Measuring satisfaction and anesthesia related outcomes in a surgical day care centre: A three-year single-centre observational study

Abstract

Study objective: To evaluate patient satisfaction and patient reported anaesthesia related outcome parameters after outpatient surgery.

Design: A three-year (2013-2016) observational study.

Setting: A surgical day care centre embedded in a tertiary care, university hospital.

Patients: Adult Dutch-speaking patients who underwent surgery under general or regional anaesthesia on an outpatient basis (n=5424).

Interventions: A questionnaire was developed to evaluate patients' satisfaction with care during their hospitalisation in the surgical day centre, as well as to assess their reports of anaesthesia related outcomes.

Measurements: Various aspects of care were measured, including care by nurses, care by doctors, organisational and safety items. Variation in satisfaction and surgery and anaesthesia related outcomes as a function of different categories (gender, age, education, type of anaesthesia, discipline and era) were also investigated.

Main results: Confirmatory factor analysis showed an excellent fit to the hypothesized factors of the survey. Satisfaction scores were very high for different aspects of care, resulting in 98% of patients being (very) satisfied (59.1% very satisfied, 38.9% satisfied). Male (p=0.0003), higher educated (p<0.0001) and older patients (p<0.0001) were more likely to be very satisfied. Postoperative nausea and vomiting (PONV) were frequent (nausea: 13.9%, vomiting: 3.3%), and more present in female than in male patients (p<0.0001). Pain scores at the PACU differed among disciplines (p<0.0001) were higher in female patients compared to male patients (3.41% versus 2.54%, p<0.0001) and after general anaesthesia compared to regional anaesthesia (3.25% versus 0.39%, p<0.0001) and decreased with higher age (p=0.0001) and education level (p=0.0033).

Conclusions: Whereas satisfaction with all aspects of care is generally high, the results regarding pain and PONV should inspire quality improvement initiatives. The questionnaire developed in this study can be a vehicle to assess and improve the quality of care in surgical day care centres.

Keywords: Ambulatory care; Outpatient surgery; Patient reported outcome measures; Patient satisfaction.