Patient satisfaction with anesthesia services

Purpose: The evaluation of services by patients is an essential component o f continuous quality improvement in anesthesiology, Little is known, howeve r, about how to achieve this objective. Our goal was to conduct a systemati c review of all available studies on patient satisfaction with anesthesia s ervices, thereby ascertaining the present level of knowledge in this field and suggesting ways of improving current measurement methodologies, Source: We reviewed relevant major data banks - Medline, Dissertation Abstr act, Psyclit and Cochrane - between 1980 and 2000 and bibliographies from p rimary sources. We used the following keywords for our search: quality impr ovement, anesthesia, quality, patient perceptions, consumer satisfaction, c ontinuous quality improvement, outcome measures. Principal findings : The review yielded 14 pertinent studies. Studies were divided into two groups (A & B), according to the quality of the psychometr ic evaluation (tests performed to verify the reliability and validity of an instrument). While ail studies reported high levels of patient satisfactio n with anesthesia services, many used methods of questionable value. None o f the 14 studies controlled for any confounding variables, such as social d esirability. Four studies had seriously biased their data collection and th e majority of the studies lacked rigour in the development of the instrumen t used to measure patient satisfaction. Only one study presented a definiti on of the concept measured, and none provided a conceptual model of patient s' satisfaction with anesthesia services. Conclusion: The currently available studies of patient satisfaction are of questionable value. Only rigorous methods and reliable instruments will yie ld valid and clinically relevant findings of this important issue in anesth esiology.