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Domain 4: Evaluation of Patient Experience with Contraception Services


Evaluation of Patient Experience


Patient experience:

defined by The Beryl Institute as “the sum of all interactions, shaped by an organization’s culture, that influence client perceptions across the continuum of care.” (The Beryl Institute, http://www.theberylinstitute.org/?page=definingpatientexp)


  • Place a comment box, clinic journal or bulletin board in the clinic for patients to provide feedback and comments about their care.1
    • Such passive assessments will give a highly selective perspective from a small subsection of motivated patients. Some complaints may be very situational and not necessarily useful for motivating clinic changes.
    • In a family planning setting, privacy concerns must be carefully protected. Thus, the handling of comments should be clearly posted (e.g., who will have access to them and how they will be discarded).
  • Conduct active evaluation activities such as a patient satisfaction survey (paper or online), exit interviews, telephone audit, mobile survey and focus groups.1.2
    • Validated patient surveys designed to evaluate patient’s primary health care experiences and interactions with their clinicians are available. Identify survey questions that are relevant to contraceptive care and for evaluating patient perceptions of cultural competency, information delivery, patient-centered communication and interpersonal care from these sources and use them to develop a brief instrument.2,3,4
    • Include an open field for patient comments to obtain feedback not captured by the survey items.
    • The survey can be administered to all patients for a set period (e.g., two days, one week). This can be done twice a year or less frequently, depending on available resources. Alternatively, the survey can be available at all times to all patients (see passive assessments above).
  • Use survey findings and resulting actions to:
    • Congratulate staff on their efforts,
    • Communicate to patients that the clinic staff care about their needs and preferences by posting information in waiting areas about current improvement efforts, and
    • Share with board members, funders, Coordinated Care Organizations and/or accreditation organizations.1
  • Establish procedures for ongoing quality improvement based on the information collected. After conducting the evaluation (active or passive), involve clinic staff in reflection on the results without assigning blame. Encourage a culture of problem solving to improve care.1,2,4,5,6,7
    • Involve staff who are being assessed in all stages of the evaluation process: data development, collection and analysis.
    • The Plan, Do, Study, Act model (see Institute for Health Care Improvement resource below) for systematically improving quality of care involves staff in developing a plan, pilot testing, evaluating and permanent implementation.8
    • Teach leadership how to evaluate services and share data in positive, productive, systems-focused communication styles.


  1. The National Family Planning Training Center, The Patient Experience Improvement Toolkit: http://fpntc.org/training-and-resourc-es/patient-experience-improvement-toolkit
  2. Patient Experience of Care: Inventory of Improvement Resources, Aligning Forces for Quality, RWJF, July 2014: http://forces4quality. org/patient-experience-care-inventory-improvement-resources-0
  3. Primary Care Satisfaction Survey for Women: http://www.wakehealth.edu/Research/WHQA/Downloads.htm
  4. Agency for Healthcare Research and Quality, CAHPS – Surveys and Tools to Advance Patient-Centered Care: https://cahps.ahrq. gov/surveys-guidance/cg/instructions/visitsurveyinst.html
  5. QFP pages 21-24: http://www.cdc.gov/mmwr/pdf/rr/rr6304.pdf
  6. Becker D, Koenig MA, Kim YM, Cardona K, Sonenstein FL. The quality of family planning services in the United States: findings from a literature review. Perspect Sex Reprod Health 2007; 39:206–15.
  7. Becker D, Tsui AO. Reproductive health service preferences and perceptions of quality among low-income women: racial, ethnic and language group di erences. Perspect Sex Reprod Health 2008; 40:202–11.
  8. Institute for Health Care Improvement. How to improve. Cam- bridge, MA: Institute for Health Care Improvement; 2014. http://www.ihi.org/knowledge/Pages/HowtoImprove/default.aspx