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Purpose: To describe the impact of an inpatient pharmacist-directed anticoagulation service (PDAS) on patient satisfaction.
Methods: This IRB-approved study was conducted at an urban, tertiary hospital. PDAS is a clinical pharmacy service that has improved transition-of-care, safety, and efficacy involving anticoagulant usage at our institution. Patients receiving inpatient anticoagulation therapy, during February 2001-April 2007 (pre-PDAS) and December 2008-December 2010 (post-PDAS), who responded to a mail-in survey, were included. Survey items included SATISFACTION (Overall, how satisfied were you with the medical care?), AMTINFO (How was the amount of information received about your medicine?), CLARITY (How was the clarity of the information received about your medicine?), ANSWER (How were the answers to your questions about your medicine?), and SPEAK (Did a pharmacist speak with you during your stay?). Response options for AMTINFO, CLARITY, ANSWER, and SATISFACTION used a five-point scale, either where 1=”very good” and 5=”very poor” or, for SATISFACTION, 1=“extremely satisfied” and 5=“not at all satisfied”. Positive response=options 1-2. Negative response=options 3-5. For SPEAK, positive response=“yes” and negative response=“no”. Patient satisfaction equaled rate of positive responses. Primary analysis compared patient satisfaction between pre-PDAS and post-PDAS respondents.
Results: Surveys were distributed to 1684 patients after discharge, with 689 (40.5%) responding. Post-PDAS respondents had improved patient satisfaction for all items (Table1). Improvements were 72.5% for AMTINFO, 68.2% for CLARITY, 52.3% for ANSWER, 12.8% for SATISFACTION, and 149% for SPEAK. Table1: Positive responses, n (%).
Pre-PDAS | Post-PDAS | P values | |
AMTINFO | 271/528 (51.3) | 138/156 (88.5) | <0.0001 |
CLARITY | 272/527 (51.6) | 138/159 (86.8) | |
ANSWER | 295/523 (56.4) | 134/156 (85.9) | |
SATISFACTION | 439/528 (83.1) | 149/159 (93.7) | |
SPEAK | 148/528 (28.6) | 113/159 (71.1) |
Conclusions: PDAS, a focused program with a systematic approach to patient-pharmacist communication, improved patient satisfaction. Given the upcoming era of hospital value-based purchasing, the impact of this type of program on standardized hospital surveys should be further explored.