The patient-provider disconnect on eye surgery satisfaction

Researchers found a low correlation between patient satisfaction and provider satisfaction with anesthesia and perioperative comfort for eye surgery, according to a study published in Clinical Ophthalmology.

Boston Medical Center said April 22 that isolating individual measures of patient satisfaction like pain and anxiety in the study did not eliminate the correlation disparity. The study included 283 eye surgery cases, with patients sedated with benzodiazepine before surgery and supplemental anesthesia throughout the procedure as needed. The correlation between patient and provider satisfaction was 0.333 on a scale of zero to one.

Since there is no standard, the type and amount of anesthesia administered depends on the setting, the patient and the provider, BMC said. 

"If provider assessment is not reflective of patient comfort, patients may not be receiving adequate sedation throughout their procedures," BMC ophthalmologist and study author Hyunjoo Lee, MD, PhD, said. 

Limited communication and patients being completely draped make satisfaction difficult to assess intraoperatively, BMC said. There is no evidence showing that measures such as increased heart rate or physical movement accurately predict patient satisfaction.

"This poor correlation may suggest differing expectations pertaining to quality care," Dr. Lee said. "For instance, surgeons may value a quiet patient with minimal eye movement during surgery, whereas a patient may value being pain-free or a complete lack of awareness of the surgery. Alternatively, an overly sedated patient might exhibit excessive eye movement, lowering surgeon satisfaction, or unstable vital signs, lowering anesthesia provider satisfaction. Ultimately, the goal should be to maximize patient satisfaction without compromising patient safety."

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