Research Award Details

2020 - POSNA Micro Grant

Parent Satisfaction in Ortho Trauma


Grant Recipient: Derek Kelly, MD

Institution:
Campbell Clinic
Additional Information:
Summary of Project:
Patient and caregiver satisfaction are measures of quality of care. Quality of care is used to judge physicians’ performance, compensation, and ratings. Higher patient satisfaction has been linked to better health outcomes due to increased treatment adherence and decreased readmission rates.1 Higher patient satisfaction has also been shown to increase profits for the healthcare provider, given that the patient may refer a friend or family member, return to that provider in the future, and lastly, be less likely to get involved with litigation if they are more satisfied with their care.2  Therefore, it is important to investigate methods of increasing both patient satisfaction and parent satisfaction. Physician Biosketch cards may provide a simple and inexpensive method to improve satisfaction. In 2014, Jahangir et al. published a study in which a group of adult orthopedic trauma patients was given a biosketch card with a photograph of their physician along with basic information, including the physician’s research interests, hobbies, education, and hometown. This study found increased patient satisfaction among those who received a Physician Biosketch card compared to those who did not.

Our study is similar; however, we are investigating the Physician Biosketch card effect in the pediatric orthopedic trauma setting by measuring parent satisfaction through a prospective, randomized, controlled trial. Caregivers of patients admitted to the hospital with an isolated orthopedic injury are assessed for their willingness to complete an experience survey via text or e-mail one week post discharge. Once they have agreed to complete the survey, patients are randomized in RedCAP. Eligible patients are then assigned to one of two groups, an intervention group or the control group.
 
Eligible patients include:
  • orthopedic trauma patients
  • 18 years old or younger
  • admitted to Le Bonheur Children’s Hospital from the hospital (not the clinic)
  • one of the six pediatric orthopedic surgeons as the attending physician
  • English speakers (with English speaking parent/guardian present)
  • an isolated orthopedic injury
Within 24 hours of admission, the patients in the intervention group will be given a biosketch card that contains their physician’s name, educational background, specialty, training, hobbies outside of work, and picture. Delivery of the biosketch cards is performed by a research assistant, a pediatric orthopedic nurse practitioner, or the study coordinator. If asked about the biosketch card during delivery, the individual who delivers the card states “This is your surgeon” to ensure the patient, and/or guardian, stay blinded to the study. The patients in the control group do not receive any form of the biosketch card during any point of their admission, or thereafter. An email/text satisfaction survey is sent to the patient’s guardians to complete within one week of discharge. The survey is administered via RedCAP. The survey includes general questions regarding the patients’ guardians’ overall satisfaction with their surgeon.

These questions include:
  • Overall, how would you rate the quality of doctor care (excellent, very good, good, fair, or poor)?
  • How would you rate your doctor on treating your child with consideration for you/your child’s needs as an individual (excellent, very good, good, fair, or poor)?
  • How would you rate your doctor on availability to see your child when needed (excellent, very good, good, fair, or poor)?
  • How would you rate your doctor on involving you in decisions about your child’s care (excellent, very good, good, fair, or poor)?
  • Would you recommend your doctor to a friend or family member? (Very likely, Likely, Neutral, unlikely, Very Unlikely)?
In addition, other factors that may contribute to their overall satisfaction are collected. 
These additional factors include:
  • patient age
  • insurance status
  • race
  • distance of travel to the facility based on zip code
  • type of trauma
  • length of hospital stay
  • type of guardian present
The physician is blinded to which of his patients received a biosketch card and to the satisfaction ratings given to him by specific patients until after the study has concluded. 

Through randomized intervention, 45 eligible patients so far have been assigned to one of two groups. The intervention group receives their Physician’s Biosketch card upon discharge. At this time, 23 patients and caregivers have been randomized to the intervention group and have receive their Physician’s Biosketch card. The control group does not receive any Physician Biosketch card and 22 patients and caregivers have been randomized to this group but they continue to receive all other standard patient and family education. The power analysis for this study requires 93 patients in each group. We are one-fourth of the way through our patient enrollment for this study. Our timeline is consistent with our anticipated 4 year time to completion. We hypothesized that the parents/guardians in the intervention group will report higher rates of surgeon satisfaction when compared to the control group.

Primary Measure of Success: We will be measuring success based on our survey data and the percentage of parents who answered positively to questions about their satisfaction with their surgeon. A preliminary look at the data reveals more positive responses in the control group versus the intervention group.

Future Plans: Upon completion of this project, it is planned to submit findings to POSNA and Pediatric Trauma Society.
 
 Table 1. Expense Report
 Item  Cost
 Statistical Analysis Support  $200
 Research Coordinator  $200
 RedCap Database Administrator Support  $150
 Biosketch Card Printing  $154
 Researcher Stipend  $300
 Total  $1,054
 
References:
1. Khanna, Krishn MD1; Diab, Mohammad MD1. The Journal of Bone and Joint Surgery: November 6, 2019 - Volume 101 - Issue 21 - p e115 doi: 10.2106/JBJS.18.01499
2. Shirley, Eric D. MD1; Sanders, James O. MD2. The Journal of Bone & Joint Surgery: May 15, 2013 - Volume 95 - Issue 10 - p e69 doi: 10.2106/JBJS.L.01048