The value of open-ended questions in surveys on patient experience: number of comments and perceived usefulness from a hospital perspective.

OBJECTIVE To analyse the patients' inclination to comment in generic patient surveys, and to evaluate how these comments were received and used for quality improvement by the hospitals. DESIGN The study is based on quantitative and qualitative data from four rounds of patient satisfaction surveys from 1999 to 2006. The open-ended questions and their applicability were evaluated by hospital and department management teams in a survey and by hospital employees and leaders, in semi-structured interviews. SETTING Eight public hospitals in a Danish county (amt). PARTICIPANTS In this study, the participants were 75 769 patients, 173 department/hospital management teams, and 24 hospital employees and leaders. INTERVENTIONS Questionnaires with open-ended questions to patients and hospital/department management teams. Semi-structured interviews with hospital employees and leaders. Main outcome measure The number of comments from patients and the usefulness of the comments as perceived by employees and leaders. RESULTS A total of 76% of the patients chose to add one or more comments to their questionnaires. The patients' inclination to comment increased over time. The patient's inclination to comment was highest for the most and the least satisfied patients. The comment-gathering was viewed as 'Very useful' or 'Useful' by 80.7% of the department management teams (31 responses). CONCLUSION To gather comments and to forward these to small organizational entities seems to make patient satisfaction measurements more informative and patient-centred. The wording of the open-ended questions, the number of questions and an appeal in the cover letter appear to be important in relation to the patient's inclination to comment.

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