2011 National Meeting

3026 — Patient Perceptions of Clinic Member Relationships: How Much Do Veterans Know About What Goes On in VA Primary Care Clinics?

Finley EP (VERDICT/STVHCS, University of Texas Health Science Center at San Antonio (UTHSCSA)) , Lanham H (VERDICT/STVHCS, UTHSCSA), Leykum L (VERDICT/STVHCS, UTHSCSA), Arar N (VERDICT/STVHCS, UTHSCSA), Veerapaneni P (UTHSCSA), Parchman ML (VERDICT/STVHCS, UTHSCSA)

Objectives:
As the VHA transitions to a model of Patient Aligned Clinical Teams (PACT), the effort to understand how learning and relationships within clinical microsystems may impact overall patient care and satisfaction has gained new importance. In a survey of Veterans seeking care within the South Texas Veterans Health Care System (STVHCS), we examined patient perceptions of clinic member relationships within VA primary care clinics and compared these with: (a) their experiences of hassles in receiving VA care, and (b) perceptions of learning and relationships by providers and staff in the same clinics.

Methods:
As part of an ongoing study of learning and relationships within VA clinics, 4,198 veterans receiving care at 11 primary care clinics in South Texas responded to a mail survey (64% response rate) about their experiences. Patient perceptions of clinic member relationships and hassles in receiving care were assessed. We also surveyed 245 providers and staff in these clinics regarding their experiences of clinic learning and relationships (99% response rate). We examined total scores for 12-item relationship and 18-item hassles scales in patient survey data, and for 12- and 40-item relationship and learning scales in clinic member survey data, and analyzed associations between scale scores.

Results:
Patient and clinic member perceptions of relationships within the clinics were significantly correlated, with an r2 value of 0.51 between patient and clinic member 12-item relationship scores and of 0.50 between patient relationship scores and clinic member 40-item relationship and learning scores. Patient perceptions of clinic relationships were also strongly associated with experiences of hassles in receiving care, with an r2 of 0.60 between patient relationship and hassles scores.

Implications:
Patient perceptions of clinic member relationships within VA primary care clinics closely match those of clinic members themselves, and are also associated with patient reports of hassles in receiving care.

Impacts:
These findings suggest that Veterans are highly aware of the quality of relationships within VA clinical care teams. Working to improve clinic member relationships may be an important component of improving patient care and satisfaction in the VA.