Effects of Contact Precautions on Patient Perception of Care and Satisfaction: A Prospective Cohort Study

TLDR

Contact precautions reduce healthcare worker–patient contact and may affect patient satisfaction. The study aimed to assess how contact precautions influence patient satisfaction by interviewing inpatients at admission and on hospital days 3, 7, 14, and after discharge. A prospective cohort of 528 inpatients was followed, with standardized interviews at each time point, a telephone interview and HCAHPS survey after discharge, and responses coded by two physicians. Patients under contact precautions reported significantly more concerns about care—particularly poor coordination and lack of respect—though HCAHPS scores did not differ.

Abstract

Contact precautions decrease healthcare worker-patient contact and may impact patient satisfaction. To determine the association between contact precautions and patient satisfaction, we used a standardized interview for perceived issues with care.Prospective cohort study of inpatients, evaluated at admission and on hospital days 3, 7, and 14 (until discharged). At each point, patients underwent a standardized interview to identify perceived problems with care. After discharge, the standardized interview and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were administered by telephone. Responses were recorded, transcribed, and coded by 2 physician reviewers.A total of 528 medical or surgical patients not admitted to the intensive care unit.A total of 528 patients were included in the primary analysis, of whom 104 (20%) perceived some issue with their care. On multivariable logistic regression, contact precautions were independently associated with a greater number of perceived concerns with care (odds ratio, 2.05 [95% confidence interval, 1.31-3.21]; P < .01), including poor coordination of care (P = .02) and a lack of respect for patient needs and preferences (P = .001). Eighty-eight patients were included in the secondary analysis of HCAHPS. Patients under contact precautions did not have different HCAHPS scores than those not under contact precautions (odds ratio, 1.79 [95% confidence interval, 0.64-5.00]; P = .27).Patients under contact precautions were more likely to perceive problems with their care, especially poor coordination of care and a lack of respect for patient preferences.