J Knee Surg 2020; 33(01): 048-052
DOI: 10.1055/s-0038-1676517
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pain Intensity: How Press Ganey Survey Domains Correlate in Total Knee Arthroplasty Patients

Nequesha S. Mohamed
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
,
Chukwuweike U. Gwam
2  Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
,
Jennifer I. Etcheson
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
,
Iciar M. Dávila Castrodad
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
,
Steven L. Gitarts
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
,
Avnish S. Jetty
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
,
Brandon A. Srour
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
,
Ronald E. Delanois
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

13 July 2018

28 October 2018

Publication Date:
28 December 2018 (online)

Abstract

Decreasing postoperative pain for total knee arthroplasty (TKA) patients has been an area of continued effort for healthcare providers. These efforts have been incentivized by legislative reform, which ties reimbursement for hospitals and providers to patient perception of care. Press Ganey (PG) surveys quantify patient satisfaction, and the “pain management” domain is thought to be the best metric for assessing pain intensity. Therefore, these responses are important, as they are used to guide further improvements in healthcare delivery. This study analyzes which PG survey domains are truly associated with pain intensity in the immediate postoperative period following TKA. We queried our PG database for all primary TKA patients between November 2012 and January 2015, yielding a total of 214 patients. Multivariate regression analysis was performed utilizing pain intensity as the dependent variable. Predictor variables included body mass index (BMI), Charlson's comorbidity index, opioid consumption, and PG survey domains. Patient ratings of “communication with doctors” (B = 58.147; p = 0.001), “responsiveness of hospital staff” (B = − 62.663; p = 0.041), “communication about medicines” (B= −45.037; p < 0.001), and “hospital environment” (B = 69.342; p = 0.017) were associated with patient pain intensity. We found survey domains, other than “pain management,” were associated with pain intensity. Efforts to improve outcomes and satisfaction should focus on staff education and communication. The current method for measuring patient satisfaction and reimbursement should be critically assessed and redesigned to better reflect true patient experiences.