Abstract
Decreasing postoperative pain for total knee arthroplasty (TKA) patients has been
an area of continued effort for healthcare providers. These efforts have been incentivized
by legislative reform, which ties reimbursement for hospitals and providers to patient
perception of care. Press Ganey (PG) surveys quantify patient satisfaction, and the
“pain management” domain is thought to be the best metric for assessing pain intensity.
Therefore, these responses are important, as they are used to guide further improvements
in healthcare delivery. This study analyzes which PG survey domains are truly associated
with pain intensity in the immediate postoperative period following TKA. We queried
our PG database for all primary TKA patients between November 2012 and January 2015,
yielding a total of 214 patients. Multivariate regression analysis was performed utilizing
pain intensity as the dependent variable. Predictor variables included body mass index
(BMI), Charlson's comorbidity index, opioid consumption, and PG survey domains. Patient
ratings of “communication with doctors” (B = 58.147; p = 0.001), “responsiveness of hospital staff” (B = − 62.663; p = 0.041), “communication about medicines” (B= −45.037; p < 0.001), and “hospital environment” (B = 69.342; p = 0.017) were associated with patient pain intensity. We found survey domains, other
than “pain management,” were associated with pain intensity. Efforts to improve outcomes
and satisfaction should focus on staff education and communication. The current method
for measuring patient satisfaction and reimbursement should be critically assessed
and redesigned to better reflect true patient experiences.
Keywords
pain intensity - patient satisfaction - Press Ganey survey - TKA - total knee arthroplasty
