Using root cause analysis to address patient satisfaction and other improvement opportunities

Jt Comm J Qual Improv. 2000 Aug;26(8):439-49. doi: 10.1016/s1070-3241(00)26037-9.


Background: Despite the considerable attention that health care organizations are devoting to the measurement of patient satisfaction, there is often confusion about how to systematically use these data to improve an organization's performance. A model to use in applying traditional quality improvement methods and tools to patient satisfaction problems includes five primary steps: (1) identifying opportunities, (2) prioritizing opportunities, (3) conducting root cause analysis, (4) designing and testing potential solutions, and (5) implementing the proposed solution.

Patient satisfaction surveys: A satisfaction survey serves best as a high-level screening device, not as a tool to provide highly detailed information about the root causes of patient dissatisfaction. The primary purpose of the survey in the model is to identify improvement opportunities and areas of significant improvement or deterioration. Secondary tools such as brief patient interviews or focus groups may better serve to probe intensively into the problem areas identified by the survey. These tools allow for a direct dialog with the patient to uncover root causes of dissatisfaction and establish potential solutions.

Discussion: Although the primary focus of this model has been patient satisfaction issues, the basic steps could easily be applied to virtually any improvement opportunity. Improvement teams should commit to a schedule of 90-minute weekly meetings for 7 weeks. The model, a simple translation of traditional improvement methods and tools to address the unique issues facing patient satisfaction improvement teams, can save improvement teams considerable time, resources, and frustration as they design and launch initiatives to improve patient satisfaction.

Publication types

  • Review

MeSH terms

  • Causality
  • Data Interpretation, Statistical
  • Health Care Surveys / methods*
  • Health Plan Implementation
  • Humans
  • Interviews as Topic / methods
  • Models, Organizational
  • Patient Satisfaction*
  • Quality Assurance, Health Care / methods*
  • United States