Sara L Toomey1, Marc N Elliott2, Alan M Zaslavsky3, Jessica Quinn4, David J Klein4, Stephanie Wagner4, Cassandra Thomson4, Melody Wu4, Sarah Onorato4, Mark A Schuster5. 1. Division of General Pediatrics, Department of Medicine (SL Toomey, J Quinn, DJ Klein, S Wagner, C Thomson, MWu, S Onorato, and MA Schuster), Boston Children's Hospital; Department of Pediatrics (SL Toomey and MA Schuster), Department of Health Care Policy (AM Zaslavsky), Harvard Medical School, Boston, Mass. Electronic address: sara.toomey@childrens.harvard.edu. 2. Department of Pediatrics (SL Toomey and MA Schuster), Department of Health Care Policy (AM Zaslavsky), Harvard Medical School, Boston, Mass. 3. RAND Corporation (MN Elliott), Santa Monica, Calif. 4. Division of General Pediatrics, Department of Medicine (SL Toomey, J Quinn, DJ Klein, S Wagner, C Thomson, MWu, S Onorato, and MA Schuster), Boston Children's Hospital. 5. Division of General Pediatrics, Department of Medicine (SL Toomey, J Quinn, DJ Klein, S Wagner, C Thomson, MWu, S Onorato, and MA Schuster), Boston Children's Hospital; Department of Pediatrics (SL Toomey and MA Schuster), Department of Health Care Policy (AM Zaslavsky), Harvard Medical School, Boston, Mass; Kaiser Permanente School of Medicine (MA Schuster), Pasadena, Calif.
Abstract
OBJECTIVE: Most US hospitals conduct patient experience surveys by mail or telephone after discharge to assess patient/family centeredness of care. Pediatric response rates are usually very low, especially for black, Latino, and low-income respondents. We investigated whether day of discharge surveying using tablets improves response rates and respondent representativeness. METHODS: This was a quasi-experimental study of parents of patients discharged from 4 units of a children's hospital. Parents were assigned to receive the Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) via an audio-enabled tablet before discharge or via mail at approximately 1 week postdischarge. Intervention and control conditions alternated by week. We compared response rates, child/respondent characteristics, and mean top-box scores between tablet and mail only arms. RESULTS:Administering Child HCAHPS on a tablet was administratively feasible and did not interfere with the discharge process (median completion time, 12.4 minutes). The response rate was 71.1% (424 of 596) for tablet versus 16.3% (96 of 588) for mail only. Although the tablet response rate was higher in every subgroup, tablet respondents were more likely to be fathers (20.4% vs 6.4%; P = .006), more likely to have a high school education or less (17.5% vs 8.4%; P = .002), less likely to be white (56.8% vs 71.9%; P = .006), and more likely to be publicly insured (31.4% vs 19.8%; P = .02). Tablet scores were significantly higher than mail only scores for 3 of 17 measures. CONCLUSIONS: The response rate for day of discharge tablet survey administration was >4-fold higher than with single-wave mail-only administration, with greater participation of hard-to-reach groups. These findings suggest tablet administration before discharge shows great promise for real-time feedback and QI and may transform the field of inpatient survey administration.
RCT Entities:
OBJECTIVE: Most US hospitals conduct patient experience surveys by mail or telephone after discharge to assess patient/family centeredness of care. Pediatric response rates are usually very low, especially for black, Latino, and low-income respondents. We investigated whether day of discharge surveying using tablets improves response rates and respondent representativeness. METHODS: This was a quasi-experimental study of parents of patients discharged from 4 units of a children's hospital. Parents were assigned to receive the Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) via an audio-enabled tablet before discharge or via mail at approximately 1 week postdischarge. Intervention and control conditions alternated by week. We compared response rates, child/respondent characteristics, and mean top-box scores between tablet and mail only arms. RESULTS: Administering Child HCAHPS on a tablet was administratively feasible and did not interfere with the discharge process (median completion time, 12.4 minutes). The response rate was 71.1% (424 of 596) for tablet versus 16.3% (96 of 588) for mail only. Although the tablet response rate was higher in every subgroup, tablet respondents were more likely to be fathers (20.4% vs 6.4%; P = .006), more likely to have a high school education or less (17.5% vs 8.4%; P = .002), less likely to be white (56.8% vs 71.9%; P = .006), and more likely to be publicly insured (31.4% vs 19.8%; P = .02). Tablet scores were significantly higher than mail only scores for 3 of 17 measures. CONCLUSIONS: The response rate for day of discharge tablet survey administration was >4-fold higher than with single-wave mail-only administration, with greater participation of hard-to-reach groups. These findings suggest tablet administration before discharge shows great promise for real-time feedback and QI and may transform the field of inpatient survey administration.
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