Clinic Staff Relationships Affect Patient Satisfaction

Lara C. Pullen, PhD

November 14, 2013

The relationships between clinicians and staff play an important role in patients' perception of quality care. A new scale, known as the Work Relationship Scale (WRS), can be used to measure these relationships and may help optimize care delivery in the primary setting.

Erin P. Finley, PhD, MPH, from South Texas Veterans Health Care System in San Antonio, Texas, and colleagues published the results of their study in the November/December issue of the Annals of Family Medicine. The article describes the WRS and the association between WRS scores and patient experiences of care, as determined by VA Survey of Healthcare Experiences of Patients data.

The authors developed the 15-item WRS on the basis of previously published literature, including observations of relationships in high-functioning, non-VA primary care clinics. The authors then validated the WRS in 17 VA primary care clinics in Texas. A total of 457 clinicians and staff completed the WRS, and 247 also participated in semistructured interviews.

The WRS measures items such as: "This clinic encourages nursing staff (ie, RN, LVN, MA, CMA) input for making changes" and "Most people in this clinic are willing to change how they do things in response to feedback from others."

Primary care clinics with lower WRS scores tended to have lower patient ratings of overall healthcare (r 2, 0.25; P < .05) and of individual clinicians (r 2, 0.43; P < .01) based on the VA Survey of Healthcare Experiences of Patients data. In contrast, the authors found no association between the VA Survey of Healthcare Experiences of Patients variables of "getting care quickly" and "clinician wait time" and clinic WRS scores.

"This study is one of the first to show that relationships within a care organization affect patient satisfaction. Clinic member relationships appear to have a significant impact on patient perceptions of care and should be assessed as part of efforts to improve delivery," the authors conclude.

This work was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. One coauthor is an investigator with the Implementation Research Institute, George Warren Brown School of Social Work, Washington University, St. Louis, through an award from the National Institute of Mental Health and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative. The other authors have disclosed no relevant financial relationships.

Ann Fam Med. 2013;11:543-549. Full text


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