While Julie Taylor's article in the Rotorua Daily Post with the catchy title "Patients can't get hospital satisfaction" takes one back to that great old Rolling Stones song, it is nevertheless somewhat misleading.

Not only does Ms Taylor cites the statistics she obtained from the latest Hospital Benchmarking Information report produced by the Ministry of Health incorrectly (the overall patient satisfaction among Lakes DHB patients is 83.7%, not 85.9%!) but, more importantly, the title ignores the fact that more than eight out of ten patients who have been treated at Rotorua and Taupo hospitals are very happy with their care!

Moreover, while it is undoubtedly true that there is room for improvement, it is wrong to merely report this single measure of overall satisfaction without taking into account approval or disapproval of more specific aspects of care such as staff availability, quality of information received, informed consent, involvement of family, cultural sensitivity, impressions of cleanliness, quality of food, and feeling safe and secure. And, mindful of the fact that the results of such surveys vary greatly over time, neither is it particularly useful to concentrate on a short period such as a three month period.

For the past four years, our company, Health Services Consumer Research, has monitored patient satisfaction in New Zealand District Health Boards in the quarterly published "New Zealand Patient Satisfaction Index".  This report is based on the same nationwide patient survey and draws on a database which presently consists of some 338,478 patient records and 5.5 million ratings from inpatients and outpatients in 21 District Health Boards. This allows us to analyse the data in greater detail than is presented in the benchmarking document produced by the Ministry of Health.

For instance, if we focus on the last 12 months rather than the latest quarterly period, and compare Lakes DHB with other DHBs on their staff's effort to make a suitable appointment for their outpatients, we find that they rank at the top rather than the bottom of the list (see Figure 1).       

Figure 1 Responses to "Please rate our staff on their effort to make a suitable appointment time"

But this comparison still misses the point. The purpose of carrying out the nationwide patient survey is not to arrive at a league table showing the winners and the losers, but to identify which DHB is good at what and to learn from that so that the overall clinical and organisational performance of all DHBs can be improved.

As the Ministry of Health says in the preface of their report:

"There is research evidence to suggest that long-term performance improvement is most likely when performance information forms part of open-ended quality improvement and learning processes within an organisation, rather than when it is wielded as a judgement or 'naming and shaming' tool by an external body. The HBI report reflects such thinking; it should be read not as an attempt to judge or control DHBs, but as a tool produced for DHBs to use in enhancing their own performance."

Ms Taylor's article, while acknowledging that Rotorua and Taupo hospitals have been extremely busy with emergency cases and agreeing that staff have dealt with these cases fast and effectively, nevertheless is written from an outmoded perspective.

Congratulations to Lakes DHB!!!