Response to Patient Satisfaction as a Possible Indicator of Quality Surgical Care

To the Editor The recent study by Lyu et al¹ found little or no association between patient satisfaction on Medicare Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) scores and the quality of care in operating rooms. This finding is in contradistinction to our recent study² that observed a significant association between facility-wide patient satisfaction (on HCAHPS scores) and the incidence of central line–associated bloodstream infections in the intensive care unit (hospital staff responsiveness estimated rate ratio, 1.16; P < .001). We came to the opposite conclusion, that quality problems in one part of a facility may reflect a facility-wide problem with the facility’s culture of safety, which, thus, may be reflected in patient satisfaction surveys.