Dorothea Wender (1990), an individual with aphasia who underwent a course of language treatment, wrote an article titled: "Quality: A Personal Perspective." She describes a "good therapist" and a "bad therapist." The good therapist was perceived as a person who respected her, treated her as an intelligent adult, smiled often, and talked with her daughters. An illustration of these divergent perceptions of quality care is found in a recent article and subsequent letter-to-theeditor in Asha. While clinicians are known to define quality primarily by their technical skill, clients are inclined to define quality by a clinician's interpersonal skills. Client Perceptions of Quality CareĬlinicians' and clients' views about quality of care can differ vastly.
These components were classified into three dimensions of satisfaction: Davis and Hobbs have identified the various components of client satisfaction to allow an accurate measurement. 25).ĭavis and Hobbs (1989), healthcare administrators who designed an outpatient satisfaction measure for the Rehabilitation Services Department of University Hospital-University of British Columbia, define client satisfaction as the extent to which a program fulfills clients' treatment expectations. A subjective summing up and balancing of these detailed judgments would represent overall satisfaction" (p. "It could pertain to the settings and amenities of care, to aspects of technical management, to features of interpersonal care, and to the physiological, physical, psychological or social consequences of care. Donabedian (1980) points out that a client's assessment of quality, expressed as satisfaction or dissatisfaction, could be remarkably detailed. Client Satisfaction: An Operational DefinitionĬlient satisfaction is a multidimensional concept, relating to both technical and interpersonal aspects of care, and the amenities of care (such as an attractive physical environment, and convenient location and parking). It is also useful in program planning and evaluation" (p. "Patient feedback is especially important to the QA process because it helps health care providers identify potential areas for improvement, such as patient education and follow-up, specific quality of care issues, and hospital procedures (e.g., reimbursement policies, the admissions process). Weisman and Koch believe that tools designed to elicit client feedback often are the only channel through which clients can alert providers to their concerns, needs, and perceptions of treatment. Furthermore, research has shown that client satisfaction (or dissatisfaction) is an indicator of other client behaviors, such as choice of practitioners or programs, disenrollment, use of services, complaints, and malpractice suits (Ware, 1987).
Weisman and Koch (1989) have indicated that satisfied clients are more likely to follow their practitioners' recommendations for treatment. Whatever its strengths and limitations as an indicator of quality, information about patient satisfaction should be as indispensable to assessments of quality as to the design and management of health care systems (p. Donabedian (1988), a noted authority in quality measurement, states: Patient satisfaction may be considered to be one of the desired outcomes of care, even an element in health status itself…It is futile to argue about the validity of patient satisfaction as a measure of quality. In recent years, client satisfaction with clinical services has gained recognition as an outcome of quality care. Yet, the client's perspective on quality care largely has been considered external to the service delivery process (Weisman & Koch, 1989). The following article was originally published by ASHA in the Winter 1991 Quality Improvement Digest.įew clinicians would debate that clients are the central focus of both service delivery and quality measurement.