that their department had a structured plan to improve patient satisfaction.
  
  
  CONCLUSIONS
  This portrait of clinicians' attitudes highlights a chasm between hospital management and frontline clinicians with respect to improving patient satisfaction. It appears that while hospital management asserts that patient-centred care is important and invests in patient satisfaction and patient experience surveys, our findings suggest that the majority do not have a structured plan for promoting improvement of patient satisfaction and engaging clinicians in the process.
authors.affiliation: Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA. rrozenblum@bics.bwh.harvard.edu
authors.forename: Ronen
authors.initials: R
authors.lastname: Rozenblum
authors.forename: Marianne
authors.initials: M
authors.lastname: Lisby
authors.forename: Peter M
authors.initials: PM
authors.lastname: Hockey
authors.forename: Osnat
authors.initials: O
authors.lastname: Levtzion-Korach
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Salzberg
authors.forename: Nechama
authors.initials: N
authors.lastname: Efrati
authors.forename: Stuart
authors.initials: S
authors.lastname: Lipsitz
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D000046:Academic Medical Centers; D003430:Cross-Sectional Studies; D003718:Denmark; D030141:Feedback, Psychological; D005260:Female; D006740:Hospital Administrators / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D007557:Israel; D016015:Logistic Models; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care; D011785:Quality Assurance, Health Care / Q000639:trends*; D011795:Surveys and Questionnaires