title: Real-time patient survey data during routine clinical activities for rapid-cycle quality improvement.
abstract: BACKGROUND
  Surveying patients is increasingly important for evaluating and improving health care delivery, but practical survey strategies during routine care activities have not been available.
  
  
  OBJECTIVE
  We examined the feasibility of conducting routine patient surveys in a primary care clinic using commercially available technology (Web-based survey creation, deployment on tablet computers, cloud-based management of survey data) to expedite and enhance several steps in data collection and management for rapid quality improvement cycles.
  
  
  METHODS
  We used a Web-based data management tool (survey creation, deployment on tablet computers, real-time data accumulation and display of survey results) to conduct four patient surveys during routine clinic sessions over a one-month period. Each survey consisted of three questions and focused on a specific patient care domain (dental care, waiting room experience, care access/continuity, Internet connectivity).
  
  
  RESULTS
  Of the 727 available patients during clinic survey days, 316 patients (43.4%) attempted the survey, and 293 (40.3%) completed the survey. For the four 3-question surveys, the average time per survey was overall 40.4 seconds, with a range of 5.4 to 20.3 seconds for individual questions. Yes/No questions took less time than multiple choice questions (average 9.6 seconds versus 14.0). Average response time showed no clear pattern by order of questions or by proctor strategy, but monotonically increased with number of words in the question (<20 words, 21-30 words, >30 words)-8.0, 11.8, 16.8, seconds, respectively.
  
  
  CONCLUSIONS
  This technology-enabled data management system helped capture patient opinions, accelerate turnaround of survey data, with minimal impact on a busy primary care clinic. This new model of patient survey data management is feasible and sustainable in a busy office setting, supports and engages clinicians in the quality improvement process, and harmonizes with the vision of a learning health care system.
authors.affiliation: Wake Forest University, Winston-Salem, NC, United States. jwofford@wakehealth.edu.
authors.forename: James Lucius
authors.identifier: http://orcid.org/0000-0002-3062-9462
authors.initials: JL
authors.lastname: Wofford
authors.forename: Claudia L
authors.identifier: http://orcid.org/0000-0003-1687-7117
authors.initials: CL
authors.lastname: Campos
authors.forename: Robert E
authors.identifier: http://orcid.org/0000-0002-4866-0046
authors.initials: RE
authors.lastname: Jones
authors.forename: Sheila F
authors.identifier: http://orcid.org/0000-0003-3407-8837
authors.initials: SF
authors.lastname: Stevens
keywords: information management/informatics; office practice issues/practice reengineering; patient-centered care; quality improvement