Improving Response Rates and Representation of Hard-to-Reach Groups in Family Experience Surveys

• Published in: Academic pediatrics Vol. 19; no. 4; pp. 446 - 453
• Main Authors: Toomey, Sara L., Elliott, Marc N., Zaslavsky, Alan M., Quinn, Jessica, Klein, David J., Wagner, Stephanie, Thomson, Cassandra, Wu, Melody, Onorato, Sarah, Schuster, Mark A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2019
• Subjects: Adolescent; Adult; Child; Child, Preschool; Computers, Handheld - statistics & numerical data; Family; Female; Hospitals; Hospitals, Pediatric; Humans; Infant; Male; Middle Aged; Parents; patient experience; Patient Satisfaction - statistics & numerical data; Postal Service - statistics & numerical data; quality improvement; Research Subjects - statistics & numerical data; survey administration; Surveys and Questionnaires - statistics & numerical data; United States; Young Adult; United States; patient experience; quality improvement; survey administration
• ISSN: 1876-2859; 1876-2867; 1876-2867
• DOI: 10.1016/j.acap.2018.07.007

Most US hospitals conduct patient experience surveys by mail or telephone after discharge to assess patient/family centeredness of care. Pediatric response rates are usually very low, especially for black, Latino, and low-income respondents. We investigated whether day of discharge surveying using tablets improves response rates and respondent representativeness. This was a quasi-experimental study of parents of patients discharged from 4 units of a children's hospital. Parents were assigned to receive the Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) via an audio-enabled tablet before discharge or via mail at approximately 1 week postdischarge. Intervention and control conditions alternated by week. We compared response rates, child/respondent characteristics, and mean top-box scores between tablet and mail only arms. Administering Child HCAHPS on a tablet was administratively feasible and did not interfere with the discharge process (median completion time, 12.4 minutes). The response rate was 71.1% (424 of 596) for tablet versus 16.3% (96 of 588) for mail only. Although the tablet response rate was higher in every subgroup, tablet respondents were more likely to be fathers (20.4% vs 6.4%; P = .006), more likely to have a high school education or less (17.5% vs 8.4%; P = .002), less likely to be white (56.8% vs 71.9%; P = .006), and more likely to be publicly insured (31.4% vs 19.8%; P = .02). Tablet scores were significantly higher than mail only scores for 3 of 17 measures. The response rate for day of discharge tablet survey administration was >4-fold higher than with single-wave mail-only administration, with greater participation of hard-to-reach groups. These findings suggest tablet administration before discharge shows great promise for real-time feedback and QI and may transform the field of inpatient survey administration.