Patient Satisfaction Survey

The Patient Satisfaction Survey (PSS) clinical audit is completed once every three years.  The RNZCGP patient survey audit is allowed as an alternative.

Registrars must complete a PSS (or approved alternative) within their first year of training, unless exempted by the Education Committee.

General instructions

Doctors should give these instructions to a member of staff, who will ask patients to complete a short form.

  • For those working in urgent care clinics, a minimum of 50 patient survey forms are required.
  • For those working in emergency departments, a minimum of 30 patient survey forms are required.

When complete, forms should be sent by reception to the College as per staff instructions.

College staff will enter the results into ePortfolio and inform the doctor when the results are available. The Director of Clinical Training (for registrars) or Director of Professional Development (for Fellows) will discuss low-scoring audits with the doctor.

Purpose

There is a link between low PSS scores and patient complaints.

One benefit for the PSS is to alert doctors with low scores to this fact, and give them the opportunity to take steps to improve their score. This may reduce complaints, and improve patient satisfaction, patient communication, and quality of care.

Interpretation of results

RNZCUC will provide a comparison of your scores with those of other urgent care doctors, expressed as standard deviations from the norm.

Our analysis indicates that overall, most patients appear to be very satisfied with their urgent care consultations – dissatisfaction rates are low.

The average overall mark lies half way between very good and excellent. Two SD below the norm lies just above or below ‘very good’.

Limitations of the urgent care PSS

Limitations include:

  • Some facilities have lower satisfaction levels
  • The sample size is small – one or two disgruntled patients can bias a 50-patient survey
  • Factors outside the doctor’s influence – e.g. long waits – could influence results.

Also, there must inevitably be doctors who are 1-2 SD below the norm – these scores in some cases could be close to the ‘pack’ and not clear outliers.

Interpretation of low scores

As above, a very low score (>2SD below the norm) can lie in the very good range.

Some doctors have opined that an average in the “very good” range cannot possibly be a cause for concern.  However, over a large number of consults it will make a big difference if dissatisfaction rates are 5%, say, when the norm is 1% – perhaps a five-fold increase in complaints.

Dealing with low scores

RNZCUC is unlikely to withhold Fellowship solely because of low scores. However it will expect doctors to take reasonable steps to address low scores:

Reflection

One step is simply to reflect on the scores, to be aware there could be an issue, and through your own efforts or in consultation with your supervisor or others, make changes – and then repeat the audit.

Repetition

Repetition will address the possibility that the low scores were simply due to small sample size and ‘bad luck’.